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Modified Posterior Arm Flap for Axillary Hidradenitis Suppurativa
David R Thomson1, Songtum Saltrese2, Syed Mehdi3
1From the Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead.
Annals of Plastic Surgery
|April 9, 2021
Summary
A modified posterior arm flap effectively treats advanced hidradenitis suppurativa (HS) by reconstructing axillary defects. This surgical technique offers excellent aesthetic and functional outcomes with no recurrence of HS symptoms.
Area of Science:
- Plastic Surgery
- Dermatology
- Surgical Reconstruction
Background:
- Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition affecting apocrine glands, with advanced stages requiring surgical excision.
- Axillary defects following HS excision present reconstructive challenges.
Purpose of the Study:
- To evaluate the efficacy of a modified posterior arm flap for reconstructing axillary defects in patients with advanced hidradenitis suppurativa.
- To assess the functional and aesthetic outcomes and recurrence rates of this reconstructive method.
Main Methods:
- A modified posterior arm flap technique was employed for axillary defect reconstruction.
- The flap design utilizes perforating vessels from the axillary artery with a brachioplasty-like incision for donor site concealment.
Main Results:
- Eight modified posterior arm flaps were performed in 6 female patients between 2014 and 2019.
- All patients achieved complete resolution of HS symptoms with no recurrence at a mean follow-up of 15 months.
- High patient satisfaction with both aesthetic and functional results was reported.
Conclusions:
- The modified posterior arm flap is a successful reconstructive option for advanced axillary hidradenitis suppurativa.
- This technique provides favorable functional and aesthetic outcomes and prevents disease recurrence.
