Chuang Chia Jueng, Lee Chiu Heng, Chen Tim Mo, Wang Hsian Jenn, Chen Shyi Gen
Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Tao-Yuan, Taiwan.
J Formos Med Assoc. 2004 Aug;103(8):644-7.
Axillary hidradenitis suppurativa is a chronic recurrent disorder characterized by abscessing inflammation, fistulating sinus tracts, and scarring. This is not only a medical disease, but also a complicated problem necessitating surgical intervention. While various management strategies have been reported, the results are frequently unsatisfactory. Primary closure of the defect after radical excision is often impossible and results in poor wound healing. Skin graft on the soft tissue defect often results in obvious scar contracture and limitation of movement. Local muscle flap can fill in the defect but the range of adduction of the arm will be limited by its muscle bulk. Free flap transfer is a choice of management but this technique calls for a trained team, laborious execution, expensive instruments and plenty of time. We describe the use of transpositional fasciocutaneous flap, which can provide a reliable flap of variable size of skin and soft tissue coverage with good elastic properties. The technique is easily adapted to the reconstruction of resultant defects. This technique was used to transfer 8 transpositional fasciocutaneous flaps in 7 patients for the closure of axillary defects resulting from radical excision of chronic hidradenitis suppurativa. No flap complication or disease recurrence was observed during 2 years of follow-up. The technique had satisfactory esthetic and functional results as well as low donor site morbidity.
化脓性汗腺炎是一种慢性复发性疾病，其特征为脓肿性炎症、瘘管性窦道和瘢痕形成。这不仅是一种医学疾病，也是一个需要手术干预的复杂问题。虽然已经报道了各种治疗策略，但结果往往不尽人意。根治性切除后对缺损进行一期缝合通常是不可能的，而且会导致伤口愈合不良。对软组织缺损进行植皮往往会导致明显的瘢痕挛缩和活动受限。局部肌皮瓣可以填充缺损，但手臂内收范围会因其肌肉体积而受到限制。游离皮瓣移植是一种治疗选择，但这项技术需要一支训练有素的团队、繁琐的操作、昂贵的器械和大量时间。我们描述了转位筋膜皮瓣的应用，它可以提供大小可变的可靠皮瓣，覆盖皮肤和软组织，具有良好的弹性。该技术很容易适用于修复由此产生的缺损。这项技术被用于为7例患者转移8个转位筋膜皮瓣，以闭合慢性化脓性汗腺炎根治性切除后腋窝缺损。在2年的随访中未观察到皮瓣并发症或疾病复发。该技术具有令人满意的美学和功能效果，供区发病率也较低。
