São Paulo, Brazil From the Division of Plastic Surgery, Faculty of Medicine, University of São Paulo.
Plast Reconstr Surg. 2011 Oct;128(4):949-953. doi: 10.1097/PRS.0b013e3182268c38.
Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesions of axillary hidradenitis suppurativa by using the thoracodorsal artery perforator flap while focusing on the preservation of arm abduction. We enrolled 12 patients with severe axillary hidradenitis suppurativa who underwent bilateral surgical treatment of their lesions by radical excision, followed by immediate reconstruction with the thoracodorsal artery perforator flap. The amplitude of arm abduction was measured preoperatively and 6 months postoperatively by goniometry, and statistical analysis was performed using Student's t test. Preoperative and 6-month postoperative mean amplitude of arm abduction were 98.7 degrees and 152.7 degrees, respectively, with a significant mean increase of 54 degrees (p<0.0001). The thoracodorsal artery perforator flap can be used as a good option for axillary reconstruction after radical excision of severe lesions of hidradenitis suppurativa, and its use would allow a significant increase in the amplitude of arm abduction. It has several other advantages when compared with other types of coverage, including its anatomical proximity to the axilla, similar thickness, and high-quality skin.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
化脓性汗腺炎是一种慢性、复发性皮肤炎症性疾病，其特征为脓肿和瘢痕。腋窝是主要受累部位，由于瘢痕收缩，导致手臂活动受限。本前瞻性研究旨在分析采用胸背动脉穿支皮瓣治疗重度腋窝化脓性汗腺炎的手术治疗，重点关注保留手臂外展功能。我们招募了 12 名患有严重腋窝化脓性汗腺炎的患者，对他们的病变进行双侧根治性切除，然后立即用胸背动脉穿支皮瓣进行重建。术前和术后 6 个月通过量角器测量手臂外展的幅度，并通过学生 t 检验进行统计学分析。术前和术后 6 个月手臂外展的平均幅度分别为 98.7 度和 152.7 度，平均增加 54 度（p<0.0001）。胸背动脉穿支皮瓣可作为根治性切除重度化脓性汗腺炎后腋窝重建的良好选择，其使用可显著增加手臂外展的幅度。与其他类型的覆盖物相比，它还有其他几个优点，包括其与腋窝的解剖接近、相似的厚度和高质量的皮肤。
临床问题/证据水平：治疗，V。
