Alharbi M, Perignon D, Assaf N, Qassemyar Q, Elsamad Y, Sinna R
Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
Infectious disease department hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
Ann Chir Plast Esthet. 2014 Feb;59(1):29-34. doi: 10.1016/j.anplas.2013.10.005. Epub 2013 Nov 28.
Axillary hidradenitis suppurativa is a chronic and debilitating disease that primarily affects the axillae, perineum, and inframammary areas. Surgical removal of all the diseased skin constitutes the only efficient treatment. Covering an axillary fossa defect is challenging, due to the range of shoulder movement required. Indeed, shoulder movement may be compromised by scar contraction after inadequate surgery. The present study is the first to apply an inner arm perforator flap to the treatment of twelve axillary skin defects in 10 patients. The defect originated from extensive excision of recurrent hidradenitis suppurativa in the axilla. The technique used to cover the defect is a V-Y advancement flap or a propeller flap from the inner arm based on one to three perforators arising from the brachial artery or the superior ulnar collateral artery. The flap provides a tensionless wound closure and a generally unremarkable postoperative course in a short hospital stay. No major complications occurred. Two patients had minor delayed wound healing. Outcomes (including donor site morbidity, function and the cosmetic outcome) were very satisfactory in all cases. We consider that the inner arm perforator flap is a valuable new option for the reconstruction of axillary defects.
化脓性汗腺炎是一种慢性致残性疾病，主要累及腋窝、会阴和乳房下区域。手术切除所有病变皮肤是唯一有效的治疗方法。由于需要一定范围的肩部活动，覆盖腋窝缺损具有挑战性。事实上，手术不充分后瘢痕挛缩可能会影响肩部活动。本研究首次应用上臂穿支皮瓣治疗10例患者的12处腋窝皮肤缺损。缺损源于腋窝复发性化脓性汗腺炎的广泛切除。用于覆盖缺损的技术是基于肱动脉或尺侧上副动脉发出的一至三支穿支的V-Y推进皮瓣或上臂推进皮瓣。该皮瓣可实现无张力伤口闭合，术后病程通常平稳，住院时间短。未发生重大并发症。两名患者伤口愈合稍有延迟。所有病例的结果（包括供区并发症、功能和美容效果）都非常令人满意。我们认为上臂穿支皮瓣是重建腋窝缺损的一种有价值的新选择。
