University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj-Napoca, Department of Plastic Surgery, Romania; Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania.
Rehabilitation Clinical Hospital Cluj-Napoca, Department of Plastic Surgery, Romania.
Injury. 2020 Dec;51 Suppl 4:S41-S47. doi: 10.1016/j.injury.2020.03.025. Epub 2020 Mar 9.
Hidradenitis suppurativa is a chronic, relapsing disease of the skin, characterized by apocrine gland and pilosebaceous complex infections, causing recurrent superficial nodules and abscesses, fistula formation, scarring and fibrosis. It is accepted that wide local excision and local coverage is the crucial treatment to prevent recurrence of the disease.
All patients presenting for surgical treatment of hidradenitis suppurativa between 2014 and 2019 were identified from the hospital database. Only patients with hidradenitis suppurativa confined to the axillary, inguinal or sacrococcygeal regions in Hurley grade II and III were included. A total of 21 patients (11 male, 10 female) aged between 21 and 76 years were evaluated retrospectively. All of the 22 defects were reconstructed with keystone perforator island flap following wide local excision. We performed descriptive analysis of demographic data, comorbidities, topographic distribution of lesions, Hurley scoring, size of defect, specific type of reconstruction, complications, follow-up period, recurrences.
21 patients with localized axillary, inguinal or sacrococcygeal hidradenitis suppurativa were identified, and 22 keystone perforator island flaps were performed. All keystone perforator island flaps survived giving a durable cover to the affected regions. There were no complications. Functional and aesthetic results were satisfactory and there were no recurrences.
These findings confirm that the keystone perforator island flap procedure can be effective for immediate defect reconstruction after wide local excision of advanced hidradenitis suppurativa of the axillary, inguinal and sacrococcygeal regions and provides excellent aesthetic results.
化脓性汗腺炎是一种慢性、复发性皮肤病，其特征为大汗腺和毛囊皮脂腺复合体感染，导致反复发作的浅表性结节和脓肿、瘘管形成、瘢痕和纤维化。广泛局部切除和局部覆盖被认为是预防疾病复发的关键治疗方法。
从医院数据库中确定了 2014 年至 2019 年间所有接受化脓性汗腺炎手术治疗的患者。仅纳入 Hurley 分级 II 和 III 级局限于腋窝、腹股沟或骶尾部的化脓性汗腺炎患者。共评估了 21 例（11 例男性，10 例女性）年龄在 21 至 76 岁之间的患者。所有 22 个缺损均在广泛局部切除后采用关键孔穿支岛状皮瓣重建。我们对人口统计学数据、合并症、病变的地理分布、Hurley 评分、缺损大小、具体重建类型、并发症、随访期、复发情况进行了描述性分析。
确定了 21 例局限性腋窝、腹股沟或骶尾部化脓性汗腺炎患者，共行 22 例关键孔穿支岛状皮瓣。所有关键孔穿支岛状皮瓣均存活，为受累区域提供了持久的覆盖。无并发症。功能和美学效果均令人满意，无复发。
这些发现证实，对于腋窝、腹股沟和骶尾部严重化脓性汗腺炎广泛局部切除后，关键孔穿支岛状皮瓣术可有效即刻重建缺损，并提供极佳的美学效果。
