Evaluation of the mobility of the shoulder and quality of life after perforator flaps for recalcitrant axillary hidradenitis

Nail-Barthelemy, R.; Stroumza, N.; Qassemyar, Q.; Delage, M.; Nassif, Aude; Atlan, Michaël

doi:10.1016/j.anplas.2018.01.003

Cited by 16 publications

(21 citation statements)

References 38 publications

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“…In addition to the low complication rate and low shoulder morbidity, the rotation advancement technique yielded a shorter mean operative time (46 ± 16 minutes) compared with that of other studies (76‐210 minutes), therefore reducing the overall time under general anaesthesia . Moreover, this technique allows for single‐staged rotation advancement flap closure, which results in fewer total operations.…”

Section: Discussionmentioning

confidence: 89%

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Ngaage

et al. 2020

International Wound Journal

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Wide local excision offers a potential cure for severe axillary hidradenitis suppurativa. However, the gold standard for reconstruction has yet to be defined. Here, we describe our rotation advancement flap technique, which allows for one‐stage closure of large axillary defects, with minimal functional morbidity to the axilla. We performed a retrospective review of all patients who underwent one‐stage surgical management for axillary hidradenitis suppurativa at a single‐centre tertiary care hospital from 2009 to 2018. We identified 34 patients, with a total of 53 operative sites. The majority were female (85%) with a mean age of 31 years and body mass index 35 kg/m2. The median defect size was 84 cm2 and the majority were treated using the rotation advancement flap technique (86%). A quarter of operative sites experienced minor complications with only one requiring re‐operation. At a median follow‐up of 32 months, two (4%) sites showed decreased range of motion. However, all patients had achieved remission without any further recurrence of disease. We describe a one‐stage rotation advancement flap technique for management of moderate to severe hidradenitis suppurativa that achieves a high local cure rate, minimal functional morbidity, and acceptable wound complication rates.

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Section: Discussionmentioning

confidence: 89%

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Ngaage

et al. 2020

International Wound Journal

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“…We identified seven clinical trials of infliximab, 23-29 six of adalimumab, [30][31][32][33][34][35] three of etanercept 22,36,37 and two of ustekinumab. 38,39 There were five publications on surgical treatment, [40][41][42][43][44] one study on combination of surgical treatment with photodynamic therapy 45 and two other studies on photodynamic therapy. 46,47 There were three studies on antibiotics, [48][49][50] single studies on metformin, 51 PUVA, 52 hyperbaric oxygen therapy, 53 alitretinoin, 54 acitretin, 55 ankinra, 56 apremilast, 57 oral zinc gluconate combined with topical triclosan 58 and verapamil.…”

Section: Clinical Trials In Hsmentioning

confidence: 99%

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Chernyshov

Zouboulis

Tómas-Aragonés

et al. 2019

Acad Dermatol Venereol

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This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient‐Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS‐specific health‐related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high‐quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double‐blind randomized placebo‐controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well‐designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long‐term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS‐specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology‐specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS‐specific, dermatology‐specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient‐Oriented Outcomes.

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“…Several methods can be available for reconstruction, from secondary healing, to vacuum assisted closure (VAC), to skin grafts and various type of flaps [1][2][3][6][7][8]. The best outcomes are obtained with perforator flaps that avoid scar contracture and functional impairment often related with the use of secondary healing techniques or skin grafting [19,20]. For this reason we do not use any VAC or secondary healing before reconstruction in an attempt at decreasing bacterial contamination.…”

Section: Discussionmentioning

confidence: 99%

“…Based on our experience and on the current literature [1][2][3][4][5][6][7][8][19][20][21], our algorithm for reconstruction of axillary defects following hydradenitis suppurativa treatment is: ▪ Unilateral cases:…”

Section: Discussionmentioning

confidence: 99%

The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa

D’Arpa

Pignatti

Vieni

et al. 2019

Handchir Mikrochir plast Chir

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Zusammenfassung Einführung Die Rekonstruktion der Axilla nach Resektion bei fortgeschrittener Hidradenitis suppurativa (Akne inversa) erfolgt in unserer Erfahrung mit gestielten Perforans-Lappenplastiken, die eine funktionelle Rekonstruktion und einen Funktionserhalt der Schulter erlauben. Die Verfügbarkeit der Haut ist um die Axilla durch die Notwendigkeit eines primären Verschlusses der Entnahmestelle begrenzt. In dieser Arbeit werden die Anwendung und die Ergebnisse von bilateralen freien DIEP-Lappenplastiken bei Patienten mit bilateraler und großflächiger Resektion vorgestellt. Patienten und Methoden Von Oktober 2008 bis Oktober 2018 wurden 39 Patienten mit Hidradenitis suppurativa chirurgisch behandelt. Bei 11 dieser Patienten erfolgte eine bilaterale Rekonstruktion mit bilateraler DIEP-Lappenplastik (22 Lappenplastiken). Bei einem Patienten wurde eine unilaterale Rekonstruktion mithilfe einer doppelt gestielten DIEP-Lappenplastik durchgeführt. Insgesamt wurden 23 Lappenpkastiken verwendet. Zwölf Lappenplastiken wurden über der Scarpa-Faszie gehoben, 6 Lappenplastiken wurden nach der Dissektion ausgedünnt. Drei Lappenplastiken wurden in der ersten Phase nicht ausgedünnt. Die durchschnittliche Lappengröße betrug bei den bilateralen Lappenplastiken 14 × 17 cm und beim doppelt gestielten Lappenplastiken 15 × 32 cm. Ergebnisse Die mittlere Nachbeobachtungszeit lag bei 64 Monaten. Die durchschnittliche Operationsdauer lag bei 324 Minuten. Es wurden keine Lappennekrosen festgestellt. In zwei Fällen kam es zu einer axillären, in einem Fall zu einer abdominalen Wunddehiszenz. Diese wurden alle konservativ behandelt. Bei einem Patienten wurde an beiden Operationsstellen ein Pyoderma gangraenosum beobachtet, das nach Kortisontherapie abheilte. Bei den Lappenplastiken, die während des primären Eingriffs ausgedünnt wurden, war keine Revision erforderlich. Die drei Patienten mit den nicht ausgedünnten Lappen benötigten nach drei Monaten eine Liposuktion zur Ausdünnung. In einem Fall kam es zu einem Krankheitsrezidiv. Dieses war unilateral und wurde chirurgisch behandelt. Schlussfolgerungen Die Rekonstruktion der Axilla mit DIEP-Lappenplastiken ermöglicht die Rekonstruktion großer und bilateraler Defekte in einem einzigen Eingriff mit primärem Verschluss der Entnahmestelle. Wenn die Lappenplastik während der Operation ausgedünnt wird, scheint postoperativ keine weitere Ausdünnung erforderlich zu sein. Ansonsten sollte der Lappen drei Monate nach dem Ersteingriff durch Liposuktion ausgedünnt werden.

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Evaluation of the mobility of the shoulder and quality of life after perforator flaps for recalcitrant axillary hidradenitis

Cited by 16 publications

References 38 publications

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa

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Evaluation of the mobility of the shoulder and quality of life after perforator flaps for recalcitrant axillary hidradenitis

Cited by 16 publications

References 38 publications

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Reconstruction for axillary hidradenitis suppurativa using one‐stage local tissue rearrangement: A retrospective analysis of 53 cases

Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

﻿The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa

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The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa