Surgical treatment of severe hidradenitis suppurativa of the axilla: Thoracodorsal artery perforator (TDAP) flap versus split skin graft

Wormald, Justin C.R.; Balzano, Antonella; Clibbon, Jonothan J.; Figus, Andrea

doi:10.1016/j.bjps.2014.04.032

Cited by 67 publications

(75 citation statements)

References 29 publications

(66 reference statements)

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“…In the literature, a high rate of postoperative morbidity such as secondary scar contractures, shoulder stiffness with objectively reduced range of movement and prolonged recovery time are reported [127]. Many procedures have been used for reconstruction after wide excision.…”

Section: Reconstruction After Radical Wide Excisionmentioning

confidence: 99%

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Scuderi

Monfrecola

Dessy

et al. 2017

Skin Appendage Disord

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%. The central pathogenic event in HS is believed to be the occlusion of the upper part of the folliculopilosebaceous unit, leading to the rupture of the sebofollicular canal with the consequent development of perifollicular lymphohistiocytic inflammation. The HS treatment choices are influenced by disease severity and its individual subjective impact, involving both medical and surgical interventions. However, given the chronic nature of HS, its destructive impact on social, working, and daily life of patients, its management is often frustrating for both the patient and physician. Hence, prompt and effective management strategies are urgently needed and a multidisciplinary approach is advocated. Therefore, in this article, we highlighted the main features of HS (clinical aspects, epidemiology, pathogenesis, diagnostic criteria, classifications, comorbidities, and treatments), so that awareness of this disease might be heightened in primary care physicians and surgeons, who may be the first health care providers to see patients with this disease owing to its characteristic clinical presentation (inflammatory nodules, abscesses, sinus tract, etc.).

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Section: Reconstruction After Radical Wide Excisionmentioning

confidence: 99%

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Scuderi

Monfrecola

Dessy

et al. 2017

Skin Appendage Disord

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“…The secondary intention healing [12] has been the chosen option to close the surgical wound, the wound being left open. Despite a long healing time, this method seems to be satisfactory in wounds up to 20 cm with a high level of acceptance by patients [13] and preferred to others such as skin graft [14] for example in order to minimize the risk of infection occurring when wound is sutured. Although widely used in axillary HS surgical treatments, this secondary intention technique may sometimes induce a contracted scar which disadvantageously causes the arm movements to be reduced.…”

Section: Case Reportmentioning

confidence: 99%

Medical Infrared Thermography assistance in the surgical treatment of axillary Hidradenitis Suppurativa: A case report

Polidori

Renard

Lorimier

et al. 2017

International Journal of Surgery Case Reports

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HighlightsWe used a Medical Infrared Thermography tool to assist the surgeon in the surgical treatment of Hidradenitis Suppurativa inflammatory disease.The advantage of the medical infrared thermography is to allow the optimization of the presurgical mapping of lesion with adequate free margins.The advantage of medical infrared thermography is to be used like a control tool after excision surgery if all the affected tissues are removed.This study was therefore conducted as an effort to fill this knowledge gap.We suggest that medical infrared thermography assessment be better performed with more case surgery.

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“…5 No entanto, a excisão cirúrgica das lesões com margens livres adequadas é o tratamento gold--standard para prevenir recorrências. 6 Existem várias opções reconstrutivas, não consensuais, desde o encerramento primário até à cobertura com retalhos locais/livres. O objetivo deste trabalho é descrever o nosso procedimento reconstrutivo em dois passos para o tratamento deste tipo de lesões.…”

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“…Leva à criação de áreas deprimidas com menor flexibilidade, 11 à redução da amplitude de movimentos do ombro, à cicatrização hipertrófica, a uma recuperação mais prolongada e a um aumento do número de procedimentos cirúrgicos. 6 Como alternativa aos enxertos de pele na axila surgiram os retalhos locais (braquial medial, braquial posterior, para-escapular, entre outros). No entanto, estes retalhos não cobrem adequadamente defeitos muito grandes.…”

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Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study

Ribeiro¹,

Guerra²

2018

Acta Med Port

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59 RESUMOA hidrosadenite supurativa é uma doença inflamatória crónica com grande impacto a nível físico e psicológico. Apesar de tratamentos conservadores serem utilizados em casos de doença ligeira, nos casos mais graves preconiza-se a excisão alargada da área afetada e posterior reconstrução. O objetivo deste trabalho é descrever o nosso procedimento reconstrutivo em dois passos para o tratamento deste tipo de lesões. ABSTRACT Hidrosadenitis supurativa is a chronic inflammatory disease with great physical and psychological impact. Although conservative treatments may be effective in mild forms of the disease, extensive surgical resection and reconstruction are necessary in more severe forms of the disease. The purpose of this paper is to describe our two-stage reconstructive procedure regarding this kind of disease.We present a clinical case of a patient with severe, bilateral axillary hidrosadenitis. In the first surgical step we excised the lesions and applied the artificial dermis secured with negative pressure wound therapy. In the second step we used a split thickness skin graft to close the wound and again applied negative pressure wound therapy. The graft take was very good, without complications. The cosmetic outcome is acceptable and shoulder mobility was not compromised. No recurrence was detected (nine months follow up). Keywords: Hidradenitis Suppurativa; Negative-Pressure Wound Therapy; Skin Transplantation INTRODUÇÃOA hidrosadenite supurativa é uma doença inflamatória crónica da pele caracterizada por abcessos recorrentes, trajectos fistulosos e cicatrização anómala.1 A doença afeta a pele que contem glândulas apócrinas, mais frequentemente envolvendo as regiões axilares e a região ano-genital. 2A fisiopatologia da doença ainda não foi completamente esclarecida, mas pensa-se que a oclusão do folículo piloso, seguida de dilatação e subsequente rutura da unidade pilosebácea seja importante.1 Algumas potenciais influências incluem a suscetibilidade genética, o tabagismo e a obesidade, alterações endócrinas e fatores microbiológicos. 3O diagnóstico da doença é clínico e a gravidade é frequentemente classificada de acordo com os estádios de Hurley. 4O tratamento pode ser dividido, genericamente, em médico ou cirúrgico. O tratamento médico inclui terapias tópicas e/ou sistémicas com antibióticos, corticóides e agentes biológicos.5 No entanto, a excisão cirúrgica das lesões com margens livres adequadas é o tratamento gold--standard para prevenir recorrências.6 Existem várias opções reconstrutivas, não consensuais, desde o encerramento primário até à cobertura com retalhos locais/livres. O objetivo deste trabalho é descrever o nosso procedimento reconstrutivo em dois passos para o tratamento deste tipo de lesões. CASO CLÍNICOApresentamos o caso clínico de uma doente do sexo feminino, 21 anos, raça caucasiana, com uma história prévia de cinco anos de sintomatologia compatível com hidrosadenite supurativa (abcessos recorrentes com drenagem). A doente tinha sido seguida em consulta de Dermatologia e realiza...

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Surgical treatment of severe hidradenitis suppurativa of the axilla: Thoracodorsal artery perforator (TDAP) flap versus split skin graft

Abstract: TDAP flap and SSG both improve QOL for patients with severe axillary HS. The TDAP flap showed greater benefits in terms of QOL, recovery, rate of complications and number of overall procedures.

Cited by 67 publications

References 29 publications

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Medical Infrared Thermography assistance in the surgical treatment of axillary Hidradenitis Suppurativa: A case report

Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study

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