Summary
The extent of axillary excision and method of closure in 17 patients (29 axillae) with symptomatic chronic axillary hidradenitis suppurativa was analyzed. Limited excision of only the diseased skin led to recurrence in 2 of 3 patients, and excision of the hair-bearing skin alone, in 2 of 5 patients. There was no recurrence in 11 patients after wide excision. Some patients had more than one procedure. Three of four patients who had skin grafts used for closure, developed axillary contractures. Primary closure was achieved successfully in 7 patients (14 axillae). Flap coverage was used to close 12 axillae in 9 patients (3 patients had both axillae treated). These flaps included Limberg 4; random fasciocutaneous 3; parascapular fasciocutaneous: 5. Our experience suggests that wound closure after wide excision in the axilla is best achieved by means of a flap. While smaller defects can be closed with random fasciocutaneous flaps, wide axillary excision often leads to a large defect. The fasciocutaneous parascapular flap should be considered where a large defect exists.
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Anderson DK, Perry AN (1975) Axillary hidradenitis. Arch Surg 110:69
Conway H, Stork RB, Climo S et al. (1952) The surgical treatment of chronic hidradenitis suppurativa. Surg Gynecol Obstet 95:453
Cormack GC, Lamberty BGH (1983) The anatomical basis of the axillary fasciocutaneous pedicled flap. Br J Plast Surg 36:425
Harrison BJ, Mudge M, Hughes LE (1987) Recurrence after surgical treatment of hidradenitis suppurativa. Br Med J 294:294–487
Harrison SH (1964) Axillary hidradenitis. Br J Plast Surg 17:95
Lister GD, Gibson T (1972) Closure of rhomboid skin defects: the flaps of Limberg and Duformantel. Br J Plast Surg 25:300
Morgan WP, Harding KG, Hughes LE (1983) A comparison of skin grafting and healing by granulation following axillary excision for hidradenitis suppurativa. Ann R Coll Surg 65:235
Mortimer PS, Dawber PR, Moore RA (1986) A double blind controlled cross-over trial of cyproterone acetate in females with hidradenitis suppurativa. Br J Dermatol 115:263
O'Brien J, Wysocke J, Anaston G (1976) Limberg flap coverage for axillary defects resulting from excision of hidradenitis suppurativa. Plast Reconstr Surg 58:354
Paletta C, Jurkiewicz MJ (1987) Hidradenitis suppurativa. Clin Plast Surg 14:383
Paletta FX (1963) Hidradenitis suppurativa: pathologic study and use of skin flap. Plast Reconstr Surg 31:307
Piggott H, Ellis H (1975) Chronic hidradenitis suppurativa: a report of 9 cases. Br J Surg 62:394
Pollock WJ (1972) Axillary hidradenitis suppurativa. Plast Reconstr Surg 49:22
Tasche C, Angelats J, Jayaram B (1975) Surgical treatment of hidradenitis suppurativa of the axilla. Plast Reconstr Surg 55:559
Tolhurst DE, Haeseker B (1982) Fasciocutaneous flaps in the axillary region. Br J Plast Surg 35:430
Watson JD (1985) Hidradenitis suppurativa — a clinical review. Br J Plast Surg 38:567
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Hudson, D.A., Krige, J.E.J. Axillary hidradenitis suppurativa: wide excision and flap coverage is best. Eur J Plast Surg 16, 94–97 (1993). https://doi.org/10.1007/BF00196440
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DOI: https://doi.org/10.1007/BF00196440