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Surgical treatment of hidradenitis suppurativa with anterior and posterior lateral thoracic fasciocutaneous flaps

ABSTRACT

Introduction:

Hidradenitis suppurativa (HS) is a chronic, multifactorial, and often recurrent bacterial infection, affecting the skin and subcutaneous tissues. However, complete HS resolution can be achieved through surgical treatment. A series of patients with HS complications is described herein, along with their evolution and complications after complete axillary surgical resection and lateral thoracic fasciocutaneous flap rotation. The evaluation of associated affected areas is also reported.

Methods:

Between 2009 and 2014, 6 patients with an average age of 25.5 years (range: 15 to 35 years) underwent surgery for the treatment of HS. All patients had long-standing, chronic axillary lesions that were refractory to non-surgical treatment.

Results:

Six patients with HS (2 males and 4 females) underwent surgery. The average follow-up period was 16 months (range: 4 months to 5 years). Complete resolution was achieved and no HS recurrence was observed. Bilateral resection was performed in 4 cases, and unilateral resection in 2. Five patients also had inguinal involvement, and 3 had surgery concurrent with the axilla. Five patients had partial dehiscence and serosanguinous discharge, followed by complete scar formation by second intention healing.

Conclusion:

Surgery is often the most appropriate and definitive treatment for HS. The lateral thoracic fasciocutaneous flap technique is associated with high success rates in this patient population.

Keywords:
Hidradenitis suppurativa; Surgical flaps; Reconstructive surgical procedures.

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