title: Thoracodorsal artery perforator flaps and muscle-sparing latissimus dorsi myocutaneous flaps for the treatment of axillary hidradenitis.
abstract: OBJECTIVE
  The purpose of this study was to review a single surgeon's experience with using the thoracodorsal artery perforator (TAP) flap for coverage of axillary defects.
  
  
  METHODS
  This is a retrospective review of all flaps performed by the senior author (D.W.L.) after excision of axillary hidradenitis between 2004 and 2010.
  
  
  RESULTS
  Nine TAP flaps were successfully performed, whereas 5 muscle-sparing latissimus dorsi (MSLD) myocutaneous flaps were necessary because of the inability to harvest a perforator flap. Overall, this equates to a 64% success rate in harvesting a perforator flap. The mean sizes of the TAP and MSLD flaps were 75 cm (range, 32-120 cm) and 83 cm (range, 48-160 cm), respectively. There were 2 (14%) flaps with wound complications. One patient had recurrent disease requiring debridement. Another patient who underwent the largest of all flaps (MSLD) had donor site and recipient bed dehiscence requiring debridement and skin grafting. This patient also later required flap debulking and Z-plasty for scar contracture.
  
  
  CONCLUSIONS
  Overall, TAP and MSLD flaps can be performed reliably for coverage of axillary defects after excision of hidradenitis. Although not free of complications, they do offer improved results compared to historic attempts at primary closure or skin grafting.
authors.affiliation: Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA 19104, USA.
authors.forename: Shareef
authors.initials: S
authors.lastname: Jandali
authors.forename: Michael N
authors.initials: MN
authors.lastname: Mirzabeigi
authors.forename: Joshua
authors.initials: J
authors.lastname: Fosnot
authors.forename: David W
authors.initials: DW
authors.lastname: Low
mesh_terms: D000328:Adult; D001365:Axilla / Q000601:surgery*; D005260:Female; D016575:Hidradenitis / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D061525:Perforator Flap / Q000637:transplantation; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000637:transplantation*; D016896:Treatment Outcome