title: Application of the inner arm perforator flap in the management of axillary hidradenitis suppurativa.
abstract: Axillary hidradenitis suppurativa is a chronic and debilitating disease that primarily affects the axillae, perineum, and inframammary areas. Surgical removal of all the diseased skin constitutes the only efficient treatment. Covering an axillary fossa defect is challenging, due to the range of shoulder movement required. Indeed, shoulder movement may be compromised by scar contraction after inadequate surgery. The present study is the first to apply an inner arm perforator flap to the treatment of twelve axillary skin defects in 10 patients. The defect originated from extensive excision of recurrent hidradenitis suppurativa in the axilla. The technique used to cover the defect is a V-Y advancement flap or a propeller flap from the inner arm based on one to three perforators arising from the brachial artery or the superior ulnar collateral artery. The flap provides a tensionless wound closure and a generally unremarkable postoperative course in a short hospital stay. No major complications occurred. Two patients had minor delayed wound healing. Outcomes (including donor site morbidity, function and the cosmetic outcome) were very satisfactory in all cases. We consider that the inner arm perforator flap is a valuable new option for the reconstruction of axillary defects.
authors.affiliation: Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Alharbi
authors.affiliation: Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: D
authors.initials: D
authors.lastname: Perignon
authors.affiliation: Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: N
authors.initials: N
authors.lastname: Assaf
authors.affiliation: Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: Q
authors.initials: Q
authors.lastname: Qassemyar
authors.affiliation: Infectious disease department hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Elsamad
authors.affiliation: Department of plastic reconstructive and aesthetic surgery, hôpital nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France. Electronic address: raphaelsinna@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Sinna
mesh_terms: D000328:Adult; D001132:Arm; D001365:Axilla / Q000601:surgery*; D005260:Female; D017497:Hidradenitis Suppurativa / Q000601:surgery*; D006801:Humans; D008297:Male; D061525:Perforator Flap; D055815:Young Adult
keywords: Axilla; Axillary hidradenitis suppurativa; Creux axillaire; Hydroadénite axillaire; Inner arm flap; Lambeau perforant; Perforator flap; lambeau face médiale de bras