gms | German Medical Science

Objectives/Interrogation: Hidradenitis suppurativa is a chronic, recurrent inflammatory condition of the apocrine sweat glands. It usually involves axilla and females are more prone to developed infection. Initially though it is confined to apocrine sweat glands but later through recurrent infections it involves other glands and subcutaneous tissue leading to extensive tissue destruction and fibrosis. This chronic debilitating disease had widespread functional and psychologoical implications. Patients face difficulty in maintaining personal hygiene; more prone to recurrent infection and also had a poor quality of life. There are different modalities of treatment ranging from conservative treatment to surgical excision and coverage of the defect by primary closure, skin graft and flap coverage. Axillary flap is a suitable option for coverage of the defects as it provides a reliable, effective and simple method of treatment.

Methods: A prospective, observational study was design to conduct in Burn & Plastic Surgery Unit, Dhaka Medical College Hospital over a period of 3 years from January, 2016 to till date. 15 axillary flaps were done for reconstruction of axillary defect after wide local excision of all hair bearing skin and subcutaneous tissue in 10 patients with hidradenitis suppurativa. Excised tissue was sent for histopathology in all cases. The patients were observed for one year postoperatively for functional and aesthetic result and for any complications or recurrence.

Results and Conclusions: All fifteen flaps were survived with excellent outcome. One patient developed recurrent lesion. Donor site was closed primarily in all cases. All operations were done under general anaesthesia. Histopathology report reveals granulomatous inflammation suggesting tuberculosis in 3 patients which was treated by anti tubercular hemotherapy. Mean hospital stay was 14 days. All are female with age range from 20 to 35 years. About 50% patients had bilateral lesion. On functional evaluation full range of movement of shoulder joint was preserved.

Axillary flap is a functionally useful and aesthetically acceptable option for reconstruction of the axillary hidradenitis suppurativa.