Perforator-based fasciocutaneous island flaps for the reconstruction of axillary defects following excision of hidradenitis suppurativa
Perforator-based fasciocutaneous island flaps for the reconstruction of axillary defects following excision of hidradenitis suppurativa
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DOI：
10.1054/bjps.2001.3783
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发表时间：
2002-03-01
期刊：
影响因子：
--
通讯作者：
Niranjan, NS
中科院分区：
文献类型：
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作者：
Geh, JLC;Niranjan, NS
化脓性汗腺炎是一种病因不明的慢性社交衰弱疾病。治疗方法包括单纯切开引流、二期切除愈合、剥离植皮、局部皮瓣重建术。所有这些方法都会留下难看的伤疤。只有对所有有毛的皮肤进行广泛的局部切除，才能显著减少疾病的复发。大多数方法需要反复入院，并在上臂和腋下留下轮廓缺陷。我们描述了一种新的方法，使用双对置V-Y穿支蒂皮瓣在广泛切除腋毛皮肤后重建腋窝轮廓。这种方法可以一次治疗两个腋窝，为治疗化脓性腋汗炎提供了一种新的选择。本文描述了四名患者：三名患者接受了双侧切除和重建，第四名患者接受了单侧手术。所有患者均接受一次手术，无一例皮瓣丢失。已知的重建手术的结果远远不能令人满意：皮肤移植会留下草皮畸形，当使用局部皮瓣时，如臂后或胸背皮瓣，它会在腋下留下一个大而大的皮瓣。在我们的技术中，皮瓣保持腋窝的菱形形状。(C)2002年英国整形外科医生协会。
Hidradenitis suppurativa is a chronic socially debilitating disorder of unknown aetiology. Treatments include simple incision and drainage, excision and healing by secondary intention, spilt-skin grafting, and local-flap reconstructions. All of these methods can leave unsightly scars. Recurrence of the disease can be significantly reduced only by wide local excision of all the hair-bearing skin. Most methods involve repeated hospital admission, and leave contour defects in the upper arm and axilla. We describe a new method using double opposing V-Y perforator-based flaps to recreate the axillary contour after wide excision of the hair-bearing skin of the axilla. This method allows both axillae to be treated in a single stage, and represents a new alternative in the treatment of axillary hidradenitis suppurativa. Four patients are described: three underwent bilateral excision and reconstruction, while the fourth had a unilateral procedure. All patients had a single surgical procedure with no flap loss. The result following known reconstructive procedures is far from satisfactory: skin grafting leaves a divot deformity, and when a local flap, such as the posterior arm or thoracodorsal flap, is used it leaves a large bulky flap in the axilla. In our technique the flaps maintain the diamond shape of the axilla. (C) 2002 The British Association of Plastic Surgeons.