Comparison of Therapeutic Results of Skin Graft with Flap in the Treatment of Axillary Hidradenitis Suppurativa

Afsharfard, A; Khodaparast, MB; Mousavi Moghadam, SF

Comparison of Therapeutic Results of Skin Graft with Flap in the Treatment of Axillary Hidradenitis Suppurativa

Authors

A Afsharfard ¹

MB Khodaparast ²

SF Mousavi Moghadam ³

¹ Professor of General Surgery, Shahid Behshti University of Medical Sciences and Health Services, Shohadaye Tajrish Hospital, Tehran, Iran

² Assistant Professor, Department of Plastic and Aesthetic Surgery, Shahid Beheshti University of Medical Sciences

³ Master of Science in Nursing, Faculty of Nursing, Jahrom University of Medical Sciences, Namazi Hospital, Shiraz

Abstract

Introduction & Objective: Axillary hidradenitis suppurativa is one of the complaints of patients who refer to surgery clinics, which, in addition to problems for patients, also faces challenges regarding appropriate treatment methods. Currently, the treatments include surgical excision and then skin graft or flap for reconstruction. However, the therapeutic results of these two methods, and their benefits and disadvantages have not been fully determined in previous studies and there is no comprehensive consensus. Therefore, this study was conducted with the aim of comparing the skin graft and flap methods for treatments of patients with axillary hidradenitis suppurativa who underwent surgery. Materials & Methods: In this clinical trial study, patients with the complaint of bilateral axillary hidradenitis suppurativa referred to Imam Khomeini Hospital in Tehran between 2009 and 2014 were included. In all patients, standard surgical treatment was performed, then skin reconstruction was conducted on the right axilla with a skin flap, and the left axilla with a graft method. Hence, the patients were followed-up for one, three, six, and twelve months, and the treatment outcomes and the recurrence rate between the graft and skin flap methods were analyzed. Results: In this study, 30 patients including 16 men and 14 women with mean age of 35.2 years (and standard deviation 9.3 years) were included. The statistical analysis showed that in the one-month follow-up, although the pain and limitation of shoulder movement in the skin graft was less compared to the flap, the rate of necrosis was less than 25% in the flap method and the satisfaction with symmetry and beauty in the flap method was reported to be higher than the graft method. However, there was no statistically significant difference between the two methods. Also, after 12 months of patient follow-up, none of them reported evidence of recurrence at the graft or flap site. Conclusions: This study showed that the treatment results and the rate of recurrence among the flap and graft methods in patients with axillary hidradenitis suppurativa did not have a statistically significant difference; therefore, both methods can be safely used in the patients according to their conditions.

Keywords

Hidradenitis Suppurativa

Skin Flap

Skin Graft

Necrosis

Pain

Limitation of Movement

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