Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis
Introduction: Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new t...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5813 |
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| author | Camille Vaillant Yanis Berkane Elise Lupon Michael Atlan Pascal Rousseau Alexandre G. Lellouch Jérôme Duisit Nicolas Bertheuil |
| author_facet | Camille Vaillant Yanis Berkane Elise Lupon Michael Atlan Pascal Rousseau Alexandre G. Lellouch Jérôme Duisit Nicolas Bertheuil |
| author_sort | Camille Vaillant |
| collection | DOAJ |
| description | Introduction: Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new therapeutic alternative by ensuring reconstructions of large defects, reducing donor site morbidity, and enhancing functional recovery. The aim of this study was to achieve a systematic review of perforator flaps use in HS. Patients and Methods: PubMed and Cochrane databases were searched from 1989 to 2021. The PRISMA statement was used in the study selection process and the review was registered on PROSPERO. Furthermore, patient characteristics, operative technique, complications, and recurrences were searched. Results: Thirty-six articles were selected including 286 patients and 387 flaps. Axillary localization was mostly represented (83.2%). Direct donor site closure was achieved in 99.1% of cases. In total, 15.1% of the flaps presented at least one of the following complications: wound dehiscence (5.5%), partial necrosis (2.9%), hematoma or seroma (2.1%), infection (2.1%), venous congestion (1.8%), and nerve injury (0.3%). Two cases of total necrosis were recorded. Recurrence of the disease was observed in 2.7% of the defects. Conclusions: Pedicled perforator flaps are a reliable and reproducible technique in the reconstruction of HS defects. They are associated with a low recurrence rate while ensuring an effective reconstruction with reduced morbidity and faster recovery compared to the techniques classically used in this indication. |
| first_indexed | 2024-03-09T21:33:11Z |
| format | Article |
| id | doaj.art-3dc090edd205470f857fb493de9a22fc |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:33:11Z |
| publishDate | 2022-09-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3dc090edd205470f857fb493de9a22fc2023-11-23T20:49:13ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119581310.3390/jcm11195813Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-AnalysisCamille Vaillant0Yanis Berkane1Elise Lupon2Michael Atlan3Pascal Rousseau4Alexandre G. Lellouch5Jérôme Duisit6Nicolas Bertheuil7Department of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, FranceDepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, FranceDepartment of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital, CHU Toulouse, 31013 Toulouse, FranceDepartment of Plastic, Reconstructive and Aesthetic Surgery, Tenon Hospital, AP-HP, 75020 Paris, FranceDepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU Angers, 49933 Angers, FranceVascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital and Shriners Children’s Boston, Harvard Medical School, Boston, MA 02115, USADepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, FranceDepartment of Plastic, Reconstructive and Aesthetic Surgery, CHU Rennes, University of Rennes 1, 35000 Rennes, FranceIntroduction: Hidradenitis suppurativa (HS) is a common and debilitating disease, in which the only effective treatment involves a wide excision of the affected skin. Secondary wound healing and skin grafting are two well-known options for managing these defects, but perforator flaps provide a new therapeutic alternative by ensuring reconstructions of large defects, reducing donor site morbidity, and enhancing functional recovery. The aim of this study was to achieve a systematic review of perforator flaps use in HS. Patients and Methods: PubMed and Cochrane databases were searched from 1989 to 2021. The PRISMA statement was used in the study selection process and the review was registered on PROSPERO. Furthermore, patient characteristics, operative technique, complications, and recurrences were searched. Results: Thirty-six articles were selected including 286 patients and 387 flaps. Axillary localization was mostly represented (83.2%). Direct donor site closure was achieved in 99.1% of cases. In total, 15.1% of the flaps presented at least one of the following complications: wound dehiscence (5.5%), partial necrosis (2.9%), hematoma or seroma (2.1%), infection (2.1%), venous congestion (1.8%), and nerve injury (0.3%). Two cases of total necrosis were recorded. Recurrence of the disease was observed in 2.7% of the defects. Conclusions: Pedicled perforator flaps are a reliable and reproducible technique in the reconstruction of HS defects. They are associated with a low recurrence rate while ensuring an effective reconstruction with reduced morbidity and faster recovery compared to the techniques classically used in this indication.https://www.mdpi.com/2077-0383/11/19/5813hidradenitis suppurativaverneuil diseaseperforator flapcomplicationsrecurrencepropeller flap |
| spellingShingle | Camille Vaillant Yanis Berkane Elise Lupon Michael Atlan Pascal Rousseau Alexandre G. Lellouch Jérôme Duisit Nicolas Bertheuil Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis Journal of Clinical Medicine hidradenitis suppurativa verneuil disease perforator flap complications recurrence propeller flap |
| title | Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis |
| title_full | Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis |
| title_fullStr | Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis |
| title_full_unstemmed | Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis |
| title_short | Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis |
| title_sort | outcomes and reliability of perforator flaps in the reconstruction of hidradenitis suppurativa defects a systemic review and meta analysis |
| topic | hidradenitis suppurativa verneuil disease perforator flap complications recurrence propeller flap |
| url | https://www.mdpi.com/2077-0383/11/19/5813 |
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