Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study
Introduction: Hidradenitis Suppurativa (HS) is a chronic socially debilitating disorder of unknown aetiology. Surgical treatments include simple incision and drainage; excision followed by healing by secondary intention or split-skin grafting and the more recent method of excision followed by local...
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JCDR Research and Publications Private Limited
2022-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/16946/57006_CE(AD)_F[SH]_PF1(SC_KM)_PN(KM).pdf |
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| author | KK Malar Jayakrishnan Kolady Anjali Ravikumar Dakshin Sitaram Padmanabhan |
| author_facet | KK Malar Jayakrishnan Kolady Anjali Ravikumar Dakshin Sitaram Padmanabhan |
| author_sort | KK Malar |
| collection | DOAJ |
| description | Introduction: Hidradenitis Suppurativa (HS) is a chronic socially debilitating disorder of unknown aetiology. Surgical treatments include simple incision and drainage; excision followed by healing by secondary intention or split-skin grafting and the more recent method of excision followed by local flap reconstructions. In this study, the use of a lateral thoracic fasciocutaneous island flap based on vessels arising from the thoracodorsal or thoracic lateral vessels is described.
Aim: To describe the benefit and outcomes of lateral thoracic flap reconstruction technique in treatment of axillary HS.
Materials and Methods: This prospective interventional study was conducted at the Plastic Surgery Department at Amala Institute of Medical Sciences, Thrissur, Kerala, India (tertiary care center), from January 2017 to June 2018. The study included 36 patients with chronic axillary hidradenitis, who underwent lateral thoracic flap surgery on one or both axillae. These patients were studied closely preoperatively during surgery and during postoperative follow-up period. The basic demographic details, clinical parameters and Hurley stage; along with postoperative outcomes were recorded. Data was summarised using descriptive statistics.
Results: The study sample consisted of 36 patients with a mean age of 38.33±13.11 years. There were 20 females and 16 males. Total 11 patients were having co-morbidities in the form of type 2 diabetes mellitus or hypertension. The mean duration of illness was 3.17±1.44 years. Six patients had bilateral axilla involvement and underwent bilateral axillary reconstructions. Out of these 36 patients; 30 patients only had antibiotic treatment previously and five patients underwent excision of affected axillary skin previously without flaps; one patient was treatment naïve. Total 24 patients were Hurley stage 2 and 12 were stage 3. These patients were taken up for repair with a lateral thoracic flap. The mean postoperative hospitalisation was six days. There was no impairment of shoulder movement in the early or late postoperative period. There were no surgical complications in terms of vessel damage or flap viability. All flaps healed without complications and there was no recurrence of disease or scar contracture during the follow-up period.
Conclusion: Lateral thoracic flap reconstruction for axillary HS is without doubt the strategy for treating axillary HS due to its lower recurrence rates. |
| first_indexed | 2024-04-10T08:46:18Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T08:46:18Z |
| publishDate | 2022-09-01 |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-dc53e2c802524614995a7dc79d2afe912023-02-22T08:53:04ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-09-01169PC06PC0910.7860/JCDR/2022/57006.16946Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional StudyKK Malar0Jayakrishnan Kolady1Anjali Ravikumar2Dakshin Sitaram Padmanabhan3Professor, Department of General Surgery, Amala Institute of Medical Sciences, Thrissur, Kerala, India.Professor, Department of Plastic Surgery, Amala Institute of Medical Sciences, Thrissur, Kerala, India.Assistant Professor, Department of General Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India.Intern, Department of Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India.Introduction: Hidradenitis Suppurativa (HS) is a chronic socially debilitating disorder of unknown aetiology. Surgical treatments include simple incision and drainage; excision followed by healing by secondary intention or split-skin grafting and the more recent method of excision followed by local flap reconstructions. In this study, the use of a lateral thoracic fasciocutaneous island flap based on vessels arising from the thoracodorsal or thoracic lateral vessels is described. Aim: To describe the benefit and outcomes of lateral thoracic flap reconstruction technique in treatment of axillary HS. Materials and Methods: This prospective interventional study was conducted at the Plastic Surgery Department at Amala Institute of Medical Sciences, Thrissur, Kerala, India (tertiary care center), from January 2017 to June 2018. The study included 36 patients with chronic axillary hidradenitis, who underwent lateral thoracic flap surgery on one or both axillae. These patients were studied closely preoperatively during surgery and during postoperative follow-up period. The basic demographic details, clinical parameters and Hurley stage; along with postoperative outcomes were recorded. Data was summarised using descriptive statistics. Results: The study sample consisted of 36 patients with a mean age of 38.33±13.11 years. There were 20 females and 16 males. Total 11 patients were having co-morbidities in the form of type 2 diabetes mellitus or hypertension. The mean duration of illness was 3.17±1.44 years. Six patients had bilateral axilla involvement and underwent bilateral axillary reconstructions. Out of these 36 patients; 30 patients only had antibiotic treatment previously and five patients underwent excision of affected axillary skin previously without flaps; one patient was treatment naïve. Total 24 patients were Hurley stage 2 and 12 were stage 3. These patients were taken up for repair with a lateral thoracic flap. The mean postoperative hospitalisation was six days. There was no impairment of shoulder movement in the early or late postoperative period. There were no surgical complications in terms of vessel damage or flap viability. All flaps healed without complications and there was no recurrence of disease or scar contracture during the follow-up period. Conclusion: Lateral thoracic flap reconstruction for axillary HS is without doubt the strategy for treating axillary HS due to its lower recurrence rates.https://jcdr.net/articles/PDF/16946/57006_CE(AD)_F[SH]_PF1(SC_KM)_PN(KM).pdfaxillabenefitslateral thoracic flapreconstructionsurgical outcomes |
| spellingShingle | KK Malar Jayakrishnan Kolady Anjali Ravikumar Dakshin Sitaram Padmanabhan Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study Journal of Clinical and Diagnostic Research axilla benefits lateral thoracic flap reconstruction surgical outcomes |
| title | Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study |
| title_full | Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study |
| title_fullStr | Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study |
| title_full_unstemmed | Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study |
| title_short | Lateral Thoracic Flap in Axillary Hidradenitis Suppurativa- A Prospective Interventional Study |
| title_sort | lateral thoracic flap in axillary hidradenitis suppurativa a prospective interventional study |
| topic | axilla benefits lateral thoracic flap reconstruction surgical outcomes |
| url | https://jcdr.net/articles/PDF/16946/57006_CE(AD)_F[SH]_PF1(SC_KM)_PN(KM).pdf |
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