Abstract
Axillary hidradenitis suppurativa cannot be cured by conservative therapy or by incision and drainage. Total resection of the lesion, including the hair-bearing area of axilla, is required for its radical treatment. The extensive skin defect, created by resection of the lesion, needs to be dealt with by functional reconstruction, taking into account that this area is involved in shoulder movement. Three cases of axillary hidradenitis suppurativa were recently treated using a two-stage operation, i.e., total resection of the hair-bearing area of axilla and covering of the skin defect with artificial skin at the first stage followed by 10/1,000 in. split-thickness skin grafting at the second stage. The artificial skin, which was used is Terudermis (Terumo Corporation, Tokyo, Japan), is a bovine dermal substitute with a silicon sheath. After surgery, there was no scar contraction of the skin-grafted area. The reconstructed axilla retained an appropriate contour and was aesthetically satisfactory. Closure of the defect could be done safely in an infection free state.
References
Hatoko M, Kuwahara M, Tanaka A et al (2000) Application of artificial dermis graft to correct a depression after tissue resection. Ann Plast Surg 45:633–640
Velpaux A (1839) Dictionaire de medicine, in repertorie general des sciences medicales sous la rapport theorique et pratique, vol 2, 2nd edn. Becht Jeune, Paris, p 91
Hudson DA, Krige EJ (1993) Axillary hidradenitis suppurativa wide excision and flap coverage is best. Eur J Plast Surg 16:94–97
Finley EH, Ratz JL (1996) Treatment of hidradenitis suppurativa with carbon dioxide laser excision and second-intention healing. J Am Acad Dermatol 34:465–469
Harrison BJ, Read GF, Hughes LE (1988) Endocrine basis for the clinical presentation of hidradenitis suppurativa. Br J Surg 75:972–975
Williams ST, Busby RC, DeMuth RJ et al (1991) Perineal hidradenitis suppurativa: presentation of two unusual complications and a review. Ann Plast Surg 26:456–462
Silverberg B, Smoot CE, Landa SJ et al (1987) Hidradenitis suppurativa: patient satisfaction with wound healing by secondary intention. Plast Reconstr Surg 79:555–559
Grosser A (1982) Surgical treatment of chronic axillary and genitocrural acne conglobata by split-thickness skin grafting. J Dermatol Surg Oncol 8:391–398
Elwood ET, Bolitho DG (2001) Negative-pressure dressings in the treatment of hidradenitis suppurativa. Ann Plast Surg 46:49–51
O’Brien J, Wysocke J, Anaston G (1976) Limberg flap coverage for axillary defects resulting from excision of hidradenitis suppurativa. Plast Reconstr Surg 58:354–358
Amarante J, Reis J, Comba AS et al (1996) A new approach in axillary hidradenitis treatment: the scapular island flap. Aesthetic Plast Surg 20:443–446
Schwabegger AH, Herczeg E, Piza H (2000) The lateral thoracic fasciocutaneous island flap for treatment of recurrent hidradenitis axillaries suppurativa and other axillary skin defects. Br J Plast Surg 53:676–678
Soldin MG, Tulley P, Kaplan H et al (2000) Chronic axillary hidradenitis-the efficacy of wide excision and flap coverage. Br J Plast Surg 53:434–436
Morgan WP, Harding KG, Hughes LE (1983) A comparison of skin grafting and healing by granulation, following axillary excision for hidradenitis suppurativa. Ann R Coll Surg Engl 65:235–236
Yannas IV, Burke JF (1980) Design of an artificial skin: Basic design principles. J Biomed Mater Res 14:65–81
Chou TD, Chen SL, Lee TW et al (2001) Reconstruction of burn scar of the upper extremities with artificial skin. Plast Reconstr Surg 108:378–384
Fujioka M, Fujii T (1997) Maxillary growth following atelocollagen implantation on mucoperiosteal denudation of the palatal process in young rabbits: implications for clinical cleft palate repair. Cleft Palate Cranio J 34:297–308
Nakamura T (1996) A clinical evaluation of “Terudermis”, an artificial skin, for the repair of deep wound and soft tissue defects: result in fifty-five cases. Jpn J Plast Reconstr Surg 39:353–364
Osaki K, Konishi J, Gotto A (1989) A new trilayer artificial skin composed of collagen matrix. Jpn J Artific Org 18:151–154
Soejima K, Nozaki M, Sasaki K et al (1997) Treatment of giant nevus using artificial dermis and a secondary skin graft from the scalp. Ann Plast Reconstr Surg 39:489–494
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Iida, N., Fukushima, K. & Kanzaki, A. A two-stage technique using a bovine dermal substitute to treat axillary hidradenitis. Eur J Plast Surg 28, 359–363 (2005). https://doi.org/10.1007/s00238-005-0784-5
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DOI: https://doi.org/10.1007/s00238-005-0784-5