Surgical treatment of axillary hidradenitis suppurativa

Abstract

Hidradenitis suppurativa is a chronic inflammatory disease of the cutis with furuncles, fistulas and abscesses, mostly located in the groin and axillary regions. A conservative treatment can not prevent a recurrence. We report on 16 patients with axillary hidradenitis suppurativa. The inflammatory region was excised, followed by immediate coverage with a transposition flap according to Limberg. Postoperatively, all patients received antibiotic treatment. After 2 weeks, physiotherapy was begun. All wounds healed primarily. Functional and aesthetic results were very satisfactory. Movement of the shoulder showed no restrictions. There was no major complication. The recurrence rate was low. Only radical debridement prevents a recurrence. The therapy of choice is radical excision of the affected region and immediate coverage by a transposition flap. Open granulation or split-skin grafting are inferior compared with a primary closure by transposition flap. Using the Limberg flap the donor site can be closed primarily.