Application of the thoracodorsal artery perforator flap in the reconstruction of axillary hidradenitis; our clinical experience

Süleyman Çeçen; Menekşe Kastamoni Başkan; Aysel Pashazade; Abdullah Demirel; Ahmet Can Apaydın; Güzin Yeşim Özgenel; Selçuk Akın

doi:10.19161/etd.1677474

TR EN

Aksillar hidradenitin rekonstrüksiyonunda torakodorsal arter perforatör flep kullanımı; klinik deneyimimiz

Öz

Amaç: Hidradenitis suppurativa (HS), esas olarak apokrin bezlerin bulunduğu bölgeleri etkileyen kronik inflamatuar bir deri hastalığıdır. İlerlemiş vakalarda geniş lokal eksizyon gerekebilir ve bu durumda optimal fonksiyonel ve estetik sonuçlar için flep rekonstrüksiyonu tercih edilmektedir. Bu çalışmada, aksiller HS nedeniyle geniş eksizyon uygulanan hastalarda torakodorsal arter perforatör (TDAP) flebi ile yapılan rekonstrüksiyon sonuçları değerlendirilmiştir. Gereç ve Yöntem: 2018–2023 yılları arasında kliniğimizde aksiller HS tanısıyla cerrahi tedavi uygulanan hastalar retrospektif olarak incelendi. Tıbbi ve lokal tedaviye yanıt vermeyen, primer kapatmaya uygun olmayan ve sadece aksilla bölgesi tutulumuna sahip hastalar çalışmaya dahil edildi. Demografik veriler, flep boyutları, defekt alanı, postoperatif komplikasyonlar ve fonksiyonel sonuçlar analiz edildi. Bulgular: Çalışmaya, yaş ortalaması 32,3 olan toplam 12 erkek hasta dahil edildi. Defekt boyutları 25–170 cm² (ortalama: 64,9 cm²) arasında değişmekteydi. Ortalama takip süresi 330 gündü. Hiçbir hastada tam flep kaybı gözlenmedi. Bir hastada flebin proksimal kenarında marjinal nekroz gelişti ve primer kapama ile başarılı şekilde tedavi edildi. Tüm hastalar cerrahi sonuçlardan memnuniyet bildirdi ve omuz hareket açıklığı korundu. Sonuç: TDAP flebi, özellikle orta ve büyük boyuttaki aksiller HS defektlerinde güvenilir ve fonksiyonel olarak üstün bir rekonstrüksiyon seçeneği sunmaktadır. Tutarlı vasküler anatomisi, minimal donör saha morbiditesi ve omuz fonksiyonunun korunması, bu flebi etkili bir yöntem haline getirmektedir. Bulguların doğrulanması için ileriye dönük karşılaştırmalı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Application of the thoracodorsal artery perforator flap in the reconstruction of axillary hidradenitis; our clinical experience

Abstract

Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition primarily affecting apocrine gland-bearing areas such as the axilla. Advanced stages often necessitate wide local excision, with flap-based reconstruction emerging as a preferred technique for optimal functional and aesthetic outcomes. This study evaluates the clinical outcomes of thoracodorsal artery perforator (TDAP) flap reconstruction following wide excision for axillary HS Materials and Methods: A retrospective review was conducted on patients who underwent surgical treatment for axillary HS between 2018 and 2023 at our institution. Inclusion criteria comprised patients with Hurley stage III HS unresponsive to medical therapy and unsuitable for primary closure. Demographic data, flap dimensions, defect size, postoperative complications, and functional outcomes were analyzed. Results: Twelve male patients (mean age: 32.3 years) were included. Defect sizes ranged from 25 to 170 cm² (mean: 64.9 cm²), with an average follow-up period of 330 days. No complete flap loss occurred. One patient experienced marginal necrosis at the flap edge, managed conservatively. All patients reported high satisfaction, with preserved shoulder mobility and no significant recurrence. Conclusion: The TDAP flap offers a reliable and functionally superior reconstructive option for axillary HS, particularly in moderate-to-large defects. Its favorable vascular anatomy, minimal donor site morbidity, and preservation of shoulder function make it an effective solution. Further comparative studies are warranted to establish long-term outcomes and validate these findings.

Keywords

References

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Details

Primary Language

English

Subjects

Plastic Reconstructive and Aesthetic Surgery

Journal Section

Research Article

Authors

Süleyman Çeçen ^*
0000-0003-2430-727X
Türkiye

Menekşe Kastamoni Başkan
0000-0002-4667-1550
Türkiye

Aysel Pashazade
0000-0001-8185-6553
Türkiye

Abdullah Demirel
0009-0005-7396-7065
Türkiye

Ahmet Can Apaydın
0009-0000-3713-705X
Türkiye

Güzin Yeşim Özgenel
0000-0003-0000-8355
Türkiye

Selçuk Akın
0000-0003-1683-0722
Türkiye

Publication Date

December 8, 2025

Submission Date

April 19, 2025

Acceptance Date

August 23, 2025

Published in Issue

Year 2025 Volume: 64 Number: 4

DOI

https://doi.org/10.19161/etd.1677474

IZ

https://izlik.org/JA39FC97HK

Cite

RIS / Bibtex

Vancouver

1.Süleyman Çeçen, Menekşe Kastamoni Başkan, Aysel Pashazade, Abdullah Demirel, Ahmet Can Apaydın, Güzin Yeşim Özgenel, Selçuk Akın. Application of the thoracodorsal artery perforator flap in the reconstruction of axillary hidradenitis; our clinical experience. EJM. 2025 Dec. 1;64(4):682-7. doi:10.19161/etd.1677474