Complete Remission of Hidradenitis Suppurativa Reported After Treatment With Thoracodorsal Artery Perforator Flap

Thoracodorsal artery perforator (TDAP) flap-based reconstruction following wide local excision (WLE) resulted in the complete remission of hidradenitis suppurativa (HS), according to a recent study published in Plastic and Reconstructive Surgery.

Researchers aimed to compare the outcomes of TDAP flap-based reconstruction and secondary intention closure (SIC) following WLE of axillary HS in a prospective study. The inpatient stay, healing time, postoperative complications rate, and pain were analyzed in a group of 33 patients who underwent a WLE procedure left to heal by secondary intention and a group of 35 patients who underwent immediate reconstruction with a homolateral TDAP flap. Preoperative shoulder function and quality of life were compared with postoperative shoulder function.

Patients who underwent the TDAP procedure had a faster recovery, fewer complications, fewer overall procedures, more improvements, and a greater reduction in pain/discomfort with better shoulder function compared with the SIC patients. All patients reported an improved quality of life after their operation.

“WLE and TDAP flap-based reconstruction for axillary stage 3 HS provide optimal post-procedural functional results with a low complication rate,” concluded the study authors. “Despite the relatively slow learning curve of this procedure, we strongly recommend this technique as a very good option for the management of stage 3 axillary HS,” they added.

Reference

La Padula S, Pensato R, Pizza C, et al. The thoracodorsal artery perforator (TDAP) flap for the treatment of hidradenitis suppurativa of the axilla: a prospective comparative study. Plast Reconstr Surg. Published online March 22, 2023. doi:10.1097/PRS.0000000000010435