Reconstruction of axillary defects with propeller parascapular flap after resection in patients with advanced hidradenitis suppurativa

Introduction: Wide excision of affected skin tissue and the apocrine glandular region is the standard treatment for advanced HS. Various flap types have been used for coverage.

Objective: This study was conducted to assess the use and outcomes of propeller parascapular flaps for unilateral or bilateral axillary defects after excision in patients with advanced axillary HS.

Materials and methods: This retrospective case series reports on 11 patients with unilateral (7 patients) or bilateral (4 patients) advanced HS treated with propeller parascapular flap surgery between July 1, 2016, and December 31, 2018. Flap dimensions were measured. Patients were evaluated in terms of 2 main postoperative complications: postoperative recurrence and flap viability. In addition, other complications such as bleeding, infection, dehiscence, contracture, and hypertrophic scarring were noted.

Results: The average flap area was 160 cm2. One flap dehisced; no infection, partial necrosis, or total flap loss occurred, and no recurrence was observed. The mean follow-up period was 18 months. At final follow-up, no patient had contractures that caused restricted movement of the shoulder joint.

Conclusion: Parascapular flaps should be the first choice in patients with advanced HS owing to low donor area morbidity, low recurrence rate, wide rotation arc, and sufficient flap size.