Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest.

Background

Surgical excision of axillary hidradenitis suppurativa (HS) often results in challenging defects. While flap techniques offer durable coverage, they are typically invasive. We present a modified method combining peripheral defect reduction with two sliding triangular island flaps from the arm and chest, designed to optimize healing with minimal invasiveness.

Methods

Twelve patients (Hurley II-III) underwent excision and dual V-Y advancement flap reconstruction. Flaps were mobilized without perforator dissection. Outcomes were assessed using patient and surgeon Likert-scale ratings at one and six months.

Results

Good healing was achieved in 91.7% of cases. Both patient acceptance and cosmetic outcomes were favorable (83.3%). No major complications were noted; one recurrence (8.3%) occurred at six months.

Conclusions

The described technique offers a safe, effective, and cosmetically favorable option for medium-sized axillary HS defects. It provides a less invasive alternative to conventional flaps, with high healing rates and patient acceptance.