Island thoracodorsal artery perforator-based V-Y advancement flap after radical excision of axillary hidradenitis.

Chronic axillary hidradenitis invariably ultimately requires surgical intervention to ameliorate this often painful, unrelenting, recurrent disease that can be disabling. The treatment of choice requires radical excision of at least all hair-bearing skin and its associated apocrine sweat glands. The ensuing large defect often is amenable to closure using a local flap instead of a skin graft to better expedite healing, to allow more rapid rehabilitation, and to minimize the risk of later scar contracture. The island thoracodorsal artery perforator V-Y advancement flap is another alternative that allows unrestricted insetting with primary donor-site closure, as presented here with 2 clinical examples.