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Case Reports
. 2024 Jan 5;16(1):8-16.
doi: 10.1159/000533387. eCollection 2024 Jan-Dec.

Parascapular Flap for Severe Hidradenitis Suppurativa

Saad Khayat  1   2 , Nuria Bonsfills  2 , Raúl Antúnez-Conde  2 , Sara Álvarez-Mokthari  1   2 , Hubert Aranibar  1 , Manuel Tousidonis  1   2 , Mario Fernández-Fernández  2   3 , Alberto Díez-Montiel  1   2
Affiliations
Case Reports

Parascapular Flap for Severe Hidradenitis Suppurativa

Saad Khayat et al. Case Rep Dermatol. .

Abstract

Hidradenitis suppurativa is a chronic inflammatory disease which affects apocrine glands and hair follicles of the skin, primarily in the axillary and groin regions. This condition can be highly debilitating, causing painful lesions and a negative psychological impact on patients. While medical and minimally invasive treatments are available, surgical intervention may be necessary for severe cases. In cases involving axillary defects, the use of local flaps such as the parascapular flap is a viable option. In this case report, we present a 34-year-old woman who presented to our clinic with a history of recurrent abscesses and cutaneous infections in the axillary region. After thorough evaluation, we chose to use the parascapular flap for reconstruction. The parascapular flap is a one-stage procedure that allows for extensive resection of the axillary area without resulting in contractions or retractions over the long term. Additionally, this technique allows for preservation of the axilla's original shape with minimal donor site morbidity.

Keywords: Hidradenitis suppurativa; Parascapular flap; Reconstructive surgery.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Anatomy of the parascapular flap. a Vascular anatomy. b Parascapular flap design based on the TDAP (green) and its recipient site (blue).
Fig. 2.
Fig. 2.
Surgical procedure. a, b Design of the affected area to be resected. c Design of the propeller flap (green line) with location of the perforator vessels (red x) over the lateral border of the scapula (black line). d Affected area is resected, showing the defect to be covered and the perforator vessels. e Parascapular flap elevated on two perforator vessels. f Parascapular flap rotated to the anterior area. g Final reconstruction with the parascapular flap in its definitive location, properly vascularized. h Reconstruction after removal of the surgical stitches (2 weeks postoperatively).
Fig. 3.
Fig. 3.
Clinical result at the end of follow-up. a Anterior view, 80° abduction. b Right axilla 90° abduction and external rotation. c Left axilla 90° abduction and external rotation. d Left axilla, closer inspection, 130° abduction. e Right axilla, closer inspection, 120° abduction.
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References

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