ejm Ege Tıp Dergisi 1016-9113 2147-6500 Ege University 10.19161/etd.1677474 Plastic Reconstructive and Aesthetic Surgery Plastik, Rekonstrüktif ve Estetik Cerrahi Aksillar hidradenitin rekonstrüksiyonunda torakodorsal arter perforatör flep kullanımı; klinik deneyimimiz Application of the thoracodorsal artery perforator flap in the reconstruction of axillary hidradenitis; our clinical experience https://orcid.org/0000-0003-2430-727X Çeçen Süleyman Bursa Uludağ Üniversitesi https://orcid.org/0000-0002-4667-1550 Kastamoni Başkan Menekşe Bursa Uludağ Üniversitesi https://orcid.org/0000-0001-8185-6553 Pashazade Aysel https://orcid.org/0009-0005-7396-7065 Demirel Abdullah Kilis Prof.Dr.Alaeddin Yavaşca Devlet Hastanesi https://orcid.org/0009-0000-3713-705X Apaydın Ahmet Can BURSA ULUDAG UNIVERSITY https://orcid.org/0000-0003-0000-8355 Özgenel Güzin Yeşim BURSA ULUDAG UNIVERSITY https://orcid.org/0000-0003-1683-0722 Akın Selçuk BURSA ULUDAG UNIVERSITY 12 08 2025 64 4 682 687 04 19 2025 08 23 2025 Copyright © 1962, Ege Journal of Medicine 1962 Ege Journal of Medicine

Amaç: Hidradenitis suppurativa (HS), esas olarak apokrin bezlerin bulunduğu bölgeleri etkileyen kronik inflamatuar bir deri hastalığıdır. İlerlemiş vakalarda geniş lokal eksizyon gerekebilir ve bu durumda optimal fonksiyonel ve estetik sonuçlar için flep rekonstrüksiyonu tercih edilmektedir. Bu çalışmada, aksiller HS nedeniyle geniş eksizyon uygulanan hastalarda torakodorsal arter perforatör (TDAP) flebi ile yapılan rekonstrüksiyon sonuçları değerlendirilmiştir. Gereç ve Yöntem: 2018–2023 yılları arasında kliniğimizde aksiller HS tanısıyla cerrahi tedavi uygulanan hastalar retrospektif olarak incelendi. Tıbbi ve lokal tedaviye yanıt vermeyen, primer kapatmaya uygun olmayan ve sadece aksilla bölgesi tutulumuna sahip hastalar çalışmaya dahil edildi. Demografik veriler, flep boyutları, defekt alanı, postoperatif komplikasyonlar ve fonksiyonel sonuçlar analiz edildi.Bulgular: Çalışmaya, yaş ortalaması 32,3 olan toplam 12 erkek hasta dahil edildi. Defekt boyutları 25–170 cm² (ortalama: 64,9 cm²) arasında değişmekteydi. Ortalama takip süresi 330 gündü. Hiçbir hastada tam flep kaybı gözlenmedi. Bir hastada flebin proksimal kenarında marjinal nekroz gelişti ve primer kapama ile başarılı şekilde tedavi edildi. Tüm hastalar cerrahi sonuçlardan memnuniyet bildirdi ve omuz hareket açıklığı korundu.Sonuç: TDAP flebi, özellikle orta ve büyük boyuttaki aksiller HS defektlerinde güvenilir ve fonksiyonel olarak üstün bir rekonstrüksiyon seçeneği sunmaktadır. Tutarlı vasküler anatomisi, minimal donör saha morbiditesi ve omuz fonksiyonunun korunması, bu flebi etkili bir yöntem haline getirmektedir. Bulguların doğrulanması için ileriye dönük karşılaştırmalı çalışmalara ihtiyaç vardır.

Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition primarily affecting apocrine gland-bearing areas such as the axilla. Advanced stages often necessitate wide local excision, with flap-based reconstruction emerging as a preferred technique for optimal functional and aesthetic outcomes. This study evaluates the clinical outcomes of thoracodorsal artery perforator (TDAP) flap reconstruction following wide excision for axillary HSMaterials and Methods: A retrospective review was conducted on patients who underwent surgical treatment for axillary HS between 2018 and 2023 at our institution. Inclusion criteria comprised patients with Hurley stage III HS unresponsive to medical therapy and unsuitable for primary closure. Demographic data, flap dimensions, defect size, postoperative complications, and functional outcomes were analyzed.Results: Twelve male patients (mean age: 32.3 years) were included. Defect sizes ranged from 25 to 170 cm² (mean: 64.9 cm²), with an average follow-up period of 330 days. No complete flap loss occurred. One patient experienced marginal necrosis at the flap edge, managed conservatively. All patients reported high satisfaction, with preserved shoulder mobility and no significant recurrence.Conclusion: The TDAP flap offers a reliable and functionally superior reconstructive option for axillary HS, particularly in moderate-to-large defects. Its favorable vascular anatomy, minimal donor site morbidity, and preservation of shoulder function make it an effective solution. Further comparative studies are warranted to establish long-term outcomes and validate these findings.

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