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

Bieniek, Andrzej; Majda, Filip; Chlebicka, Iwona; Knecht-Gurwin, Klaudia; Szepietowski, Jacek C.

doi:10.3390/jcm14175945

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

by

Andrzej Bieniek

¹,

Filip Majda

²,

Iwona Chlebicka

^3,4,

Klaudia Knecht-Gurwin

^1,3 and

Jacek C. Szepietowski

^3,4,*

¹

University Center for General and Oncological Dermatology, Wroclaw Medical University, 50-367 Wroclaw, Poland

²

Regional Specialist Health Care Center—Diabetology Clinic, Dobrzyńska 21/23, 50-403 Wroclaw, Poland

³

Department of Dermato-Venereology, 4th Military Hospital, 50-981 Wroclaw, Poland

⁴

Division of Dermatology, Venereology and Clinical Immunology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-377 Wroclaw, Poland

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2025, 14(17), 5945; https://doi.org/10.3390/jcm14175945

Submission received: 1 July 2025 / Revised: 18 August 2025 / Accepted: 21 August 2025 / Published: 22 August 2025

(This article belongs to the Section Dermatology)

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Abstract

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.

Keywords: hidradenitis suppurativa; star technique; triangular flap; surgery

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MDPI and ACS Style

Bieniek, A.; Majda, F.; Chlebicka, I.; Knecht-Gurwin, K.; Szepietowski, J.C. Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest. J. Clin. Med. 2025, 14, 5945. https://doi.org/10.3390/jcm14175945

AMA Style

Bieniek A, Majda F, Chlebicka I, Knecht-Gurwin K, Szepietowski JC. Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest. Journal of Clinical Medicine. 2025; 14(17):5945. https://doi.org/10.3390/jcm14175945

Chicago/Turabian Style

Bieniek, Andrzej, Filip Majda, Iwona Chlebicka, Klaudia Knecht-Gurwin, and Jacek C. Szepietowski. 2025. "Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest" Journal of Clinical Medicine 14, no. 17: 5945. https://doi.org/10.3390/jcm14175945

APA Style

Bieniek, A., Majda, F., Chlebicka, I., Knecht-Gurwin, K., & Szepietowski, J. C. (2025). Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest. Journal of Clinical Medicine, 14(17), 5945. https://doi.org/10.3390/jcm14175945

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

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