{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:28:12Z","timestamp":1792621692156,"version":"4.5.0"},"reference-count":19,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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\u2013III) 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.<\/jats:p>","DOI":"10.3390\/jcm14175945","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T15:57:47Z","timestamp":1755878267000},"page":"5945","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Treatment of Axillary Hidradenitis Suppurativa Using Preliminary Defect Closure and Two Sliding Island Triangular Skin-Subcutaneous Flaps from the Arm and Chest"],"prefix":"10.3390","volume":"14","author":[{"given":"Andrzej","family":"Bieniek","sequence":"first","affiliation":[{"name":"University Center for General and Oncological Dermatology, Wroclaw Medical University, 50-367 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Majda","sequence":"additional","affiliation":[{"name":"Regional Specialist Health Care Center\u2014Diabetology Clinic, Dobrzy\u0144ska 21\/23, 50-403 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Chlebicka","sequence":"additional","affiliation":[{"name":"Department of Dermato-Venereology, 4th Military Hospital, 50-981 Wroclaw, Poland"},{"name":"Division of Dermatology, Venereology and Clinical Immunology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-377 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Knecht-Gurwin","sequence":"additional","affiliation":[{"name":"University Center for General and Oncological Dermatology, Wroclaw Medical University, 50-367 Wroclaw, Poland"},{"name":"Department of Dermato-Venereology, 4th Military Hospital, 50-981 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-6342","authenticated-orcid":false,"given":"Jacek C.","family":"Szepietowski","sequence":"additional","affiliation":[{"name":"Department of Dermato-Venereology, 4th Military Hospital, 50-981 Wroclaw, Poland"},{"name":"Division of Dermatology, Venereology and Clinical Immunology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-377 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1111\/j.1524-4725.2010.01763.x","article-title":"Surgical treatment of hidradenitis suppurativa: Experiences and recommendations","volume":"36","author":"Bieniek","year":"2010","journal-title":"Dermatol. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.5114\/ada.2022.115323","article-title":"Surgical management of hidradenitis suppurativa","volume":"39","author":"Gierek","year":"2022","journal-title":"Adv. Dermatol. Allergol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00238-019-01608-9","article-title":"A review of the reconstructive methods in the management of axillary hidradenitis suppurativa","volume":"43","author":"Lee","year":"2020","journal-title":"Eur. J. Plast. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/00006534-197505000-00005","article-title":"Surgical treatment of hidradenitis suppurativa of the axilla","volume":"55","author":"Tasche","year":"1975","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1054\/bjps.1999.3285","article-title":"Chronic axillary hidradenitis\u2014The efficacy of wide excision and flap coverage","volume":"53","author":"Soldin","year":"2000","journal-title":"Br. J. Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0007-1226(65)80005-4","article-title":"Subcutaneous pedicle flaps","volume":"18","author":"Barron","year":"1965","journal-title":"Br. J. Plast. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/00006534-197008000-00008","article-title":"Sliding subcutaneous-pedicle flaps to close a circular defect","volume":"46","author":"Trevaskis","year":"1970","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/0970-0358.26898","article-title":"Reconstruction in extensive axillary hidradenitis suppurativa with local fasciocutaneous V-Y advancement flaps","volume":"39","author":"Sharma","year":"2006","journal-title":"Indian J. Plast. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S0094-1298(03)00034-8","article-title":"The angiosomes of the body and their supply to perforator flaps","volume":"30","author":"Taylor","year":"2003","journal-title":"Clin. Plast. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00238-014-1043-4","article-title":"The freestyle pedicle perforator flap: A new favorite for the reconstruction of moderate-sized defects of the torso and extremities","volume":"38","author":"Gunnarsson","year":"2015","journal-title":"Eur. J. Plast. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1111\/iwj.14010","article-title":"Application of the free-style brachial artery perforator based propeller flap in the management of axillary hidradenitis suppurativa","volume":"20","author":"Datli","year":"2023","journal-title":"Int. Wound J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e5301","DOI":"10.1097\/GOX.0000000000005301","article-title":"Axillary hidradenitis suppurativa: A comparison between two perforator flap reconstructive approaches after radical surgical management","volume":"11","author":"Alabdulkareem","year":"2023","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.anplas.2013.10.005","article-title":"Application of the inner arm perforator flap in the management of axillary hidradenitis suppurativa","volume":"59","author":"Alharbi","year":"2014","journal-title":"Ann. Chir. Plast. Esthet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/00006534-197406000-00018","article-title":"Closure of axillary hidradenitis defects with local triangular flaps","volume":"53","author":"Lipshutz","year":"1974","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Vaillant, C., Berkane, Y., Lupon, E., Le Bras, E., Alabdulkareem, M., and Duteille, F. (2022). Outcomes and reliability of perforator flaps in the reconstruction of hidradenitis suppurativa defects: A systemic review and meta-analysis. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195813"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1001\/jamasurg.2021.3655","article-title":"Efficacy and Safety of Adalimumab in Conjunction With Surgery in Moderate to Severe Hidradenitis Suppurativa: The SHARPS Randomized Clinical Trial","volume":"156","author":"Bechara","year":"2021","journal-title":"JAMA Surg."},{"key":"ref_17","first-page":"885","article-title":"Guidelines How to Integrate Surgery and Targeted Therapy with Biologics for the Treatment of Hidradenitis Suppurativa: Delphi Consensus Statements from an Italian Expert Panel","volume":"240","author":"Offidani","year":"2024","journal-title":"Dermatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"adv00257","DOI":"10.2340\/00015555-3616","article-title":"Neoadjuvant Biologic Therapy in the Surgical Management of Patients with Hidradenitis Suppurativa: A Cohort Study","volume":"100","year":"2020","journal-title":"Acta Derm. Venereol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/SAP.0000000000000584","article-title":"Outcomes After Combined Radical Resection and Targeted Biologic Therapy for the Management of Recalcitrant Hidradenitis Suppurativa","volume":"77","author":"DeFazio","year":"2016","journal-title":"Ann. Plast. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/5945\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:34:14Z","timestamp":1760034854000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/5945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":19,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14175945"],"URL":"https:\/\/doi.org\/10.3390\/jcm14175945","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]}}}