A Multicenter Comparison of Reconstruction Strategies after Wide Excision for Severe Axillary Hidradenitis Suppurativa

For patients with severe HS, wide excision with complete removal of the affected skin, underlying adipose tissue and adequate free margins (1–3 cm) is reported to have the highest success.1 However, although reconstruction after wide excision is crucial for cure, aesthetics, and function, there is no consensus on the optimal method. There is a lack of high-quality evidence and most of the available, usually small single-center studies, analyze their results combining outcomes after surgery in multiple anatomic locations. This could lead to bias, given recurrence rates may differ between the affected areas.2 Moreover, differentiating between anatomic locations is crucial because each location possesses different anatomical features and functions that must be considered when choosing the reconstruction strategy.3,4 In this study, we evaluated different reconstruction strategies after wide excision in patients with severe axillary HS, to determine the recurrence rate, complications, limb function, aesthetics, and patient satisfaction.