[Axillary hidradenitis suppurativa: a single-stage surgical treatment]. / Hidrosadénite axillaire : une stratégie thérapeutique en un temps.

INTRODUCTION: Hidradenitis suppurativa is a chronic inflammatory disease, particularly incapacitating. Wide surgical excision of the whole affected skin is the only radical and successful treatment that can be offered. Coverage of the defect is then generally obtained with a split-thickness skin graft after a period of granulation. We expose a single-stage procedure which reduces the number of surgical times and the period of recovery. PATIENTS AND METHODS: We have documented a series of five patients who underwent uni- (three cases) or bilateral (two cases) axillary hidradenitis suppurativa, between December 2008 and December 2009. Surgical procedure included excision of the lesions and coverage with a split-thickness skin graft. The graft was meshed in a ratio of 1.5:1, and secured with a negative-pressure dressing. This dressing, which provided a continuous subatmospheric pressure of -75 mmHg, was removed after five days. Then, complete healing was obtained with conventional vaseline gauze dressings. RESULTS: After removal of the negative-pressure dressings, the graft take was 90% on average (80-100%). Complete healing was obtained within an average of 34 days (20-43 days), with a good quality of scar tissue, no retraction and no limitation of arm's abduction. CONCLUSION: This technique, enabled by negative-pressure dressings, provides a quick and good quality healing, with only one surgical stage. It has many advantages: reduced morbidity, faster healing, higher level of patient's comfort, and lower costs.

[Bony regrowth after major erosion of the maxillary following silastic malar augmentation. Case report]. / Régénération osseuse après érosion majeure du maxillaire sur implants malaires en silicone. Cas clinique.

Alloplastic malar augmentation has become a routine procedure associated with few complications. Among them, authors have described bony erosion and resorption. The case presented here illustrates an unusual case of maxillary bone erosion after silastic malar augmentation. Implants were surgically removed and no more surgical intervention was performed. After 15 months, contrast-enhanced CT scan has showed nearly complete bony regrowth to an almost normal state. Considering resorption phenomenons following silastic chin implants, Peled et al. reported no long-term sequellae after implant removal and bony regrowth to the presurgical state after 9 months. Accordingly, we conclude that these phenomenons, even spectacular, are always reversible after implants removal and that treatment should just consist in ablation of the offending prosthetic material.