Deroofing: a tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions.
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, often refractory to treatment. Patients with HS and dermatologists are in need of an effective, fast surgical intervention technique. Deroofing is a tissue-saving technique, whereby the "roof" of an abscess, cyst, or sinus tract is electrosurgically removed. The use of a probe is mandatory to explore the full extent of a lesion.


OBJECTIVE
We sought to evaluate the efficacy and patient satisfaction of the deroofing technique for recurrent Hurley I (mild) or II (moderate) graded HS lesions at fixed locations.


METHODS
An open study consisted of 88 deroofed lesions in 44 consecutive patients with HS, treated by a single clinician with a follow-up time of up to 5 years.


RESULTS
Fifteen of 88 (17%) treated lesions showed a recurrence after a median of 4.6 months. In all, 73 treated lesions (83%) did not show a recurrence after a median follow-up of 34 months. The median patient satisfaction with the procedure rated 8 on a scale from 0 to 10. Of the treated patients, 90% would recommend the deroofing technique to other patients with HS. One side effect occurred in the form of postoperative bleeding.


CONCLUSIONS
Some patients were lost to follow-up.


CONCLUSIONS
The deroofing technique is an effective, simple, minimally invasive, tissue-saving surgical intervention for the treatment of mild to moderate HS lesions at fixed locations and it is suitable as an office procedure.
van der Zee
Hessel H
HH
Departments of Dermatology and Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. h.vanderzee@erasmusmc.nl
Prens
Errol P
EP
Boer
Jurr
J
D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D003646:Debridement / Q000379:methods; D003880:Dermatology / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D017497:Hidradenitis Suppurativa / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology