title: Surgical approach to extensive hidradenitis suppurativa.
abstract: BACKGROUND
  Hidradenitis suppurativa (HS) is a chronic suppurative disease of skin with high recurrence.
  
  
  OBJECTIVE
  To determine factors affecting complications and recurrence of HS in patients who underwent surgery.
  
  
  METHODS
  We operated on 15 patients with HS at 36 sites between 1999 and 2009. The affected areas were classified as groin, axilla, buttocks, nuchae, perianal, and perineal. All patients were treated using wide surgical excision under general anesthesia. The methods of reconstruction varied depending on the size and location of the defect.
  
  
  RESULTS
  The female:male ratio of patients was 4:11. Mean age was 41.8 ± 10.6. Twenty-eight (77%) of the lesions were Stage III according to Hurley's staging system. Mean follow-up was 42 months. Radical excision was performed on all lesions; 20 were reconstructed with primary closure, nine with fasciocutaneous flaps, and five with split-thickness skin grafts. The overall complication rate was 25% (9/36) and complications occurred mostly in perineal, perianal, and buttocks sites. Two (5.5%) recurrences were seen only in buttocks site.
  
  
  CONCLUSIONS
  To prevent complication, avoid recurrence of HS, and improve patients' quality of life, early and wide surgical excision is important and effective. The recurrence and complications are mostly related to the location of the disease. The authors have indicated no significant interest with commercial supporters.
authors: Department of General Surgery, Abant İzzet Baysal University Medical Faculty, Bolu, Turkey. oktaybuyukasik@gmail.com
authors: Oktay
authors: O
authors: Büyükaşik
authors: Ahmet Oğuz
authors: AO
authors: Hasdemir
authors: Nurettin
authors: N
authors: Kahramansoy
authors: Cavit
authors: C
authors: Çöl
authors: Hayri
authors: H
authors: Erkol