A review of wide surgical excision of hidradenitis suppurativa.
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich of apocrine glands. It can be associated with fistulating sinus, scarring and abscesses formation. Hidradenitis suppurativa is a challenging aspect and requires a proper treatment plan which may involve different specialties. We present herein the option of surgical treatment involving wide surgical excision and methods of reconstruction as well as the rate of recurrence. Furthermore, review of the literature regarding surgical treatment of hidradenitis suppurativa is provided.


METHODS
A retrospective analysis reviewed 50 operative procedures for 32 patients in 5 anatomical sites. These anatomical sites have been divided to 23 sites involving the axilla, 17 sites involving the inguinal region and 8 sites involving the perianal/perineal area, 1 site involving the gluteal region and 1 site involving the trunk region.


RESULTS
Twenty six patients (81, 25 %) showed no recurrence after surgery and the average time of hospital stay period was 5 days. Recurrence was observed only in 6 patients (18, 75 %).


CONCLUSIONS
Elimination of the acute inflammatory process should occur in advance, including the use of antibiotics and minor surgeries such as abscess drainage with proper irrigations. After stabilizing the acute phase, wide surgical excision is recommended. Herein, planning of surgical reconstruction should be initiated to achieve the best outcome and consequently decreasing the risk of recurrence and complications after surgery.
Department of Plastic and Hand Surgery, Burn Unit, Medical Faculty, RWTH Aachen University, Aachen, Germany. zalharbi@ukaachen.de
Ziyad
Z
Alharbi
Jens
J
Kauczok
Norbert
N
Pallua
D000293:Adolescent; D000328:Adult; D005260:Female; D017497:Hidradenitis Suppurativa / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013514:Surgical Procedures, Operative / Q000379:methods*; D055815:Young Adult