Plastic Surgical Management of Hidradenitis Suppurativa

Taylor, E. Stewart; Hamaguchi, Ryoko; Kramer, Kimberly M.; Kimball, Alexa B.; Orgill, Dennis P.

doi:10.1097/prs.0000000000007677

Cited by 13 publications

(33 citation statements)

References 43 publications

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“…15,16 Stage III is the most severe form of the disease, which is described as combined lesions with tunnel formation, scarring, and inflammation. 24…”

Section: Discussionmentioning

confidence: 99%

Our Experience in Using Lateral Chest Flap to Treat Axillary Hidradenitis Suppurativa

Lahham

Aljassem

Omari

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Hidradenitis suppurativa is a chronic inflammatory condition that affects apocrine gland-bearing areas‚ causing abscesses and sinuses. Multimodality treatment is suggested for management. The surgical option is becoming more widely used, especially in drug-resistant cases. In this article, we describe a series of bilateral axillary hidradenitis cases which we treated with wide local excision and immediate reconstruction with lateral chest flap. Methods: Fourteen patients presented to our clinic with bilateral hidradenitis suppurativa of the axilla. The cases were all resistant to medical treatment. They were managed by excision and simultaneous reconstruction with lateral chest flaps. Results: At 3 months postoperatively, all patients had full shoulder range of motion and were completely satisfied with the aesthetic outcome, except for one patient who complained of the bulky look of his axilla. Liposuction was performed for him‚ with a pleasant resultant outcome. Conclusions: Our patients underwent wide local excision of bilateral disease plus reconstruction with lateral chest flaps in the same session. Our aim was to introduce a treatment option for moderate to severe axillary hidradenitis suppurativa that offers good aesthetic and functional outcomes.

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“…15,16 Stage III is the most severe form of the disease, which is described as combined lesions with tunnel formation, scarring, and inflammation. 24…”

Section: Discussionmentioning

confidence: 99%

Our Experience in Using Lateral Chest Flap to Treat Axillary Hidradenitis Suppurativa

Lahham

Aljassem

Omari

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…In advanced cases of the disease manifestation, radical surgical excision may be the only curative option 4 . Ideally, this should only be approached if the acute phase of inflammation is mitigated with optimal medical multimodal management 3 . Effective education and open communication with the patients are the major principles in the treatment pathway to management expectations.…”

Section: Discussionmentioning

confidence: 99%

“…A wide range of surgical interventions has been described for HS disease control and management. These are tailored to the disease stage, extent of disease, degree of bacterial contamination, anatomical location, and failed previous surgical interventions, ranging from simple incision and drainage to wide excision and reconstruction 2 , 3 . Reconstructive approaches include healing by secondary intention, primary closure, local and regional flaps, staged closure with negative pressure wound therapy, split-thickness skin grafting, and dermal substitute with a subsequent skin graft.…”

Section: Introductionmentioning

confidence: 99%

Acellular dermal substitute use in the reconstruction of axillary hidradenitis suppurativa

et al. 2022

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Hidradenitis suppurativa (HS) is a chronic recurrent debilitating condition that affects the skin near to the follicular glands. The disease manifests with the formation of abscesses that can be complicated by rupture, sinus tracts, and scarring leading to pain, chronic discharge, malodor, and scar contractures. The management of HS is multidisciplinary, involving general lifestyle modification, medical treatment, and surgery. A wide range of surgical interventions has been described for HS disease control and management. However, surgical management strategies are highly variable. We describe the case of a 33-year-old female with refractory HS which was reconstructed with Matriderm® and an immediate split-thickness skin graft. Acellular dermal skin substitutes may be an alternative to conventional means of HS reconstruction, producing subtle, pliable, and durable skin.

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“…The treatment options of hidradenitis suppurativa are wide-ranging. The conservative treatment options are diverse and include antibiotic or hormone therapy, steroids, and treatment with biologicals ( 14 ). In many cases, conservative treatment is not successful and leads to a chronic and/or progressive course of the disease.…”

Section: Discussionmentioning

confidence: 99%

The Value of Negative-Pressure Wound Therapy and Flap Surgery in Hidradenitis Suppurativa – A Single Center Analysis of Different Treatment Options

et al. 2022

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BackgroundHidradenitis suppurativa is manifested by painful abscesses and scarring of sweat glands. Axillary, inguinal and genital regions are mostly affected. Multiple options exist in the treatment of hidradenitis suppurativa. The aim of this retrospective, mono-center cohort study was to analyze the outcome of different treatment methods after radical excision of hidradenitis suppurativa.MethodsWe retrospectively evaluated the treatment strategy and recurrence rate of hidradenitis suppurativa. We included all eligible patients of legal age between February 2003 and October 2021, with the diagnosis of Hidradenitis suppurativa and the necessity for surgical treatment. All patients with surgical treatment and direct wound closure by suture were excluded. Bacterial load and flora were analyzed for primary and secondary reconstruction in combination with negative-pressure wound therapy. Patient data were analyzed for recurrence rate and remission time according to different reconstructive techniques.ResultsIn 44 affected anatomical sites (n = 23 patients) we treated 15 patients with negative-pressure wound therapy. Bacterial load and flora were lower in the last wound swab of patients with multi-surgical procedures (22 localizations) compared to the first wound swab independent of the use of negative-pressure wound therapy.Wound closure, independent of a direct and multi-stage procedure was achieved by local fasciocutaneous flaps (n = 12), secondary intention healing (n = 7), secondary intention healing with buried chip skin grafts (n = 10), or split-thickness skin grafts (n = 15). Radical excision combined with split-thickness skin grafts showed the lowest recurrence rate in the follow-up (16%; n = 4).ConclusionRadical excision of hidradenitis suppurativa as gold standard for surgical treatment combined with negative-pressure wound therapy as multi-stage procedures ultimately reduced bacterial load and flora in our study. The use of split-thickness skin grafts showed the lowest recurrence rate.

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Plastic Surgical Management of Hidradenitis Suppurativa

Cited by 13 publications

References 43 publications

Our Experience in Using Lateral Chest Flap to Treat Axillary Hidradenitis Suppurativa

Our Experience in Using Lateral Chest Flap to Treat Axillary Hidradenitis Suppurativa

Acellular dermal substitute use in the reconstruction of axillary hidradenitis suppurativa

The Value of Negative-Pressure Wound Therapy and Flap Surgery in Hidradenitis Suppurativa – A Single Center Analysis of Different Treatment Options

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