Surgical and postsurgical wound care in hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Several medical treatments, with varying degree of efficacy, have been developed. However, in most cases of advanced (HS), the definitive treatment option is often represented by surgical excisions. Surgical techniques, reconstructive approach, and local wound care should be accurately designed in order to obtain the best result. In this letter, we analyzed the possible surgical treatments and local wound care. A literature review was performed on the various surgical treatments, reconstructive techniques, and local wound care. Surgical treatment is a common therapeutic modality for HS. Different surgical reconstructive techniques and postsurgical wound care approaches are described for the management of HS patients. There were few high‐quality evidence‐based studies evaluating the surgical management of HS. Many disparate HS severity scores were used in these studies making comparison between them difficult. Nonetheless, research into different surgical approaches and wound care management has increased substantially in the past decade and has given patients more surgical therapeutic strategies. The description of the best combinations and timing of surgery, wound care and medical therapies, will be a matter of future research for the definition of the optimal management of HS patient.

Hidradenitis Suppurativa: Surgical and Postsurgical Management

“…Scuderi et al [17] recently reviewed several surgical and reconstructive techniques for HS. Despite the many surgical and reconstructive techniques available, there is still no general consensus on the preferred surgical technique [18,19] (Table 1).…”

Intraoperative Injection of Coloring Dye in the Surgical Treatment of Hidradenitis Suppurativa: A Case Report

“…In spite of attempts to treat it with various medications, painful abscesses with malodorous purulent discharge associated with deep sinus tracts frequently recur [1]. Since this constellation of repeated symptoms has a negative impact on the psychosocial life quality of lives of patients, a variety of surgical treatments such as incision and drainage of abscesses and deroofing of tracts, and local and wide excision of affected skin regions have been proposed [4][5][6][7]. However, inadequate excision during surgery due to vague boundaries of the lesions brought on by repeated wound inflammation is pointed out as the most probable cause of recurrence [4].…”

“…However, inadequate excision during surgery due to vague boundaries of the lesions brought on by repeated wound inflammation is pointed out as the most probable cause of recurrence [4]. While wide excision involving adjacent viable tissues is considered the most effective treatment with the lowest recurrence rate, such surgical procedures additionally require a higher cascade of reconstructive procedures [4][5][6][7][8]. Therefore, many clinicians have attempted to develop a method to evaluate the extent of the disease, and to determine a precise resection margin that reduces the risk of recurrence and postoperative recovery time with less permanent scarring [4,7,9,10].…”

Potential predictive biomarkers of adalimumab response in patients with hidradenitis suppurativa*

“…6,7 Thus, severe HS often requires excisional surgery to remove involved tissue and requires extensive postoperative wound care. [8][9][10] Patients with HS have significant unmet needs for wound care, which greatly affects their quality of life (QoL). 11 These unmet needs are reported to have such a profoundly negative impact on QoL in patients with HS so as to be greater in scope than other dermatological conditions, including psychosocial, occupational and interpersonal aspects.…”

“…HS lesions have been characterized by epithelial perturbations resulting in epithelial tendril penetration deep within the dermis, fibrosis and profuse immune infiltration 6,7 . Thus, severe HS often requires excisional surgery to remove involved tissue and requires extensive postoperative wound care 8–10 . Patients with HS have significant unmet needs for wound care, which greatly affects their quality of life (QoL) 11 .…”