Surgical Management of Hidradenitis Suppurativa

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands.Method: This study reviewed 54 sites in 27 patients with moderate to extensive chronic inflammatory skin lesions treated surgically in our hospital from 2004 through 2009, with a follow-up of at least 6 months.Result: A total number of 54 operative procedures were performed during the study period with 42% (23 sites) involving the axilla, 20% (11 sites) involving the gluteal area, %24 (13 sites) involving the perineal area and 12% (7 sites) involving the inguinal region.Conclusion: Conservative treatment methods have little or no effects especially on gluteal, perineal/perianal, axillary hidradenitis suppurativa. The morbidity associated with the established form of this disease is significant, and the only successful treatment is wide surgical excision.

Novel Surgical Approach for Axillary Hidradenitis Suppurativa Using a Bilayer Dermal Regeneration Template

“…16 Other recent studies have also reviewed results of the available musculocutaneous and fasciocutaneous flap repairs. 14,17 In 2010, Menderes published results for 27 patients, which included 16 patients (23 axillae) who underwent a wide local axillary excision for HS, and reported no disease recurrence. Ten axillae were repaired primarily, and 13 with fasciocutaneous or musculocutaneous flaps.…”

“…6,12 The literature advocates wide local excision of the diseased tissue, but does not define what constitutes adequate tissue removal. 3,7,9,[13][14][15] Morgan et al 15 have used an atropine/oxytocin/iodine method to define apocrine gland-bearing tissue and demarcate the area of excision. On average, this was an 11 × 8 cm area for the axilla.…”

Surgical Treatment of Extensive Sacrococcygeal Hidradenitis Suppurativa With Triangular Closure Technique

“…15 Another fasciocutaneous perforatorYbased flap for closure of sacrococcygeal defects is the fasciocutaneous V-Y flap which has such advantages as providing local healthy tissue without impairing muscle function. 16 Nevertheless, the major disadvantages of this flap are that it requires a scrutinized dissection and they usually fail to achieve a tension-free closure of the large sacrococcygeal defects. Yunqin et al 17 has reported pediceled fasciocutaneous flap of multi-island design for large sacral defects.…”

Verneuil's disease: A case report and literature review

“…5 The most frequently isolated microorganisms are: Proteus mirabilis, Staphylococcus aureus, and Escherichia coli. 6 Diagnosis is difficult if there is no experience with the disease, and therefore it tends to become chronic and extend from the involved area. 7 The concept of hidradenitis suppurativa is not new, but its etiology is unknown, 8 and so the following was concluded upon analyzing the present case:…”