Hidradenitis suppurativa--a clinical review

Area of Science:

• Plastic Surgery
• Dermatology
• Surgical Oncology

Background:

• Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition.
• Axillary involvement is common and can significantly impact quality of life.
• Surgical intervention is often necessary for refractory HS.

Purpose of the Study:

• To evaluate the efficacy of different surgical techniques for axillary hidradenitis suppurativa.
• To compare recurrence rates associated with various surgical methods.
• To identify the optimal surgical approach for managing axillary HS.

Main Methods:

• Retrospective review of 72 patients with surgically treated hidradenitis suppurativa.
• Analysis of surgical outcomes based on treatment modality: excision and suture, excision and split-skin grafting, or excision and local flap cover.
• Comparison of reoperation rates for recurrence across treatment groups.

Main Results:

• Excision and suture for axillary HS resulted in a high reoperation rate of 54% due to recurrence.
• Excision and split-skin grafting showed a significantly lower recurrence rate (13%).
• Excision and local flap cover demonstrated a recurrence rate of 19%.

Conclusions:

• Surgical treatment of axillary hidradenitis suppurativa by excision and suture is associated with a high risk of recurrence.
• Excision with split-skin grafting is a superior surgical technique for axillary HS, offering lower recurrence rates.
• Split-skin grafting should be the preferred method for reconstructing defects after excising axillary hidradenitis suppurativa.