Surgical Interventions in Advanced Hidradenitis Suppurativa: A Systematic Review

Area of Science:

• Dermatology
• Surgical Oncology
• Immunology

Background:

• Hidradenitis suppurativa (HS) is a chronic, immune-mediated skin condition causing painful nodules and scarring.
• Moderate-to-severe HS (Hurley Stages II and III) often necessitates surgical intervention for effective management.

Purpose of the Study:

• To compare surgical interventions for Hurley Stage II and III HS.
• Evaluate recurrence rates, postoperative complications, and patient-centered outcomes across different surgical methods.

Main Methods:

• A systematic review of MEDLINE and EMBASE databases.
• Included 136 English-language studies (5,646 procedures) reporting surgical outcomes for HS.

Main Results:

• Primary closure had the highest recurrence (38.0%) and complication rates (29.4%).
• Wide excision showed moderate recurrence (17.2%) and high cosmetic dissatisfaction.
• Laser-assisted surgery demonstrated the lowest complication (2.2%) and recurrence rates (5.7%).

Conclusions:

• Surgical outcomes for advanced HS differ significantly by intervention type.
• Laser-assisted surgery and wide excision may offer better disease control compared to primary closure.
• Individualized surgical planning is recommended for Hurley Stage II and III HS.