Surgical treatment of chronic hidradenitis suppurativa: CO2 laser stripping-secondary intention technique

The objective of our study was to evaluate a surgical method of management of patients with hidradenitis suppurativa (HS), using a CO2 laser technique for stepwise horizontal vaporization and peroperative monitoring of the removal of diseased tissue. Twenty-four patients were selected for treatment, 21 women and three men, who had suffered from HS for a mean of 13 years (range 1-28 years) and experienced more than three recurrences of suppurating lesions during the year prior to entering the study. The mean follow-up time after CO2 laser surgery was 27 months (range 15-47 months), with clinical follow-up once or twice a week during the wound-healing period, and then at intervals of 1-3 months to evaluate recurrences and assess the end result. The patients' healing time was approximately 4 weeks (range 3-5 weeks). During the follow-up period two patients had recurrences in the treated areas. Twenty-two patients had no recurrences in the treated areas, but in four cases de novo suppurating lesions appeared 5-10 cm beyond the initial sites of surgery. Ten patients had exacerbations of HS lesion(s) in a region other than the treated site. Eight patients did not have any recurrences. Post-surgery results were satisfactory both cosmetically and with regard to quality of life. The CO2 laser stripping-secondary intention technique is a rapid, efficient, and economical method for the treatment of HS. It allows simple treatment of early lesions which would otherwise have been treated using less effective local conservative remedies.