The role of negative pressure wound therapy in the management of hidradenitis suppurativa: a case report and literature review

Abstract

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic, recurrent inflammatory disease affecting skin that bears apocrine glands. It is characterised by the presence of tender subcutaneous nodules that may rupture, resulting in deep dermal abscesses, fibrosis with dermal contractures and induration of the skin. The management of HS is a challenge for physicians as the pathogenesis is not clearly defined and prevents the use and development of directed therapies. Treatment options are oral agents (antibiotics, immunomodulators) and surgical excision. Historically, surgical management has been complicated by difficult closure and high recurrent rates. In the last 10 years, negative pressure wound therapy (NPWT) has proven to be a great adjunct for wound management as it provides the adequate conditions for wound healing, promotes granulation and helps to control infection. Here, we report a case of severe perineal HS treated with radical excision and NPWT as an adjunct. The patient only had a recurrence 3 years after primary treatment and was surgically treated for cosmetic reasons without any complications. Finally, we present a review of the relevant literature.

Keywords: Acne inversa; Hidradenitis suppurativa; Negative pressure wound therapy; Split-thickness skin grafting.

Figure 1

Inmediate postoperative period without the negative pressure wound therapy dressings. A wide resection of the affected regions in the perineal area was done.

Figure 2

8^Th day postoperatively before the reconstructive procedure.

Figure 3

Reconstruction of the vulvar area with pubic split‐thickness grafts and two fasciocutaneous gluteal flaps

Figure 4

6^th month after discharge. Tissue is scared and no signs of relapse are observed.