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Meta-Analysis
. 2020 Aug;46(8):e1-e7.
doi: 10.1097/DSS.0000000000002403.

Recurrence Rates Following Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis

Zachri N Ovadja  1   2 , Wilco Jacobs  3 , Mislav Zugaj  1 , Chantal M A M van der Horst  1 , Oren Lapid  1
Affiliations
Meta-Analysis

Recurrence Rates Following Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis

Zachri N Ovadja et al. Dermatol Surg. 2020 Aug.

Abstract

Background: Surgery is considered to be the best treatment for recurrent hidradenitis suppurativa (HS). Varying recurrence rates have been reported in the literature.

Objective: To provide an up-to-date systematic review of the complete literature for different excision strategies and their recurrence rates in HS.

Methods: A systematic literature search of the complete available literature and a meta-analysis of proportions were performed on the included studies.

Results: Of a total of 1,593 retrieved articles, 125 were included in the analysis. Most of these studies were retrospective with 8 prospective analyses and one randomized controlled trial (RCT). The techniques described were divided into partial excision (PE) and wide excision (WE), described in 33 and 97 included studies, respectively. The average estimated recurrences were 26.0% (95% confidence interval [CI], 16.0%-37.0%) for PE and 5.0% (95% CI, 3.0%-9.0%) for WE (p < .01). Female sex (p = .016) and HS caudal of the umbilicus (p = .001) were significantly associated with the overall recurrence rate. Quality of evidence was poor, and the reporting of results was mostly heterogeneous.

Conclusion: This systematic review showed higher recurrence rates when it was not intended to resect affected HS tissue with a radical margin. There is a need for more RCT's and uniformly reported treatment outcomes.

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Comment in

  • Step by step surgery for hidradenitis suppurativa.
    Di Guida A, Forgione P, Fornaro L, Marasca D, Fabbrocini G, Marasca C. Di Guida A, et al. Dermatol Ther. 2022 Dec;35(12):e15938. doi: 10.1111/dth.15938. Epub 2022 Oct 25. Dermatol Ther. 2022. PMID: 36239203 No abstract available.

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