Surgical management of hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronic disease, which causes painful discomfort. The main regions involved in this disease are axillary, inguinal and perianal. The etiology is unknown at present. It is suggested that genetics, smoking and diabetes are involved in HS. General treatment consists of antibiotics and anti-inflammatory biological drugs. HS is a multidisciplinary disease, which involves surgical treatment as well. We would like to present surgical treatment in HS. Deroofing and drainage/incisions are the most frequent techniques in general surgery departments. The article describes additional techniques such as skin grafts and flaps. We conclude that local flaps are the best choice in surgical treatment.

Keywords: flaps; hidradenitis suppurativa; skin grafts; surgical treatment of hidradenitis suppurativa.

Figure 1

A – Pre-op. acne inversa (left axilla). B – Pre-op. acne inversa (left axilla/chest). C – Skin grafts 6 month post-op. (left). D – Skin grafts immediately after excision (operation image)

Figure 2

A – Wide resection of the right axilla. B – Flap preparation. C – Successful wound closure with rotatory local flap. D – Wide excision of the left axilla. E – Successful reconstruction with local flap and skin graft (mixed technique)