Abstract
Abstract
Purpose of Review
Hidradenitis suppurativa is a chronic inflammatory skin condition marked by significant structural changes such as nodules, abscesses, and subcutaneous tunnels, often accompanied by drainage and pain. Medical treatment alone usually does not suffice for optimal disease control. Therefore, surgical interventions, particularly for moderate-to-severe cases with tunnel formation, are a crucial adjunct to medical therapy. This paper aims to outline a practical approach to deroofing in hidradenitis suppurativa, covering the necessary materials, surgical approach, wound care, common complications, and frequent patient questions.
Recent Findings
Classically, wide excision of the entire anatomical area affected by hidradenitis suppurativa is performed in the operating room under general anesthesia. As a tissue-sparing alternative, deroofing—excision of tunnels—can be performed in-office under local anesthesia. This method allows for targeted application to either single lesions or entire anatomic regions, preserving the base of the cavity. Post-surgical wounds are typically left to heal by secondary intention.
Summary
Deroofing is a safe, in-office procedure for the management of hidradenitis suppurativa, with minimal rates of post-surgical complications. It is generally well-tolerated and associated with high patient satisfaction. When combined with proper medical treatment, deroofing can help patients achieve local disease control. Optimizing post-operative wound care is paramount to facilitate patient recovery.
Publisher
Springer Science and Business Media LLC
Reference23 articles.
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3. • Bermudez NM, et al. Hidradenitis suppurativa: surgery, lasers, and emerging techniques. Surg Technol Intern. 2023;42:sti42/1659-sti42/1659. This paper on hidradenitis suppurativa (HS) is significant for its comprehensive exploration of the disease, emphasizing its prevalence, impact on quality of life, and the current management paradigms. The document meticulously details various surgical interventions, ranging from established techniques like intralesional corticosteroids, incision and drainage, punch debridement, and deroofing, to emerging methods such as Skin-Tissue-Sparing Excision with Electrosurgical Peeling (STEEP), lasers, cryoinsufflation, and antibiofilm therapy. Comparative analyses and summary tables provide valuable insights for clinicians, while the paper stresses the importance of integrating surgical approaches with medical management for optimal outcomes. Additionally, the document underscores the need for further research, especially randomized controlled trials, to enhance our understanding of HS and refine treatment strategies. Overall, this paper serves as a comprehensive resource for healthcare professionals involved in addressing the complexities of hidradenitis suppurativa.
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