32631 Survey-based study to understand HS patient experiences and perceptions about I&D procedures

Abstract

Incision and drainage (I&D) procedures are frequently used to manage acutely painful abscesses in patients with hidradenitis suppurativa (HS). While previous literature shows that I&D results in high recurrence rates, the benefits, drawbacks, and various approaches to the procedure have not been well-characterized. Similarly, patient perceptions about I&D procedures have not been well-characterized. We sought to characterize patient perceptions and experiences with I&D procedures. We investigated aspects of the procedure and associated wound care that are linked to negative patient perceptions. We created an IRB-approved survey instrument to better characterize experiences with I&D procedures in HS patients, ages 7–99. Surveys were distributed online to HS support group moderators, who delegated surveys to eligible group members. No identifiable information was collected. A total of 110 participants with HS reported at least one I&D. Demographic data collected include age (41 ± 11), race (74% white), and average number of procedures per participant (12). The most common locations for I&D were groin (27%) and axillae (24%). Procedures were performed by a wide range of specialists. Many patients found I&D to be helpful for improving symptoms but found the procedures very painful and highly dread future I&D. Recurrence was common, though nearly 25% of lesions fully resolved with treatment. Notably, wound packing was frequent despite RCT data for nonHS abscesses demonstrating that wound packing is unlikely to be beneficial and adds to patient discomfort. Ongoing analysis will look for associations between level of patient discomfort and other aspects of the procedure and wound care.