Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Several medical treatments, with varying degree of efficacy, have been developed. However, in most cases of advanced (HS), the definitive treatment option is often represented by surgical excisions. Surgical techniques, reconstructive approach, and local wound care should be accurately designed in order to obtain the best result. In this letter, we analyzed the possible surgical treatments and local wound care. A literature review was performed on the various surgical treatments, reconstructive techniques, and local wound care. Surgical treatment is a common therapeutic modality for HS. Different surgical reconstructive techniques and postsurgical wound care approaches are described for the management of HS patients. There were few high-quality evidence-based studies evaluating the surgical management of HS. Many disparate HS severity scores were used in these studies making comparison between them difficult. Nonetheless, research into different surgical approaches and wound care management has increased substantially in the past decade and has given patients more surgical therapeutic strategies. The description of the best combinations and timing of surgery, wound care and medical therapies, will be a matter of future research for the definition of the optimal management of HS patient.

Highlights

  • Hidradenitis suppurativa (HS) is a chronic inflammatory disorder

  • Primary suture is mostly done in the “mild” variety of the disease and it is appropriate only in case of minor defects surrounded by lax skin

  • The goal of postoperative care in large wounds left for Secondary intention healing (SIH) is to maintain a moist and clean wound, achieved with wound dressing changes, hydrotherapy and physical therapy

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Summary

Secondary intention healing

Secondary intention healing (SIH) is the most elemental form of wound closure and the most basic technique in the reconstructive ladder. This approach may be successful both in narrow wounds produced by deroofing and in larger surgical defects, resulting from wide excision. SIH of large wounds has many advantages, including scars that have considerably smaller dimensions in comparison with the initial defect, lack of donor sites, no flap or graft loss and an acceptable range of motion. Disadvantages include the relatively long healing times, painful dressing changes, need for meticulous wound care, and risk of wound contracture, with large excisions

Artificial dermis and skin graft
Postsurgical wound care
Primary suture and flap
| CONCLUSION
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