Split-thickness skin grafts and negative-pressure dressings in the treatment of axillary hidradenitis suppurativa

Hynes, Patrick; Earley, Michael; Lawlor, D.

doi:10.1054/bjps.2002.3899

Cited by 38 publications

(41 citation statements)

References 13 publications

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“…Some of these studies were summarized in the Introduction, and our literature search has revealed many others including prospective studies, 20,22,24,29 cohort studies and small case series with no control, [9][10][11]14,15,21,25,[31][32][33][34][35][36] and retrospective studies. 12,13,19,[26][27][28]30 These investigations have been useful to find ways to improve treatment success for high-risk wounds; however, their results cannot necessarily be extrapolated to all patients and all wound types.…”

Section: Discussionmentioning

confidence: 99%

“…Strict relative immobility of the grafted tissue to the wound bed with minimization of shear stress is also important for graft survival, and the uniform compression provided by NPD is an excellent way to achieve this goal, especially around joints that would otherwise require immobilization or areas that are difficult to immobilize. [8][9][10][11][12][13][14][15] Prevention of exudate accumulation and hematoma formation at STSG sites is likely a mechanical benefit of NPD maintaining compression between the graft and the wound bed because reduction in bacterial load has not been found. [16][17][18] Finally, the water tight seal of NPD helps to prevent graft desiccation.…”

Section: Introductionmentioning

confidence: 99%

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Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Kempton¹,

Larson²,

Montijo³

et al. 2015

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Kempton¹,

Larson²,

Montijo³

et al. 2015

Journal of Orthopaedic Trauma

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“…Rarely, the chronic inflammation results in malignant transformation to squamous cell carcinoma 10. In such a developed phase, antibiotics are usually ineffective alone and surgical treatment is required 4,9,14…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Hidradenitis Suppurativa

Menderes¹,

Sunay²,

Vayvada³

et al. 2010

Int. J. Med. Sci.

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Background: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands.Method: This study reviewed 54 sites in 27 patients with moderate to extensive chronic inflammatory skin lesions treated surgically in our hospital from 2004 through 2009, with a follow-up of at least 6 months.Result: A total number of 54 operative procedures were performed during the study period with 42% (23 sites) involving the axilla, 20% (11 sites) involving the gluteal area, %24 (13 sites) involving the perineal area and 12% (7 sites) involving the inguinal region.Conclusion: Conservative treatment methods have little or no effects especially on gluteal, perineal/perianal, axillary hidradenitis suppurativa. The morbidity associated with the established form of this disease is significant, and the only successful treatment is wide surgical excision.

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“…Para além disso todos eles deixam uma grande cicatriz, inestéti-ca 8 e ficam muito salientes na axila. 12 A considerar também é a superior taxa de recorrência associada à reconstrução com retalhos relativamente ao enxerto de pele.…”

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Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study

Ribeiro¹,

Guerra²

2018

Acta Med Port

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59 RESUMOA hidrosadenite supurativa é uma doença inflamatória crónica com grande impacto a nível físico e psicológico. Apesar de tratamentos conservadores serem utilizados em casos de doença ligeira, nos casos mais graves preconiza-se a excisão alargada da área afetada e posterior reconstrução. O objetivo deste trabalho é descrever o nosso procedimento reconstrutivo em dois passos para o tratamento deste tipo de lesões. ABSTRACT Hidrosadenitis supurativa is a chronic inflammatory disease with great physical and psychological impact. Although conservative treatments may be effective in mild forms of the disease, extensive surgical resection and reconstruction are necessary in more severe forms of the disease. The purpose of this paper is to describe our two-stage reconstructive procedure regarding this kind of disease.We present a clinical case of a patient with severe, bilateral axillary hidrosadenitis. In the first surgical step we excised the lesions and applied the artificial dermis secured with negative pressure wound therapy. In the second step we used a split thickness skin graft to close the wound and again applied negative pressure wound therapy. The graft take was very good, without complications. The cosmetic outcome is acceptable and shoulder mobility was not compromised. No recurrence was detected (nine months follow up). Keywords: Hidradenitis Suppurativa; Negative-Pressure Wound Therapy; Skin Transplantation INTRODUÇÃOA hidrosadenite supurativa é uma doença inflamatória crónica da pele caracterizada por abcessos recorrentes, trajectos fistulosos e cicatrização anómala.1 A doença afeta a pele que contem glândulas apócrinas, mais frequentemente envolvendo as regiões axilares e a região ano-genital. 2A fisiopatologia da doença ainda não foi completamente esclarecida, mas pensa-se que a oclusão do folículo piloso, seguida de dilatação e subsequente rutura da unidade pilosebácea seja importante.1 Algumas potenciais influências incluem a suscetibilidade genética, o tabagismo e a obesidade, alterações endócrinas e fatores microbiológicos. 3O diagnóstico da doença é clínico e a gravidade é frequentemente classificada de acordo com os estádios de Hurley. 4O tratamento pode ser dividido, genericamente, em médico ou cirúrgico. O tratamento médico inclui terapias tópicas e/ou sistémicas com antibióticos, corticóides e agentes biológicos.5 No entanto, a excisão cirúrgica das lesões com margens livres adequadas é o tratamento gold--standard para prevenir recorrências.6 Existem várias opções reconstrutivas, não consensuais, desde o encerramento primário até à cobertura com retalhos locais/livres. O objetivo deste trabalho é descrever o nosso procedimento reconstrutivo em dois passos para o tratamento deste tipo de lesões. CASO CLÍNICOApresentamos o caso clínico de uma doente do sexo feminino, 21 anos, raça caucasiana, com uma história prévia de cinco anos de sintomatologia compatível com hidrosadenite supurativa (abcessos recorrentes com drenagem). A doente tinha sido seguida em consulta de Dermatologia e realiza...

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Split-thickness skin grafts and negative-pressure dressings in the treatment of axillary hidradenitis suppurativa

Cited by 38 publications

References 13 publications

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Surgical Management of Hidradenitis Suppurativa

Hidradenitis Suppurativa: Combined Treatment with Dermal Template, Skin Graft and Negative Pressure Wound Therapy, a Case Study

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