Surgical treatment of chronic hidradenitis suppurativa in the gluteal and perianal regions

Abstract

The conservative treatment methods had little effect, particularly on gluteal and perianal/perineal HS. The only successful treatment was wide surgical excision. Management of the wound after wide excision should be tailored to the individual patient.

Accelerated wound healing after wide excisions in Hidradenitis Suppurativa using autologous split‐thickness skin grafting and platelet‐rich plasma

“…A recent systematic review describes lower recurrence rates with wide excision using skin flaps or skin grafts as the closure methods (14). Moreover, in the gluteal and perianal regions, complete wound healing after wide surgical excision with the use of (delayed) skin grafting was accomplished faster than wounds left open for secondary healing (15,16). In conclusion, the use of autologous SSG (from lesional HS skin that would become waste material) with the complementary application of PRP is a simple, inexpensive closure technique reducing peri-surgical morbidity and pain and to speeding up recovery after extensive HS surgery.…”

Hidradenitis suppurativa: A case series of eight patients

“…"almost to the fascia" in the other 3 cases. Most authors agree that the surgical treatment has no alternative in other types of treatments if we want to come to a definite solution of the problem [19][20][21][22]. A dilemma is whether to perform the excision to the fascia or "almost to the fascia" until the granulation begins [23].…”

Hidradenitis suppurativa/Acne inversa – operative Optionen, Rekonstruktionen und Kombinationen mit medikamentösen Therapien – Ein Update

“…Diskutiert werden Methoden mit bis zu 2 cm Sicherheitsabstand oder auch die Exzision der gesamten behaarten Haut der Region ebenso wie die Exzision bis auf die Muskelfaszie oder aber die Begrenzung der Exzision auf die makroskopisch veränderten Hautschichten [ 26 – 29 ].…”