The Personal Impact of Daily Wound Care for Hidradenitis Suppurativa

Abstract

<b><i>Background:</i></b> Recurring nodules, abscesses, and lesions characterise hidradenitis suppurativa (HS): a chronic, inflammatory skin disorder. Globally the prevalence of HS is estimated to be around 1% of the population. Leakage, pain, and odour from HS wounds require substantial management. Little is known of the personal burdens that routine wound management imposes on the patient. <b><i>Objectives:</i></b> To evaluate how routine HS wound management impacts patients in terms of the time spent changing dressings, the number of dressings required per day, pain experienced during dressing changes, and negative impact on various domains of their personal lives. <b><i>Methods:</i></b> An anonymous online questionnaire was posted on closed social media patient support groups between April and May 2019. Pearson χ<sup>2</sup> test was used to evaluate if Hurley stages influenced the personal impact of wound care routines on patients. Statistical significance was determined as <i>p</i> value <0.05. <b><i>Results:</i></b> In total<i>,</i> 908 people from 28 countries responded. Of these, 81% (<i>n</i> = 734) reported that regular dressing changes negatively impacted on their quality of life. Most patients, 82% (<i>n</i> = 744), experience pain during dressing changes. 16% (<i>n</i> = 142) of patients required five or more dressings daily, and 12% (<i>n</i> = 108) spend over 30 min daily tending to wounds. Patients indicated high levels of dissatisfaction with currently available wound dressings. <b><i>Conclusion:</i></b> HS wound management imposes a substantial personal burden on patients. There is a clear unmet need for HS-specific wound dressings and wound care provisions, and a greater awareness of the condition and its impact is needed among clinicians.

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa—Part II: Procedural and Wound Care Therapies

“…HidraWear AX (HidraMed Solutions, Galway, Ireland) is a wound dressing system that combines multiple underlayer garments with adhesive-free dressings that are held in place by the underlayers. Adhesive dressings or adhesive tape can cause pain and skin injuries, and patients have reported negative impact on their quality of life related to regular dressing changes [ 3 , 66 ]. HidraWear was studied in 15 female patients with axillary HS in a single arm open label pilot study [ 3 ].…”

Innate immunity and microbial dysbiosis in hidradenitis suppurativa – vicious cycle of chronic inflammation

“…Biologics can be used in conjunction with surgical therapy in patients with severe disease to maximize clinical response ( 174 ). Surgical procedures can be focused, such as deroofing procedures or skin-sparing excision with electrosurgical peeling, or more extensive such as wide excisions, and wound management in HS remains a large burden for patients ( 175 ). Currently, there is a paucity of HS-specific wound dressing options available.…”

Immune Dysregulation and Current Targeted Biologics in Hidradenitis Suppurativa

“…As the disease advances, these lesions progress to form sinus tracts and fistulas which heal as fibrotic scars [6]. Patients experience significant reduction in their quality of life due to the pruritus, purulent drainage, disfigurement, and movement restriction associated with these lesions [7,8]. Studies show that HS patients have an increased risk of developing chronic pain, depression, and suicidal ideation [9,10].…”