Surgery under general anaesthesia in severe hidradenitis suppurativa: a study of 363 primary operations in 113 patients
- 15 January 2015
- journal article
- Published by Wiley in Journal of the European Academy of Dermatology and Venereology
- Vol. 29 (8), 1590-1597
- https://doi.org/10.1111/jdv.12952
Abstract
Treatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure.To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia.A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013. Patient satisfaction was retrospectively investigated with questionnaires.A total of 482 operations (363 primary operations and 119 re-operations) were performed during the study period. The proportion of women in the included population was 68%. The median diagnostic delay (patient's and doctor's delay) was 6.5 years. Relapses occurred after 29.2% of primary operations. Women had higher relapse rates than men [odds ratio 2.85 (1.07;7.61)]. Hypergranulation of the wound was the most common complication and occurred in 7% of all operations. The median score patients attributed to the medical effect of surgery was eight of 10 (zero corresponding to very dissatisfied and 10 to very satisfied).The diagnostic delay in HS is long due to a lack of knowledge in both patients and health care professionals, indicating that there is a need for education. Deroofing and the STEEP are effective surgical procedures in severe cases of HS and lead to a relatively high patient satisfaction. The postoperative relapse risk is higher in women. Prospective studies are required for the development of clear guidelines on the appropriate choice of surgery.Keywords
Funding Information
- AbbVie Inc.
This publication has 33 references indexed in Scilit:
- A review of wide surgical excision of hidradenitis suppurativaBMC Dermatology, 2012
- Surgical Treatment of Sinuses by Deroofing in Hidradenitis SuppurativaDermatologic Surgery, 2012
- Management of Severe Anogenital Acne Inversa (Hidradenitis Suppurativa)Dermatologic Surgery, 2012
- Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL-1βBritish Journal of Dermatology, 2011
- Long-term results of acitretin therapy for hidradenitis suppurativa. Is acne inversa also a misnomer?British Journal of Dermatology, 2010
- Surgical Treatment of Hidradenitis Suppurativa: Experiences and RecommendationsDermatologic Surgery, 2010
- Resorcinol peels as a possible self-treatment of painful nodules in hidradenitis suppurativaClinical and Experimental Dermatology, 2010
- Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severityJournal of the American Academy of Dermatology, 2009
- Endocrine basis for the clinical presentation of hidradenitis suppurativaBritish Journal of Surgery, 1988
- Mediation of hidradenitis suppurativa by androgens.BMJ, 1986