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Surgical Management of Hidradenitis Suppurativa
Ahmed Alsayed MD
Rajiv Chandawarkar MD MBA
The Ohio State University
2024-01-31
Presenter: Ahmed Alsayed MD
Affidavit:
Resident participated in creating this manuscript with the corresponding Principal Author.
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
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. Treatment for this debilitating disease has
been medical management with antibiotics and immune modulators. With the advent of
better reconstructive surgical techniques, the role of surgery in the treatment of HS has
expanded, from being a last resort to a modality that is deployed earlier. Larger defects
can be more easily reconstructed allowing for a more radical excision of diseases areas.
Locoregional flaps, perforator flaps, and propeller flaps that use the fasciocutaneous
tissue allow reconstruction of defects with similar tissue, and provide better cosmetic
and functional outcomes. They are easy to execute and can be performed even in
resource-poor settings with concurrent use of immune modulators and postoperative
antibiotics. Hidradenitis can be successfully treated with surgery in early stages as well
as severe disease – due to the advances in understanding disease behavior, multidisciplinary
care and advanced reconstructive techniques. Coupled with a
multidisciplinary care team, surgery offers a durable, lasting cure for HS, significantly
reducing disease morbidity.
