Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Surgical Management of Hidradenitis Suppurativa

J Surg Res; 2018 Sep; Ruan, Chen, Singhal, et al

The management of hidradenitis suppurativa (HS) can be complex and may require a multidisciplinary surgical approach, according to a recent study that aimed to delineate the types of operations performed, the risk factors associated with these operations, and the surgical services involved based on a national database. Data were collected through the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2016. Researchers found:

  • 2,594 patients were diagnosed with HS: 1,405 (54.2%) had incision and drainage, 1,017 (39.2%) debridement, 31 (1.2%) skin graft, and 141 (5.4%) flap reconstruction.
  • There were significant differences in transfusion rates and operation time among the 4 procedures.
  • Skin graft and flap reconstruction had the highest complications and longest operation time.
  • Bleeding requiring preoperative transfusion and a number of comorbidities were significant risk factors for postoperative complications.
  • Flap reconstructions by plastic surgeons compared to general surgeons had significantly shorter operation times (134.89 vs 209.82 minutes) and lower transfusion rates (2.2% vs 12.8%).

Ruan QZ, Chen AD, Singhal D, Lee BT, Fukudome EY. Surgical management of hidradenitis suppurativa: Procedural trends and risk factors. J Surg Res. 2018;229:200-207. doi:10.1016/j.jss.2018.04.007.