Surgical treatment of hidradenitis suppurativa: an analysis of postoperative outcome, cosmetic results and quality of life in 255 patients

J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1570-1574. doi: 10.1111/jdv.14892. Epub 2018 Mar 23.

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with increasing incidence. Severe disease stages are seen as a therapeutic challenge and pose the threat of significant restrictions on patients' life quality.

Objectives: We evaluated postoperative outcome after wide local excision for HS as well as postoperative course, cosmetic results, disease recurrence and quality of life.

Methods: All patients receiving radical surgical treatment for HS (Hurley III) between 2006 and 2015 were identified and received a letter-based survey. They were asked about postoperative course, cosmetic results, recurrence and life quality.

Results: Two hundred and fifty-five patients (103 men, 152 women) answered the questionnaire. Ninety-five percentage of patients reported disease-specific restrictions on everyday life. Seventy-five percentage of patients did not experience any postoperative adverse events; however, postoperative pain with need for analgesics was reported in 38%. The majority of patients (80%) were very satisfied or satisfied after surgery, and 85% of patients would recommend surgery to other affected persons.

Limitations: The retrospective design of the study was a limitation.

Conclusions: The well-known negative psychological and social effects are a relevant part of HS and emphasize the importance of immediate therapy. As long-lasting local disease-control can be achieved, surgery should be considered as first-line therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Female
  • Hidradenitis Suppurativa / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Patient Satisfaction*
  • Quality of Life*
  • Recurrence
  • Retrospective Studies
  • Social Participation
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult

Substances

  • Analgesics