N. Nweze1, R. Ahuja1, A. Parsikia1, L. Force1, L. Cetrulo1, J. Strain1, A. R. Joshi1,2 1Einstein Healthcare Network,Surgery,Philadelphia, PA, USA 2Jefferson Medical College,Surgery,Philadelphia, PA, USA
Introduction:
Hidradenitis suppurativa (HS) is a chronic, inflammatory cutaneous disease of the apocrine sweat glands, most commonly in the axilla. Surgical treatments for HS include incision and drainage or surgical excision with or without closure.
Methods:
We reviewed 214 patients (with 293 surgical procedures) with axillary HS who underwent surgical intervention. We divided the cohort into two groups based on recurrence, and then compared them.
Results:
The mean age of onset of HS was 32.5 years. Females comprised 84.1% of the cohort. Average BMI was 33.37. 55% of patients smoked. 19.2% of patients had diabetes. 1.9% of patients had a positive MRSA history. 35.5% of patients had bilateral axillary disease, and 9.3% had extra-axillary disease. The vast majority (93.5%) of interventions included excision of the diseased area, with a median area of excision of 78cm2. 45.4% of these wounds were closed, 48.8% were allowed to heal by secondary intention, and 4.8% were treated with a vacuum device. 22/214 (10.3%) of patients had recurrent disease. Closure vs. non-closure was not associated with a proclivity towards recurrence. Recurrence after surgical treatment was significantly associated with extra-axillary disease (p=0.039).
Conclusion:
Patients with HS were overwhelmingly obese and female, and many of them smoked. Surgical excision was the most common intervention, and closure was employed in roughly half of patients. Recurrence after excision, albeit uncommon, was associated with extra-axillary disease, but not closure after excision. These characteristics may be helpful in counseling patients about risk of recurrence and overall prognosis.