Author(s): Mehdizadeh A, Hazen PG, Bechara FG, Zwingerman N, Moazenzadeh M, Bashash M, Sibbald RG, Alavi A
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of apocrine-bearing skin. Treatment is challenging and long-standing. Surgery is one of the treatment options with varying reported success rates.
OBJECTIVE: This study provides a comprehensive systematic review of surgical approaches in the management of HS.
METHODS: A systematic literature search and meta-analysis of proportions were performed on the included studies.
RESULTS: Of a total of 1147 retrieved articles, 22 were included in the analysis. These were the estimated average recurrences: wide excision, 13.0% (95% confidence interval [CI], 5.0-22.0%); local incision, 22.0% (95% CI, 10.0-37.0%); and deroofing, 27.0% (95% CI, 23.0-31.0%). In the wide excision group, recurrence rates were as follows: 15% (95% CI, 0-72%) for primary closure, 8% (95% CI, 2.0-16.0%) for using flaps, and 6.0% (95% CI, 0.0-24.0%) for grafting. The secondary intention healing option was most commonly chosen after local excision and deroofing.
LIMITATIONS: There was poor quality evidence and potential improper reporting of the results.
CONCLUSION: This systematic review found lower recurrence rates with wide excision, using skin flaps or skin grafts as the closure methods. The heterogeneity of the patient populations was high and statistically significant within and across all types of excisions.
Dermatology Journal and/or Publisher
Journal Name: Journal of the American Academy of Dermatology
Journal Abbreviation: J. Am. Acad. Dermatol.
Journal Date Published: 2015-10-16
National Center for Biotechnology Information
Article Source: http://www.ncbi.nlm.nih.gov/pubmed/26470621
Lasted Revision: 2015-10-16
Abstract Source: National Center for Biotechnology Information, U.S. National Library of Medicine Abstract Query for Hidradenitis suppurativa (HS).