Surgical Interventions for the Treatment of Hidradenitis Suppurativa: A Systematic Review of Surgical Impact on DLQI
Sarah Moffitt, Mehdi Rizk, Nicholas Alford, Richard J. Rivera, Aleena Boby, Meredith Moore, Kinsey Rice, Kristen Whalen, Nicole K. Le, Brielle WeinsteinBACKGROUND
Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by painful cutaneous nodules, abscesses, and fistulas in regions containing apocrine glands.
OBEJECTIVE
This study reviews the literature on surgical interventions of hidradenitis suppurative and their effect on quality of life.
PATIENTS AND MATERIALS/METHODS
A systematic review was performed in accordance with PRISMA using Dermatologic Life Quality Index as our primary outcome. Search terms included ‘hidradenitis suppurativa” and “DLQI.” Eight surgical studies were included.
RESULTS
Wide local excision has the shortest operative time but carries a risk of recurrence and requires daily wound care if left to secondary intention. Wide local excision with a skin graft does not seem to have any advantages over alternative methods. Photodynamic therapy after wide local excision showed promising results but requires consistent follow-up and access to the therapy. For the axilla, wide local excision with either a thoracodorsal artery perforator flap or muscle-sparing latissimus dorsi flap may be most effective at maintaining a relatively smooth postoperative course and preventing recurrence.
CONCLUSION
Surgery greatly improves the lives of patients with hidradenitis suppurativa. Each surgical technique carries their own risks and benefits for postoperative outcomes.