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J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1590-7. doi: 10.1111/jdv.12952. Epub 2015 Jan 15.

Surgery under general anaesthesia in severe hidradenitis suppurativa: a study of 363 primary operations in 113 patients.

Author information

1
Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
2
Department of Dermatology, Antonius Hospital, Sneek, The Netherlands.
3
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Abstract

BACKGROUND:

Treatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure.

OBJECTIVES:

To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia.

METHODS:

A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013. Patient satisfaction was retrospectively investigated with questionnaires.

RESULTS:

A total of 482 operations (363 primary operations and 119 re-operations) were performed during the study period. The proportion of women in the included population was 68%. The median diagnostic delay (patient's and doctor's delay) was 6.5 years. Relapses occurred after 29.2% of primary operations. Women had higher relapse rates than men [odds ratio 2.85 (1.07;7.61)]. Hypergranulation of the wound was the most common complication and occurred in 7% of all operations. The median score patients attributed to the medical effect of surgery was eight of 10 (zero corresponding to very dissatisfied and 10 to very satisfied).

CONCLUSION:

The diagnostic delay in HS is long due to a lack of knowledge in both patients and health care professionals, indicating that there is a need for education. Deroofing and the STEEP are effective surgical procedures in severe cases of HS and lead to a relatively high patient satisfaction. The postoperative relapse risk is higher in women. Prospective studies are required for the development of clear guidelines on the appropriate choice of surgery.

PMID:
25589154
DOI:
10.1111/jdv.12952
[Indexed for MEDLINE]

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