Surgical treatment of hidradenitis suppurativa: A 10-year experience
Surgical treatment of hidradenitis suppurativa: A 10-year experience
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DOI：
10.1016/j.surg.2005.06.053
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发表时间：
2005-10-01
期刊：
影响因子：
3.8
通讯作者：
Warden, GD
中科院分区：
文献类型：
--
作者：
Kagan, RJ;Yakuboff, KP;Warden, GD
背景。化脓性汗腺炎（HS）是一种大汗腺疾病，导致慢性伤口脓肿、鼻窦和纤维化。由于许多接受治疗的患者有复发性和进行性残疾，我们试图确定哪些因素对结果影响最大，以便我们可以开发手术治疗算法。从1994年1月到2003年12月，我们确定了57例HS患者因慢性复发性HS接受手术治疗。对图表进行人口学、治疗和结局数据的回顾。平均发病年龄34岁，平均症状持续时间6.7年。三分之二的患者接受了一次或多次切开引流手术，90%的患者接受了长期抗生素治疗。88%的女性腋窝受累，一半的患者是双侧受累。87%的男性存在腹股沟会阴受累，92%的患者存在双侧受累。根据受累程度、慢性和合并症制定了手术治疗算法。92例手术，50%涉及腋窝，36%涉及会阴，14%涉及腹股沟区域。局部病变采用切除和初步闭合；广泛切除，不论有无。弥漫性病变采用植皮术。HS是一种慢性复发性疾病，经常引起致残性疼痛、活动范围缩小和社会孤立。最终的治疗包括手术切除受损伤的大汗腺组织，并应根据疾病的分期和部位进行个体化治疗。
Background. Hidradenitis suppurativa (HS) is a disease of the apocrine sweat glands resulting in chronic wounds with abscesses, sinuses, and fibrosis. Because many patients referred for treatment have both recurrent and progressive disability, we attempted to determine which factors have the greatest impact on outcome so we could develop an operative treatment algorithm.Methods. We identified 5 7 patients with HS who underwent operative treatment for chronic recurrent HS from January 1994 through December 2003. Charts were reviewed for demographic, treatment, and outcome data.Results. The mean age at presentation was 34 years and the average duration of symptoms was 6.7 years. Two thirds of the patients had undergone 1 or more incision and drainage procedures and 90% had received long-term antibiotic therapy. Axillary involvement was present in 88% of women and was bilateral in half of all patients. Inguinoperineal involvement was present in 87% of men and was bilateral in 92% of all patients. An algorithm for operative treatment was developed based on the extent of involvement, chronicity, and comorbid conditions. Ninety-two operative procedures were performed, 50% involved the axilla, 36% involved the perineum, and 14% involved the inguinal region. Excision and primary closure was used for localized disease; wide excision with or without. skin grafting was used for diffuse disease.Conclusions. HS is a chronic relapsing disease that frequently causes disabling pain, diminished range Of motion, and social isolation. Definitive treatment involves operative excision of the involved apocrine tissue and should be individualized based on the stage and location of the disease.