Long-term results of wide surgical excision in 106 patients with hidradenitis suppurativa
Long-term results of wide surgical excision in 106 patients with hidradenitis suppurativa
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DOI：
10.1046/j.1524-4725.2000.00043.x
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发表时间：
2000-07-01
影响因子：
2.4
通讯作者：
Petres, J
中科院分区：
文献类型：
--
作者：
Rompel, R;Petres, J
背景化脓性汗腺炎是一种慢性复发性疾病，其特征是炎症、瘘管形成和瘢痕形成。好发部位是三叉神经间区。这种病的严重病程要求及早治疗。本研究的目的是审查根治性手术切除的治愈率和潜在的并发症在一个大组的患者的影响。我们分析了106例化脓性汗腺炎患者在1980年至1998年期间接受治疗的数据。平均病程7年。在大约90%的情况下，两个或两个以上的网站受到影响。腹股沟（70.8%）和腋窝（61.3%）最常见。所有患者均行广泛根治性切除术，术中用甲基紫溶液标记窦道。重建方法取决于缺损的大小和位置。中位术后随访时间为36个月。总并发症发生率为17.8%。其中大部分为轻微并发症，如缝线裂开、术后出血和血肿。仅3.7%的患者发生伤口感染。手术野内复发率为2.5%。重建的手术方法和复发率之间没有关系。复发与疾病的严重程度有关。我们的研究结果证实早期根治性切除术作为治疗化脓性汗腺炎的选择。使用术中彩色标记的窦道，复发率是最低的。重建方法对复发没有影响，应根据切除区域的大小和位置进行选择。
BACKGROUND. Hidradenitis suppurativa (acne inversa) is a chronic recurrent disorder characterized by abscessing inflammation, fistulating sinus tracts, and scarring. Predilection sites are the intertriginal regions. The severe course of the disease demands an early and curative treatment.OBJECTIVE. The aim of this study was to review the effect of radical surgical excision concerning cure rate and potential complications within a large group of patients.METHODS. We analyzed data for 106 patients suffering from hidradenitis suppurativa treated during the period 1980-1998. The mean duration of the disease was 7 years. In about 90% of the cases, two or more sites were affected. Inguinal (70.8%) and axillary regions (61.3%) were most commonly involved. All patients were treated by radical wide excision using intraoperative marking of sinus tracts with methylviolet solution. The method of reconstruction depended on the size and location of the defect. Median postoperative follow-up time was 36 months.RESULTS. The overall complication rate was 17.8%. Most of these were minor complications such as suture dehiscence, postoperative bleeding, and hematoma. Wound infection occurred in only 3.7% of patients. The rate of recurrence within the operated fields was 2.5%. There was no relation between the surgical method of reconstruction and the rate of recurrence. Recurrence was related to the severity of the disorder.CONCLUSION. Our results confirm early radical excision as the treatment of choice for hidradenitis suppurativa. Using intraoperative color-marking of sinus tracts, the recurrence rate is minimal. The method of reconstruction has no influence on recurrence and should be chosen with respect to the size and location of the excised area.