Surgical treatment of extensive perianal hidradenitis

2020 ◽  
Vol 99 (9) ◽  
Keyword(s):  
Surgical Treatment ◽  
Hidradenitis Suppurativa ◽  
Soft Tissues ◽  
Case Reports ◽  
Radical Excision ◽  
Skin Flaps ◽  
Perianal Area ◽  
Apocrine Glands ◽  
Patient Preparation ◽  
Two Stages

Introduction: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurative, and fistulising disease of apocrine glands, adjacent anal canal and soft tissues. Perianal area is the second most common affected area after axilla. There are three grades of the disease. Hidradenitis suppurativa represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses, followed by the formation of sinus tracts and subsequent scarring. Perianal hidradenitis suppurativa is the last and the most serious grade of the disease and a specific access is needed for patient preparation and surgical treatment alone. The currently preferred method of treatment for patients with extensive perianal hidradentitis is excision and closure with combination of skin flaps, primary suture and skin graft in one or two stages. Case reports: There are three case reports of perianal hidradenitis suppurativa in this article. The local and overall initial treatment of patients followed by a radical excision and closure with a rotation skin flaps and skin grafts is described. The final results were satisfactory, with no recurrence or serious complication.

scholarly journals Multi-stage surgical treatment of extensive gluteal localized hidradenitis suppurativa combined with negativ pressure wound therapy

2021 ◽  
Vol 97 (1) ◽  
pp. 56-63
Author(s):  
Tímea Pálházy ◽  
◽  
Stephan Bennemann ◽  
András Fülöp ◽  
L. Hunor Gergely ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Graft ◽  
Negative Pressure ◽  
Hidradenitis Suppurativa ◽  
Successful Outcome ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Apocrine Glands ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Hidradenitis suppurativa (HS) is a chronic, recurrent infammatory disease of the hair follicles in the skinfolds containing apocrine glands, which greatly impairs the quality of life of patients. The fnal solution in extensive cases is surgical treatment. There is no ideal treatment or uniform therapeutic template equally suitable for all patients. Treatment is personalized. In this paper, we present the case of a 53-year-old patient who underwent a two-stage surgical treatment for therapy-resistant HS, Hurley stage III, causing permanent complaints. During the frst surgery, the fstula openings were flled with methylene blue, then the skin and the scary subcutaneous tissue were excised, and after 10 days, in a second step, the surgical site was covered with split thickness skin graft from the back. After both surgeries, negative pressure wound therapy (NPWT) was initiated. After the applied treatment, 98-100% graft adhesion was observed, and the patient was emitted without complaints after 3 weeks. Our case illustrates that in cases where the prospects for fap replacement in HS are poor or the healing tendency of the faps is questionable (infective wound base, poor quality surrounding skin), split thickness skin grafting combined with negative pressure therapy may be less stressful and provides a successful outcome. The combined treatment (NPWT + split thickness skin graft) is excellent not only for clearing and stimulating the wound base, but also provides an excellent wound base and allows successful wound closure / coverage, signifcantly shortening the duration of the long and cumbersome open treatment has been used so far. In this case, NPWT treatment can also be considered as a “bridging” step.

scholarly journals A Novel Technique for the Treatment of a Case of Verneuil's Disease of Perineum and Axillary Regions

2021 ◽  
Vol 07 (03) ◽  
pp. e163-e167
Author(s):  
Etienne El-Helou ◽  
Alaa Kansoun ◽  
Elissa Abi Fadel ◽  
Ali Nassif ◽  
Houssam Bashir Mazraani ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Inflammatory Disease ◽  
Hidradenitis Suppurativa ◽  
Care Management ◽  
Daily Life ◽  
Chronic Inflammatory Disease ◽  
Apocrine Glands ◽  
Novel Technique

AbstractHidradenitis suppurativa (HS) is a chronic inflammatory disease involving apocrine glands of the skin. It carries out an important burden on the daily life of the patient. Unfortunately, it presents a major concern for medical care management in the absence of clear guidelines for proper medical and surgical treatment. Hence, we report a case of concomitant axillary and perianal HS. We opted for surgical management using a novel technique, which proved efficacy for a year of follow-up recurrence free.

Axillary Hidradenitis Suppurativa: A Further Option for Surgical Treatment

2004 ◽  
Vol 8 (1) ◽  
pp. 6-10 ◽  
Author(s):  
S. Altmann ◽  
H. Fansa ◽  
W. Schneider
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Hidradenitis Suppurativa ◽  
Donor Site ◽  
High Rate ◽  
Radical Excision ◽  
Limberg Flap ◽  
Transposition Flap ◽  
Split Skin Grafting ◽  
Axillary Hidradenitis Suppurativa

Background:Hidradenitis suppurativa is a chronic inflammatory disease of the cutis with furuncles, fistulas, and abscesses. The disease is mostly located in groin and axilla. As conservative treatment can usually not prevent recurrence, surgical treatment is the method of choice.Methods:We report on 20 patients with axillary hidradenitis suppurativa. The inflammatory region was excised in a rhomboid shape and immediately covered with a transposition flap according to Limberg. Postoperatively, all patients received antibiotic treatment and immobilization of the arm. Physiotherapy started after 2 weeks.Results:No flap complications occurred. The functional and aesthetic results were very satisfactory. Movement of shoulder showed no restrictions. A recurrence with single fistulas was seen in 3 patients.Conclusions:Conservative treatment of hidradenitis suppurativa is followed by a high rate of recurrence. Only radical debridement offers a cure. The therapy of choice is the radical excision of the affected region and immediate coverage with a flap. Open granulation or split skin grafting often results in a prolonged hospitalization, higher morbidity, and functional problems. Thus, open granulation is inferior to primary closure by a transposition flap. Using the Limberg flap, the donor site is allowed to be closed primarily.

Hemangiomatosis of the greater omentum – a case report

2019 ◽  
Vol 98 (4) ◽  
pp. 178-180
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Histological Examination ◽  
Case Reports ◽  
Greater Omentum ◽  
Surgical Removal ◽  
Consumption Coagulopathy ◽  
Cavernous Hemangiomas ◽  
Mesodermal Origin ◽  
Benign Tumours

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

Seven Years' Outcome of Simultaneous Surgical Treatment of Atrial Septal Defect and Atrial Flutter in 2 Children: Case Reports

2010 ◽  
Vol 13 (2) ◽  
pp. E105-E107
Author(s):  
Valquiria Pelisser Campagnucci ◽  
Ana Maria Rocha Pinto ◽  
Argemiro Scatolini Neto ◽  
Liane Huile Catani ◽  
Maria Lucia Bastos Passarelli ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Atrial Septal Defect ◽  
Atrial Flutter ◽  
Septal Defect ◽  
Case Reports

scholarly journals Cutaneous Squamous Cell Carcinoma in Patients with Hidradenitis Suppurativa

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1153
Author(s):  
Elysia Racanelli ◽  
Abdulhadi Jfri ◽  
Amnah Gefri ◽  
Elizabeth O’Brien ◽  
Ivan Litvinov ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Hidradenitis Suppurativa ◽  
Case Reports ◽  
Rare Complication ◽  
Cox Proportional Hazards ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Statistical Hypothesis ◽  
Statistical Hypothesis Testing

Background: Cutaneous squamous cell carcinoma (cSCC) is a rare complication of hidradenitis suppurativa (HS). Objectives: To conduct a systematic review and an individual patient data (IPD) meta-analysis to describe the clinical characteristics of HS patients developing cSCC and determine predictors of poor outcome. Methods: Medline/PubMed, Embase, and Web of Science were searched for studies reporting cSCC arising in patients with HS from inception to December 2019. A routine descriptive analysis, statistical hypothesis testing, and Kaplan–Meier survival curves/Cox proportional hazards regression models were performed. Results: A total of 34 case reports and series including 138 patients were included in the study. The majority of patients were males (81.6%), White (83.3%), and smokers (n = 22/27 reported) with a mean age of 53.5 years. Most patients had gluteal (87.8%), Hurley stage 3 HS (88.6%). The mean time from the diagnosis of HS to the development of cSCC was 24.7 years. Human papillomavirus was identified in 12/38 patients tested. Almost 50% of individuals had nodal metastasis and 31.3% had distant metastases. Half of the patients succumbed to their disease. Conclusions: cSCC is a rare but life-threatening complication seen in HS patients, mainly occurring in White males who are smokers with severe, long-standing gluteal HS. Regular clinical examination and biopsy of any suspicious lesions in high-risk patients should be considered. The use of HPV vaccination as a preventive and possibly curative method needs to be explored.

scholarly journals Maternal Bochdalek Hernia during Pregnancy: A Systematic Review of Case Reports

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1261
Author(s):  
Jin-Young Choi ◽  
Song-Soo Yang ◽  
Jong-Hwa Lee ◽  
Hyun-Jin Roh ◽  
Jun-Woo Ahn ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Case Reports ◽  
Expectant Management ◽  
Bochdalek Hernia ◽  
Hernia Surgery ◽  
Maternal Deaths ◽  
Individualized Care ◽  
Non Surgical Treatment ◽  
Simultaneous Delivery

Background: Since the first report of a diaphragmatic hernia from Ambroise Paré’s necropsy in 1610, the Bochdalek hernia (BH) of the congenital diaphragmatic hernia (CDH) has been the most common types with high morbidity and mortality in the neonatal period. Due to the nature of the disease, CDH associated with pregnancy is too infrequent to warrant reporting in the literature. Mortality of obstruction or strangulation is mostly due to failure to diagnose symptoms early. Data sources and study selection: A systematic literature search of maternal BH during pregnancy was conducted using the electronic databases (PubMed and EMBASE) from January 1941 to December 2020. Because of the rarity of the disease, this review included all primary studies, including case reports or case series that reported at least one case of maternal BH in pregnant. Searches, paper selection, and data extraction were conducted in duplicate. The analysis was performed narratively regardless of the control groups’ presence due to their rarity. Results: The search retrieved 3450 papers, 94 of which were deemed eligible and led to a total of 43 cases. Results of treatment showed 16 cases in delayed delivery after hernia surgery, 10 cases in simultaneous delivery with hernia surgery, 3 cases in non-surgical treatment, and 14 cases in hernia surgery after delivery. Of 16 cases with delayed delivery after hernia surgery, 13 (81%) cases had emergency surgery and three (19%) cases had surgery after expectant management. Meanwhile, 10 cases underwent simultaneous delivery with hernia surgery, 6 cases (60%) had emergent surgery, and 4 cases (40%) had delayed hernia surgery after expectant management. 3 cases underwent non-surgical treatment. In this review, the maternal death rate and fetal/neonatal loss rate from maternal BH was 5% (2/43) and 16% (7/43), respectively. The preterm birth rate has been reported in 35% (15/43) of maternal BH, resulting from maternal deaths in 13% (2/15) of cases and 6 fetal loss in 40% (6/15) of cases; 44% (19/43) of cases demonstrated signs of bowel obstruction, ischemia, or perforation of strangulated viscera in the operative field, resulting from maternal deaths in 11% (2/19) of cases and fetal-neonatal loss in 21% (4/19) of cases. Conclusion: Early diagnosis and surgical intervention are imperative, as a gangrenous or non-viable bowel resection significantly increases mortality. Therefore, multidisciplinary care should be required in maternal BH during pregnancies that undergo surgically repair, and individualized care allow for optimal results for the mother and fetus.

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jurr Boer
Keyword(s):  
Total Dose ◽  
Hidradenitis Suppurativa ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Postal Survey ◽  
Long Term Follow Up ◽  
Late Treatment

<b><i>Background:</i></b> Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. <b><i>Objectives:</i></b> To evaluate the long-term efficacy of RT in early-stage HS. <b><i>Methods:</i></b> A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. <b><i>Results:</i></b> The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. <b><i>Conclusions:</i></b> RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

Sign in / Sign up

Export Citation Format

Share Document