Purpose: Suppurative hidradenitis is a chronic relapsing inflammatory disease that affects the apocrine sweat glands. Therefore, it is most often located in the axilla, groin and perianal area. Usually, people of working age affected. Perineal and perianal locations cover about 37% of the total morbidity rate and are more common in males. The objective of this study was to share our experience with the application of deroofing for the treatment of purulent perineal hidradenitis.
Material and methods: This prospective interventional study covered 13 patients with suppurative fistulasing hidradenitis of perineum treated in Division of Coloproctology and Septic Surgery, Georgi Stranski University Hospital of Pleven for the period from 2008 till 2013.
Results: The interval between the occurrence of disease and its surgical treatment was very long - from two to 36 years (average of 9,2 years). It resulted from the progression of the disease with enlarged soft tissue involvement. Sometimes, the disease was complicated by chroniosepsis. The average hospital stay was 13,5-day long. Operative wounds healed secondarily at an average of about 30 days. The patients were followedup for six months, one year and two years. Two patients with relapses on the sixth postoperative month were hospitalized again. The surgical intervention warranted good results.
Conclusion: Treatment of suppurative hidradenitis of the perineum is complex, both in terms of local status and systematic violations resulting in chronic infection. There are numerous surgical techniques for treating this pathology. The advantages of deroofing are the following: minimal trauma to the patient, application by using local anesthesia at the early stage in order to minimize hospital stay, no need of special equipment, a lower recurrence rate than the other methods and formation of aesthetically acceptable scar.
Alharbi, Z., J. Kauczok, N. Pallua. A review of wide
surgical excision of hidradenitis suppurativa.- BMC
Dermatol., 12, 2012, No 9, 1-8.
Culp, C. E. Chronic hidradenitis suppurativa of the
anal canal: a surgical skin disease.- Dis. Colon Rectum,
, 1983, No 10, 669-676.
Mustafa, E. B., S. D. Ali, L. H. Kurtz. Hidradenitis
suppurativa: review of the literature and management
of the axillary lesion.- J. Natl Med. Assoc., 72, 1980,
No 3, 237-243.
Thornton, J. P., H. Abcarian. Surgical treatment of
perianal and perineal hidradenitis suppurativa.- Dis.
Colon Rectum, 21, 1978, No 8, 573-577.
van der Zee, H. H, E. P. Prens, J. Boer. Deroofing: A
tissue-saving surgical technique for the treatment of
mild to moderate hidradenitis suppurativa lesions.- J.
Am. Acad. Dermatol., 63, 2010, No 3, 475-480.
van der Zee, H. H. Hidradenitis suppurativa:
pathogenesis and treatment. PhD thesis. Rotterdam,
Erasmus Universiteit Rotterdam, 2011, 208 p.
Verneuil, A. Etudes sur les tumeurs de la peau: de
quilques maladies des glandes sudoripares.- Arch.
Gen. Med., 2, 1854, 447-468.
Wiltz, O., D. J. Schoetz, Jr., J. J. Murray, P. L. Roberts,
J. A. Coller, M. C. Veidenheimer. Perianal hidradenitis
suppurativa. The Lahey Clinic experience.- Dis.
Colon Rectum, 33, 1990, No 9, 731-734.
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