Deroofing: A safe, effective and well-tolerated procedure in patients with hidradenitis suppurativa.

Autor: Krajewski PK; Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain.; European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany., Sanz-Motilva V; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain., Flores Martinez S; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain., Solera M; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain., Ochando G; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain., Jfri A; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia., Martorell A; Servicio de Dermatologia, Hospital de Manises, Valencia, Spain.; European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany.
Jazyk: angličtina
Zdroj: Journal of the European Academy of Dermatology and Venereology : JEADV [J Eur Acad Dermatol Venereol] 2024 May; Vol. 38 (5), pp. 931-936. Date of Electronic Publication: 2024 Jan 26.
DOI: 10.1111/jdv.19810
Abstrakt: Introduction: Hidradenitis suppurativa (HS) is a recurrent, debilitating, chronic disorder of the pilosebaceous unit. Although advances in HS treatment have been made, more than 45% of patients remain dissatisfied with systemic treatment, and more than one-third are dissatisfied with surgical procedures.
Objectives: A prospective, observational study on the deroofing procedures in HS with special attention paid to patient satisfaction and complications.
Methods: HS lesions were assessed clinically and by the use of ultrasound. Patients reported outcomes, including pain, itch and satisfaction, were measured at 24 h post-surgery by a numeric rating scale (NRS) ranging from 0 to 10. Additionally, the timeline of objective wound closure reported by patients in (weeks), in addition to the need for any analgesics use, were both evaluated.
Results: The mean closure time of the post-deroofing wound was assessed as 4.4 ± 1.9 weeks. A statistically longer time was necessary for complete closure in males than in females (4.9 ± 2.2 weeks and 3.9 ± 1.6 weeks, respectively; p = 0.046). The closure time correlated positively yet weakly with the HS tunnel's width (r = 0.27, p = 0.016) and length (r = 0.228, p = 0.044). Patients assessed mean pain at 24 h post-op as mild with 0.7 ± 1.2 points according to NRS, with no differences between sexes. Similarly, itch in the first 24 h was assessed as mild with 1.8 ± 1.1 points, without differences between sexes. No pain, itch or adverse events were reported after 1 week following deroofing. Moreover, no cases of wound infection were reported. An overall patient satisfaction was assessed as 9.9 ± 0.4 points (range 9-10 points).
Conclusion: Deroofing is an easy, effective and safe dermatosurgical procedure that does not require surgical experience or operating theatre. It is associated with no complications and very low post-op pain and should be part of holistic HS management.
(© 2024 European Academy of Dermatology and Venereology.)
Databáze: MEDLINE
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