Recurrence Rates Following Reconstruction Strategies After Wide Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis
| Autor: | Mislav Zugaj, Chantal M.A.M. van der Horst, Zachri N. Ovadja, Wilco Jacobs, Oren Lapid |
|---|---|
| Přispěvatelé: | Plastic, Reconstructive and Hand Surgery, ACS - Atherosclerosis & ischemic syndromes, AMS - Musculoskeletal Health, AMS - Rehabilitation & Development, ACS - Diabetes & metabolism, AMS - Amsterdam Movement Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Wide excision Umbilicus (mollusc) Treatment outcome MEDLINE Dermatology Surgical Flaps law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Recurrence law medicine Humans Hidradenitis suppurativa Wound Healing business.industry Skin Transplantation General Medicine Plastic Surgery Procedures medicine.disease Confidence interval Hidradenitis Suppurativa Surgery 030220 oncology & carcinogenesis Meta-analysis business |
| Zdroj: | Dermatologic surgery, 47(4), e106-e110. Wolters Kluwer Health |
| ISSN: | 1076-0512 |
| Popis: | BACKGROUND: Wide excision (WE) is generally considered to be the most common treatment for recurrent hidradenitis suppurativa. When performed, excision is followed by decisions regarding best options for management of the surgical defect. Different reconstructive strategies (RSs) have been used, with varying rates of recurrence. OBJECTIVE: To provide an up-to-date systematic review of the complete literature for different RS after WE and their recurrence rates. METHODS: A systematic literature search of the complete available literature and a meta-analysis of proportions were performed on the included studies. RESULTS: Of a total of 1,813 retrieved articles, 79 were included in the analysis. Most were retrospective analyses, with only one randomized controlled trial (RCT) and 7 prospective analyses. The RS described were divided into primary closure (PC), secondary intention healing (SIH), skin graft (SG), and fasciocutaneous flaps (FCF). The average estimated recurrence for PC was 22.0% (95% confidence interval [CI], 8.0%-40.0%), for SIH 11.0% (95% CI, 5.0%-20.0%), for SG 2.0% (95% CI, 0.0%-5.0%), and for FCF 2.0% (95% CI, 1.0%-5.0%) (p < .001). Hidradenitis suppurativa below the umbilicus was significantly associated with overall recurrence (p = .006). Quality of evidence was poor, and the reporting of results was mostly heterogeneous. CONCLUSION: After WE, PC has the highest recurrence rates, whereas SG and FCF have the lowest rates. There is a need for more RCTs and guidelines, to be able to report uniformly on treatment outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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