When is surgery indicated in the treatment of hidradenitis suppurativa (HS)?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Surgery is necessary at times, especially in chronic hidradenitis suppurativa. Wide surgical excision, with margins well beyond the clinical borders of activity, remains the most definitive surgical therapy. [5] With this technique, sufficient resection of the lesion is the most important issue. [7] Although recurrence rates may be lower with surgery that is more aggressive, recurrences continue. [10, 11] After radical excision, the disease recurred in 33% of the patients. [11] Surgery is most valuable in the chronic and recurrent stages of hidradenitis suppurativa. [5, 7]

More limited surgical intervention consisting of unroofing abscesses and sinus tracts, with vigorous curettage of the base, and secondary-intention healing can be valuable in some cases.


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