Document Detail


Gluteal and perianal hidradenitis suppurativa: surgical treatment by wide excision.
MedLine Citation:
PMID:  12847371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Hidradenitis suppurativa is a chronic inflammatory disease of the skin and subcutaneous tissue. Extensive gluteal and perianal disease represents a challenge presentation. The aim of this study was to present results of management of extensive hidradenitis suppurativa in gluteal, perineal, and inguinal areas. METHODS: From January 1980 to May 2000, 56 patients underwent treatment of hidradenitis suppurativa in gluteal, perineal, and inguinal areas through wide excision; 52 (93 percent) were male and 36 (64 percent) were white. Mean age was 40 years. We evaluated distribution of disease, associated conditions, use of diverting colostomy, management of operative wounds, time to complete healing, complications, and recurrence. RESULTS: Twenty-one (37.6 percent) and 17 (30.6 percent) patients had gluteal and perineal disease, respectively. Squamous-cell carcinoma and Crohn's disease were observed in one patient each. Wide surgical excision was performed in all. Healing by second intention was the choice in 32 (57.1 percent) patients, and 24 (42.9 percent) patients underwent delayed skin-grafting. Diverting colostomy was used in 23 (41 percent) patients. Mean time for complete healing in the nongrafted group was 10 (range, 7-17) weeks and in the skin graft group was 6 (range, 3-9) weeks. New resection was performed in five (8.9 percent) patients. Partial graft loss rate was 37.5 percent and recurrence was observed in only one (1.8 percent) patient. CONCLUSION: Significant morbidity derives from extensive gluteal and perineal hidradenitis suppurativa caused by the disease extension and large wounds that result from surgical treatment. Wide surgical excision is the treatment of choice and leads to cure. Skin-grafting and healing by second intention lead to effective wound healing.
Authors:
Sylvio F Bocchini; Angelita Habr-Gama; Desidério R Kiss; Antonio R Imperiale; Sergio E A Araujo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  46     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-08     Completed Date:  2003-09-02     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  944-9     Citation Subset:  IM    
Affiliation:
Division of Colorectal Surgery, University of São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anal Canal
Buttocks
Colostomy
Female
Groin
Hidradenitis Suppurativa / surgery*
Humans
Male
Middle Aged
Skin Transplantation
Surgical Procedures, Operative / methods*
Wound Healing / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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