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- Presentation
HS Surgery from Start to Finish: Planning, Procedures, and Post-op Care
Description
The presentation focuses on the comprehensive process of managing surgeries for patients with hidradenitis suppurativa (HS), from planning to post-operative care. The speaker shares insights from six years of surgical experience, highlighting the benefits of second intention healing for certain wounds, particularly in concave anatomical areas, leading to rapid healing with fewer complications compared to traditional closure methods. Addressing post-operative care, the discussion covers common complications such as hypergranulation and fibrinous slough, advocating for moisture and occlusion but also the importance of airing wounds as they heal. Specific strategies for wound care, including the use of simple dressings like Vaseline, and patient education about the healing process, are emphasized. Approaches to manage complications are detailed, including methods to address bleeding during and post-surgery, and treating hypergranulation tissue with airtime and topical steroids. The presentation concludes with an invitation for questions, encouraging an open discussion about experiences in managing HS surgeries.
View moreConclusions
- Second intention healing can result in fewer complications and lower recurrence rates compared to traditional closure methods.
- Complexities in wound healing vary based on the wound's depth, width, and anatomical concavity.
- Patients should be carefully prepared for the visual impact of open healing to reduce anxiety and alarm after surgery.
- Initial management of open wounds should focus on moisture and occlusion, avoiding excessive dampness that can lead to hypertrophic granulation tissue.
- Common post-operative complications include bleeding, hypergranulation, and infection, with bleeding being the most frequent issue.
- Hypergranulation can often be managed effectively with increased air exposure and topical treatments.
- Fibrinous debris is a frequent obstacle in healing and can benefit from manual debridement and moisture management strategies.
- Overall, patient satisfaction remains high even when outcomes are not perfect.
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- Drew K. Saylor, Nicholas D. Brownstone, Haley B. Naik. Office-Based Surgical Intervention for Hidradenitis Suppurativa (HS): A Focused Review for Dermatologists. Dermatol Ther (Heidelb) (2020) 10:529-549.