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  • Presentation

Preoperative Planning and Expectation Setting for Hidradenitis Suppurativa Surgery

Description

This session focuses on preoperative planning and expectation setting for patients undergoing surgery for Hidradenitis Suppurativa (HS). It emphasizes identifying suitable surgical candidates, understanding surgical approaches like wide local excision and de roofing, and the importance of managing inflammation before surgery to improve healing and reduce complications. Patients should be well-managed on medical treatments, ideally biologics, before surgery to enhance outcomes. The discussion covers the differences in surgical techniques, recovery times, and the importance of patient involvement in decision-making. Postoperative care, including pain management and wound care, is highlighted, with strategies to address common complications like bleeding and hypergranulation. Expectations regarding healing time and potential discomfort are crucial for patient reassurance. Overall, effective preoperative planning, including clear communication with patients about the surgery process and recovery, significantly contributes to better surgical experiences for those suffering from HS.

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Conclusions

  • Surgery is an effective option for many patients with hidradenitis suppurativa (HS).
  • Patients who have improved on biologic or other medical therapies but are still symptomatic are typically the best surgical candidates.
  • Well-controlled HS leads to fewer postoperative complications and better surgical outcomes.
  • Deroofing, staged regional deroofing, and wide local excision are all viable surgical approaches for HS.
  • Deroofing is associated with a lower complication rate compared to wide local excision.
  • Patient education and expectation setting prior to surgery contribute to a positive surgical experience.
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  • Bechara FG, Podda M, Prens EP, Horváth B, Giamarellos-Bourboulis EJ, Alavi A, Szepietowski JC, Kirby J, Geng Z, Jean C, Jemec GBE, Zouboulis CC. Efficacy and Safety of Adalimumab in Conjunction With Surgery in Moderate to Severe Hidradenitis Suppurativa. JAMA Surgery. [Original Investigation].
  • Saylor DK, Brownstone ND, Naik HB. Office-Based Surgical Intervention for Hidradenitis Suppurativa (HS): A Focused Review for Dermatologists. Dermatol Ther (Heidelb). 2020;10:529-549.