doiSerbia

Surgical treatment of chronic hidradenitis suppurativa in the gluteal and perianal regions

Bilali Sokol (General Surgery Clinic, University Hospital Center "Mother Teresa", Tirana, Albania)
Todi Vangjel (General Surgery Clinic, University Hospital Center "Mother Teresa", Tirana, Albania)
Lila Ali (General Surgery Clinic, University Hospital Center "Mother Teresa", Tirana, Albania)
Bilali Valbona (General Surgery Clinic, University Hospital Center "Mother Teresa", Tirana, Albania)
Habibaj Julian (Obstetric and Gynecologic University Hospital "Queen Geraldine", Tirana, Albania)

Introduction: Verneuil disease, or perianal hidradenitis suppurativa (HS), is a chronic suppurative disease with a tendency to develop sinus formation, fibrosis, and sclerosis, having a great impact on quality of life. HS affect the apocrine sweat glands or sebaceous glands and may arise in each of the regions where the apocrine glands are prominent: the axilla, breast aureole, umbilicus, perineum, groin, and buttocks. We present here moderate and extensive HS cases, with their respective treatment methods and outcomes. Methods: A retrospective re-view of 6 patients’ medical records from January 2001 to December 2010. Results: The 6 patients underwent treatment for HS in the gluteal and perianal regions with surgical excision. Five of the patients were male (83%). The median age was 42.5 years. We performed a total of 8 operations on these patients. In 3 patients, the wound was left open for secondary healing, and the mean time for complete wound healing was 11.3 weeks (range: 9.5-19 weeks). Delayed skin grafting was used for 2 patients in whom the wounds had been left open after the first operation. In this group, complete wound healing took 2 months in total. One patient underwent primary wound closure using rotation flaps, with a complete healing time of 2 weeks. Successful treatment without recurrence was accomplished in 5 (83.3%) of the patients. Conclusion: The conservative treatment methods had little effect, particularly on gluteal and perianal/perineal HS. The only successful treatment was wide surgical excision. Management of the wound after wide excision should be tailored to the individual patient.

Keywords: hidradenitis suppurativa, apocrine gland, treatment, gluteal, perianal