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

• Published in: Acta chirurgica Iugoslavica Vol. 59; no. 2; pp. 91 - 95
• Main Authors: Bilali, Sokol, Todi, Vangjel, Lila, Ali, Bilali, Valbona, Habibaj, Julian
• Format: Journal Article
• Language: English
• Published: Serbia 2012
• Subjects: Adult; Buttocks; Chronic Disease; Female; Hidradenitis Suppurativa - surgery; Humans; Male; Perineum; Wound Healing
• ISSN: 0354-950X; 2406-0887
• DOI: 10.2298/ACI1202091B

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. A retrospective review of 6 patients' medical records from January 2001 to December 2010. 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. 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.