Management of hidradenitis suppurativa wounds with an internal vacuum-assisted closure device

Y. Erin Chen, Theodore Gerstle, Kapil Verma, Matthew D. Treiser, Alexandra B. Kimball, Dennis P. Orgill

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Hidradenitis suppurativa is a chronic, debilitating disease that is difficult to treat. Once medical management fails, wide local excision offers the best chance for cure. However, the resultant wound often proves too large or contaminated for immediate closure. Methods: The authors performed a retrospective chart review of hidradenitis cases managed surgically between 2005 and 2010. Data collected included patient characteristics, management method, and outcomes. Approximately half of the patients received internal vacuum-assisted closure therapy using the vacuum-assisted closure system and delayed closure and half of the patients received immediate primary closure at the time of their excision. Delayed closure consisted of closing the majority of the wound in a linear fashion following internal vacuum-assisted closure while accepting healing by means of secondary intention for small wound areas. Results: Patients managed with internal vacuum-assisted closure had wounds on average four times larger in area than patients managed without internal vacuum-assisted closure. In both groups, all wounds were eventually closed primarily. Healing times averaged 2.2 months with internal vacuum-assisted closure and 2.7 months without. At an average follow-up time of 2.3 months, all patients with internal vacuum-assisted closure had no recurrence of their local disease. Conclusions: Severe hidradenitis presents a treatment challenge, as surgical excisions are often complicated by difficult closures and unsatisfactory recurrence rates. This study demonstrates that wide local excision with reasonable outcomes can be achieved using accelerated delayed primary closure. This method uses internal vacuum-assisted closure as a bridge between excision and delayed primary closure, facilitating closure without recurrence in large, heavily contaminated wounds.

Original languageEnglish (US)
Pages (from-to)370e-377e
JournalPlastic and reconstructive surgery
Volume133
Issue number3
DOIs
StatePublished - Mar 1 2014
Externally publishedYes

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Hidradenitis Suppurativa
Negative-Pressure Wound Therapy
Equipment and Supplies
Wounds and Injuries
Hidradenitis
Recurrence
Chronic Disease

ASJC Scopus subject areas

  • Surgery

Cite this

Management of hidradenitis suppurativa wounds with an internal vacuum-assisted closure device. / Chen, Y. Erin; Gerstle, Theodore; Verma, Kapil; Treiser, Matthew D.; Kimball, Alexandra B.; Orgill, Dennis P.

In: Plastic and reconstructive surgery, Vol. 133, No. 3, 01.03.2014, p. 370e-377e.

Research output: Contribution to journalArticle

Chen, Y. Erin ; Gerstle, Theodore ; Verma, Kapil ; Treiser, Matthew D. ; Kimball, Alexandra B. ; Orgill, Dennis P. / Management of hidradenitis suppurativa wounds with an internal vacuum-assisted closure device. In: Plastic and reconstructive surgery. 2014 ; Vol. 133, No. 3. pp. 370e-377e.
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