15821 Efficacy and safety of carbon dioxide laser excision in hidradenitis suppurativa: Experience from an urban academic medical center
Braunberger TL, Vakharia P, Narla S, Nicholson C, Parks-Miller A, and Hamzavi IH. 15821 Efficacy and safety of carbon dioxide laser excision in hidradenitis suppurativa: Experience from an urban academic medical center. Journal of the American Academy of Dermatology 2020; 83(6):AB47.
Journal of the American Academy of Dermatology
Background: Hidradenitis suppurativa (HS) is often refractory to standard medical and surgical interventions. Carbon dioxide (CO2) laser excision has demonstrated promising results, yet little evidence exists to expand and support previous studies.
Objective: To examine the efficacy and safety of CO2 laser excision for HS. Methods: A retrospective review was performed at Henry Ford Hospital of patients with refractory hidradenitis suppurativa who underwent CO2 laser excision with secondary intention healing from August 2014 to May 2017. Outcomes included wound healing status, time to healing, recurrence, and postoperative complication rates.
Results: Overall, 71 total sites in 48 patients underwent CO2 laser excision. Of patients with Hurley stage data available, 25 had Hurley stage 3, 16 had Hurley stage 2, and 1 had Hurley stage 1 disease. Of 57 treated sites (n = 40) with wound healing information available, 50 had documented full healing (87.7%) with a median time to healing of 5 months (interquartile range 3-7). Four patient had recurrence at an average of 5.2 months post-operatively, and 8 cases had complications (infection n = 4, contracture n = 2, dehiscence n = 1, nerve entrapment n = 1).
Conclusions: While our cohort exhibited a recurrence rate of 7.9%, others have reported recurrence rates of 1.1% and 29.3%. One study found post-operative healing time following CO2 excision to be 8.8 weeks, but our average healing time was prolonged in comparison. Our study on CO2 excision found satisfactory healing rates and time to healing with reduced recurrence and complication rates in hidradenitis suppurativa patients, and this modality should be further investigated.