Factors Affecting Healing in Patients Participating in a Hidradenitis Suppurativa Multidisciplinary Clinic
Worden AP, Saab I, Siddiqui A, and Yoho D. Factors Affecting Healing in Patients Participating in a Hidradenitis Suppurativa Multidisciplinary Clinic. J Am Coll Surg 2019; 229(4):S222.
J Am Coll Surg
Introduction: Hidradenitis suppurativa (HS) is a debilitating condition with treatment that varies with patients’ circumstances and symptoms. We present our experience with surgical treatment for HS patients who follow in our Hidradenitis Suppurativa Multidisciplinary Program (HSMP). Methods: We retrospectively reviewed outcomes of 248 HSMP patients who underwent surgical treatment at a single institution from January 2013 to December 2015. Inclusion criteria included adults with HS and exclusion criteria included patients with <2 years follow-up. Demographic data, type of operation, healing rates, and potential factors contributing to wound healing were analyzed. Results: Mean follow-up was 28 months. An overall healing rate of 76% was seen, with ablative procedures healing better than primary repairs (78.5% vs 68%; p = 0.011). Hurley stage (p = 0.09) or number of sites involved (p = 0.959) were not significant predictors of healing. Postoperative compliance with the HSMP was the strongest predictor of healing (78% vs 45%; p = 0.004). Multivariate analysis showed sex, age, BMI, tobacco use, diabetes, preoperation hemoglobin, and family history of HS did not significantly affect healing. Immune modulating therapy use within 2 weeks of operation was a negative predictor for healing (odds ratio 0.23; p = 0.004). Conclusions: Postoperative compliance with our HSMP was a strong predictor of achieving long-term healing. Hurley stage and number of involved sites did not correlate with successful healing. Ablative procedures healed better than primary repairs. Use of biologics within 2 weeks of surgical intervention negatively affected long-term healing.