Recurrence Rates Following Reconstruction Strategies After Wide Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis

Zachri N. Ovadja, Mislav Zugaj, Wilco Jacobs, Chantal M.A.M. Van Der Horst, Oren Lapid

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

BACKGROUND Wide excision (WE) is generally considered to be the most common treatment for recurrent hidradenitis suppurativa. When performed, excision is followed by decisions regarding best options for management of the surgical defect. Different reconstructive strategies (RSs) have been used, with varying rates of recurrence.OBJECTIVE To provide an up-to-date systematic review of the complete literature for different RS after WE and their recurrence rates.METHODSA systematic literature search of the complete available literature and a meta-analysis of proportions were performed on the included studies.RESULTS Of a total of 1,813 retrieved articles, 79 were included in the analysis. Most were retrospective analyses, with only one randomized controlled trial (RCT) and 7 prospective analyses. The RS described were divided into primary closure (PC), secondary intention healing (SIH), skin graft (SG), and fasciocutaneous flaps (FCF). The average estimated recurrence for PC was 22.0% (95% confidence interval [CI], 8.0%-40.0%), for SIH 11.0% (95% CI, 5.0%-20.0%), for SG 2.0% (95% CI, 0.0%-5.0%), and for FCF 2.0% (95% CI, 1.0%-5.0%) (p <.001). Hidradenitis suppurativa below the umbilicus was significantly associated with overall recurrence (p =.006). Quality of evidence was poor, and the reporting of results was mostly heterogeneous.CONCLUSION After WE, PC has the highest recurrence rates, whereas SG and FCF have the lowest rates. There is a need for more RCTs and guidelines, to be able to report uniformly on treatment outcomes.

Original languageEnglish
Pages (from-to)E106-E110
JournalDermatologic Surgery
Volume47
Issue number4
DOIs
StatePublished - 1 Apr 2021
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Fingerprint

Dive into the research topics of 'Recurrence Rates Following Reconstruction Strategies After Wide Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis'. Together they form a unique fingerprint.

Cite this