Current Surgical Management of Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis.
Journal
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
ISSN: 1524-4725
Titre abrégé: Dermatol Surg
Pays: United States
ID NLM: 9504371
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
pubmed:
23
1
2021
medline:
18
8
2021
entrez:
22
1
2021
Statut:
ppublish
Résumé
Hidradenitis suppurativa (HS) is a chronic dermatologic condition that often necessitates surgical treatment. Surgical approaches vary substantially with little data on efficacy and safety. Summarize the literature on HS surgery with regards to patient characteristics, surgical approaches, and study quality. Compare postsurgical recurrence rates with a meta-analysis. PubMed, Embase, and Scopus were searched for studies on surgical HS management published after 2004. A random effects meta-analysis of recurrence rates was performed on eligible studies. Of 715 identified studies, 59 were included in the review and 33 in the meta-analysis. Twenty-two studies of wide excision had the lowest pooled recurrence rate at 8% (95% confidence interval [CI] 2%-16%); local excision had the highest at 34% (95% CI 24%-44%). For studies of wide/radical excision, flap repair had the lowest pooled recurrence rate at 0% (95% CI 0%-4%); delayed primary closure had the highest at 38% (95% CI 20%-59%). Wide excision and flap-based reconstruction are associated with a lower postsurgical HS recurrence, although this must be balanced against potentially higher morbidity of extensive procedures. Heterogeneity and methodological limitations of the evidence limit the ability to make a strong conclusion about the relative recurrence rates associated with surgical techniques. PROSPERO ID: CRD42020159948.
Sections du résumé
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic dermatologic condition that often necessitates surgical treatment. Surgical approaches vary substantially with little data on efficacy and safety.
OBJECTIVE
Summarize the literature on HS surgery with regards to patient characteristics, surgical approaches, and study quality. Compare postsurgical recurrence rates with a meta-analysis.
METHODS
PubMed, Embase, and Scopus were searched for studies on surgical HS management published after 2004. A random effects meta-analysis of recurrence rates was performed on eligible studies.
RESULTS
Of 715 identified studies, 59 were included in the review and 33 in the meta-analysis. Twenty-two studies of wide excision had the lowest pooled recurrence rate at 8% (95% confidence interval [CI] 2%-16%); local excision had the highest at 34% (95% CI 24%-44%). For studies of wide/radical excision, flap repair had the lowest pooled recurrence rate at 0% (95% CI 0%-4%); delayed primary closure had the highest at 38% (95% CI 20%-59%).
CONCLUSIONS
Wide excision and flap-based reconstruction are associated with a lower postsurgical HS recurrence, although this must be balanced against potentially higher morbidity of extensive procedures. Heterogeneity and methodological limitations of the evidence limit the ability to make a strong conclusion about the relative recurrence rates associated with surgical techniques.
REGISTRATION
PROSPERO ID: CRD42020159948.
Identifiants
pubmed: 33481433
doi: 10.1097/DSS.0000000000002892
pii: 00042728-900000000-97638
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
349-354Informations de copyright
Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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