The Single-Stage Split-Thickness Skin Grafting for the Treatment of Hurley Stage III Hidradenitis Suppurativa: A Retrospective Analysis of 23 Patients

Abstract

Advanced hidradenitis suppurativa (HS) is often irresponsive to conservative treatment and requires extensive surgery to improve the clinical symptoms and prevent recurrence. This study aimed to assess the effectiveness of single-stage split-thickness skin grafting in patients with Hurley Stage III HS. A retrospective review of all cases of Hurley Stage III HS received skin grafting was done. Data on patient demographics, lesion characters, surgical details, and follow-up information were collected. Fifty-two cases of Hurley Stage III HS located in the axillary, groin, perineum, buttock, and penis were treated with split-thickness skin grafting. There were 20 male and 3 female patients included with a mean age of 38.7 years (range: 24–77). The overall success rate was 96.2% at a mean follow-up time of 29.3 months (range: 2–86). Early complications and late complications were observed in 30.7% (n = 16) and 59.6% (n = 31) of the cases, respectively. Wound scarring was the most common complication reported in 32.7% (n = 17) of the cases. Only one case (1.9%) of recurrence was reported in the perianal region at the postoperative 4.4 months. The satisfaction survey showed that 78.3% (18 of 23) patients were satisfied or very satisfied with the surgical result. Despite the advances in HS surgery, the recurrence rates continue to be high. Single-stage split-thickness skin grafting is a feasible approach for treating Hurley Stage III HS with a high success rate, low HS recurrence rates, and high patient satisfaction during long-term follow-up.