CO2 Laser Versus Surgical Deroofing for the Treatment of Hidradenitis Suppurativa Tunnels: A Comparative Multicentric, Retrospective Study.

IF 2.5 3区医学 Q2 DERMATOLOGY Dermatologic Surgery Pub Date : 2024-11-19 DOI:10.1097/DSS.0000000000004498

Andrea Sechi, Raffaele Dante Caposiena Caro, Alessandra Michelucci, Valentina Dini, Stefano Piaserico, Iris Zalaudek, Francesco Savoia, Jacopo Tartaglia

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Abstract

Background: Tunnels of hidradenitis suppurativa (HS) are one of the most challenging aspects to manage, and different surgical techniques have been proposed for their treatment. CO2 laser and surgical deroofing are 2 of the most widely used techniques, but no studies have compared them directly.

Objective: The objective of this study was to compare the efficacy and outcomes of CO2 laser treatment versus surgical deroofing for HS tunnels, with a focus on healing time, complication rates, pain perception, and cosmetic outcomes.

Materials and methods: The authors performed a multicentric retrospective analysis of 20 patients with HS tunnels who were treated with either CO2 laser (n = 10) or surgical deroofing (n = 10). The primary end point was to compare the 2 procedures in terms of healing time, complication rates, pain, and cosmetic outcome. Outcome measures included Visual Analog Scale for pain, the Vancouver Scar Scale for scar evaluation, and the relapse rate at 6 months. Secondary end point included the identification of variables associated with the healing time.

Results: The mean time to healing was 4.7 ± 1.9 weeks in the CO2 laser group and 10.9 ± 4.1 weeks in the surgical deroofing group (p < .01). Pain score at the first dressing change was lower in the CO2 laser group, with a mean Visual Analog Scale score of 1.7 ± 0.8 in the CO2 laser group and 4.9 ± 1.7 in the surgical deroofing group (p < .01). The mean scar evaluation score using the Vancouver Scar Scale at 6-month follow-up was 2.5 ± 1.3 in the CO2 laser group and 3.4 ± 1.1 in the surgical deroofing group. The number of postprocedural complications was low in both groups (1 in the CO2 laser group and 3 in the surgical deroofing group). The proportion of patients achieving complete healing of the tunnels at 6 months was similar among the CO2 laser and the surgical deroofing group (90% in the CO2 laser group vs 80% in the surgical group).

Conclusion: CO2 laser is a safe and effective treatment for HS tunnels, with fast healing rates and low pain perception.

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治疗化脓性扁桃体炎隧道的二氧化碳激光与外科脱毛术：一项多中心回顾性比较研究。

背景：化脓性扁桃体炎（HS）的隧道是最难处理的问题之一，目前已提出了不同的手术治疗方法。二氧化碳激光和手术切除是应用最广泛的两种技术，但还没有研究对它们进行直接比较：本研究旨在比较二氧化碳激光治疗与手术切除 HS 隧道的疗效和结果，重点关注愈合时间、并发症发生率、疼痛感和美容效果：作者对20名HS隧道患者进行了多中心回顾性分析，这些患者接受了二氧化碳激光治疗（10人）或外科脱毛治疗（10人）。主要终点是比较两种治疗方法的愈合时间、并发症发生率、疼痛和美容效果。结果测量包括疼痛的视觉模拟量表、疤痕评估的温哥华疤痕量表以及6个月后的复发率。次要终点包括确定与愈合时间相关的变量：二氧化碳激光组的平均愈合时间为 4.7 ± 1.9 周，手术切除组为 10.9 ± 4.1 周（P < .01）。首次换药时的疼痛评分在二氧化碳激光组较低，二氧化碳激光组的平均视觉模拟量表评分为（1.7 ± 0.8），而手术切除组为（4.9 ± 1.7）（p < .01）。在 6 个月的随访中，CO2 激光组使用温哥华疤痕量表进行的平均疤痕评估分数为 2.5 ± 1.3，手术切除组为 3.4 ± 1.1。两组术后并发症的发生率都很低（二氧化碳激光组 1 例，手术切除组 3 例）。6个月后隧道完全愈合的患者比例在二氧化碳激光组和手术脱毛组中相似（二氧化碳激光组为90%，手术组为80%）：二氧化碳激光是一种安全有效的HS隧道治疗方法，具有愈合快、疼痛感低等优点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.