Patient impressions and outcomes after clinic-based hidradenitis suppurativa surgery

Authors

Saranya Ravi, School of Medicine, The University of North Carolina at Chapel Hill.
Jonathan A. Miles, Department of Dermatology, The University of North Carolina at Chapel Hill.
Chelsea Steele, Advocate Aurora Health
Mary Kate Christiansen, School of Medicine, The University of North Carolina at Chapel Hill.
Christopher J. Sayed, Department of Dermatology, The University of North Carolina at Chapel Hill.

Recommended Citation

Ravi S, Miles JA, Steele C, Christiansen MK, Sayed CJ. Patient Impressions and Outcomes After Clinic-Based Hidradenitis Suppurativa Surgery. JAMA Dermatol. 2022;158(2):132-141. doi:10.1001/jamadermatol.2021.4741

Affiliations

Aurora St Luke's Medical Center

Abstract

Importance: Surgical intervention is frequently needed to treat hidradenitis suppurativa (HS). Patient satisfaction is high based on previous studies, but reports of patient impressions of clinic-based operative experiences and postoperative recovery are limited.

Objective: To characterize patient impressions, outcomes, and recovery time after clinic-based surgical treatment of HS and examine patient characteristics associated with outcomes.

Design, setting, and participants: This retrospective cohort study included patients 12 years or older who underwent clinic-based surgical procedures for treatment of HS at a single subspecialty HS clinic at the University of North Carolina Department of Dermatology from April 2014 to December 2018. Data analysis was performed from January to September 2021.

Exposures: Clinic-based deroofing and excisional procedures performed as part of routine care.

Main outcomes and measures: The primary outcomes were patient-reported recurrence of HS at the site of surgery, patient satisfaction with the procedures and outcomes, and patient-reported pain and recovery associated with surgery obtained from electronic medical record review and patient questionnaires.

Results: Outcomes of 194 procedures for 78 patients (65 [83%] female; mean [SD] age, 35.1 [12.1] years) were analyzed. Self-reported rate of recurrence was 41% (79 procedures). Despite recurrence, most patients (148 procedures [76%]) were very satisfied with their surgical results. The median number of missed days of work or school was 2 (IQR, 1-7 days), and the median number of days until return to normal activity was 10 (IQR, 3-14 days). In addition, for 126 of the 194 procedures (65%), patients stated that pain during an HS flare was worse than pain during surgical recovery.

Conclusions and relevance: In this cohort study, patients reported high rates of satisfaction with clinic-based HS surgery. Recovery was typically rapid, with most patients rating postsurgical pain as less severe than their HS pain.

Document Type

Article

PubMed ID

34985494