ABSTRACT
OBJECTIVE: Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. METHOD: An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol. Using ICD-9 codes (705.83) and CPT codes (11041, 11042, 11451, 11600, 11601, 11602, 11603, 11604) we reviewed cases performed at our institution from 1 January 2008 to 24 Febuary 2014 and we selected patients based on bilateral axillary involvement (alone) and >1 year history of active disease. Patients were excluded if resection of tissue encompassed regions outside of the immediately adjacent axillary. RESULTS: A total of seven patients matching criteria for bilateral axillary hidradenitis were selected for analysis. Clinical course, cost and surgical techniques were assessed. Of the seven patients, six required admission throughout their treatment due to lack of funding making use of negative pressure wound therapy at home not possible. These patients stayed an average of 10 days with a mean hospital charge of $35,178 and a mean hospital provider charge of $10,019. No recurrence was demonstrated. All patients attained full range of motion, post grafting. No patient required a further operation due to graft failure. CONCLUSION: Split-thickness skin grafting without use of bilayer dermal regenerative templates yielded definitive results with acceptable cosmesis and functionality, without the added cost of treatments such as a bilayer dermal regenerative template.
Subject(s)
Axilla , Hidradenitis Suppurativa/surgery , Pressure Ulcer/surgery , Adult , Female , Hidradenitis Suppurativa/economics , Hidradenitis Suppurativa/nursing , Humans , Male , Negative-Pressure Wound Therapy , Pressure Ulcer/economics , Pressure Ulcer/nursing , Retrospective Studies , Skin Transplantation , Wound Healing , Young AdultABSTRACT
This article identifies the care and treatment of a male patient during an acute flare up of hidradenitis suppurativa (HS). This article looks at HS, which can be a progressive chronic condition that impacts heavily on all aspects of a patient's quality of life. The choice of a silver alginate dressing proved effective in managing multiple surgical wounds in a comfortable and effective manner, improving the patient's quality of life.
Subject(s)
Bandages , Hidradenitis Suppurativa/nursing , Hidradenitis Suppurativa/surgery , Skin Care/methods , Alginates/therapeutic use , Chronic Disease , Humans , Male , Middle Aged , Silver Compounds/therapeutic useABSTRACT
Trata-se de um relato de experiência com o objetivo de descrever o caso de um paciente portador de hidradenite supurativa, com ferida infectada na região glútea tratada inicialmente com curativos de carvão e prata e alginato de cálcio e posteriormente com hidrofibra e prata. A ferida demandou cerca de 3 meses para epitalizar. Durante esse período o paciente não apresentou novo episódio de infecção ou outras complicações na ferida, apesar da abertura anal localizada no meio da mesma e do desenvolvimento de pequenos abcessos na região glútea e escrotal.
Subject(s)
Humans , Male , Middle Aged , Bandages , Wound Healing , Hidradenitis Suppurativa/nursing , Buttocks/pathology , Alginates/therapeutic use , Silver/therapeutic useSubject(s)
Adaptation, Psychological , Attitude to Health , Hidradenitis Suppurativa/psychology , Activities of Daily Living , Body Image , Cost of Illness , Hidradenitis Suppurativa/nursing , Humans , Quality of Life , Self Care/methods , Self Care/psychology , Self-Help Groups/organization & administration , Severity of Illness IndexABSTRACT
Hidradenitis suppurativa is a chronic, suppurative, and cicatricial cutaneous disease with clinical manifestations including inflammatory lesions and nodules, abscesses, and sinus tracts. We describe an unusual case of peristomal lesions that may represent hidradenitis suppurativa. Peristomal hidradenitis suppurativa has not been previously reported. This unusual complication demonstrates the need for a thorough patient history to identify any systemic disease that may contribute to peristomal skin problems.
Subject(s)
Hidradenitis Suppurativa/etiology , Hidradenitis Suppurativa/nursing , Ileostomy/adverse effects , Crohn Disease/surgery , Humans , Male , Middle Aged , Nurse Clinicians , Skin CareABSTRACT
Hidradenitis suppurativa is a painful skin condition which affects the skin glands. The condition can be successfully treated with surgery, but requires skillful and sensitive pre- and post-operative nursing care.
