Name of the Procedure:

Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair

Summary

This surgical procedure involves removing affected skin and underlying tissue in the groin area to treat hidradenitis suppurativa, a chronic skin condition. After excision, the area is repaired using advanced techniques to ensure proper healing and minimize scarring.

Purpose

The procedure aims to:

• Treat severe or recurrent hidradenitis suppurativa that does not respond to other treatments.
• Remove painful abscesses and sinus tracts to reduce infection and improve quality of life.
• Promote healing and prevent future flare-ups by excising diseased tissue and performing complex repairs.

Indications

• Persistent, painful lumps and abscesses in the groin area.
• Recurrent infections and drainage that do not improve with medical treatments.
• Significant scarring and sinus tract formation.

Preparation

• Patients may need to fast for several hours before surgery.
• Pre-operative assessments and blood work are typically required.
• Medications may need to be adjusted; patients should inform their healthcare provider about all drugs they are taking.

Procedure Description

1. The affected area in the groin is cleaned and sterilized.
2. Anesthesia is administered (usually general anesthesia).
3. An incision is made to remove the diseased skin and subcutaneous tissue.
4. The complex repair involves techniques like flap closure or skin grafts to reconstruct the area.
5. The area is closed with sutures, and dressings are applied.

Duration

Typically, the procedure takes about 1 to 3 hours, depending on the extent of the disease and the complexity of the repair.

Setting

The procedure is performed in a hospital or specialized surgical center.

Personnel

• Surgeon specializing in dermatology or general surgery.
• Anesthesiologist.
• Surgical nurses and support staff.

Risks and Complications

• Infection.
• Bleeding.
• Scarring.
• Wound dehiscence (reopening).
• Adverse reactions to anesthesia.

Benefits

• Significant reduction in pain and discomfort.
• Decreased risk of future hidradenitis suppurativa flare-ups.
• Improved quality of life and skin appearance.
• Benefits may be noticed shortly after the healing process begins.

Recovery

• Patients may need to stay in the hospital overnight.
• Pain management with prescribed medications.
• Avoid strenuous activities and keep the area clean and dry.
• Follow-up appointments for wound care and to monitor healing.
• Complete recovery typically takes several weeks to a few months.

Alternatives

• Medical management with antibiotics, anti-inflammatory medications, and biologic agents.
• Laser therapy.
• Incision and drainage, which may be less effective and have higher recurrence rates compared to excision with complex repair.

Patient Experience

• Patients will be under anesthesia and should not feel pain during the procedure.
• Post-operative pain will be managed with medications.
• Mild discomfort and swelling are expected; proper wound care and follow-up are important for a smooth recovery.