Department of Plastic and Reconstructive Surgery, University of Tokushima Graduate School, Tokushima, Japan.
Dermatol Surg. 2014 Feb;40(2):110-5. doi: 10.1111/dsu.12400. Epub 2013 Dec 16.
Hidradenitis suppurativa is a chronic and often refractory skin disease that can require radical excision of the full layer of fatty tissue under the lesion. Closure using a split-thickness skin graft often results in depression deformity and lack of tissue flexibility. We have developed a two-stage procedure to preserve fatty tissue during radical excision and apply an artificial dermis graft, and we have performed this procedure in 18 patients (33 lesions).
To describe our two-stage procedure and report results of the procedure in our patient series.
In the first step, all diseased skin including the superficial subcutaneous fatty tissue is excised; normal deep subcutaneous fatty tissue is preserved. Artificial dermis is then grafted to the preserved fatty tissue. Two weeks later, split-thickness skin grafts are applied to the skin defects. We evaluated graft success, any recurrence, and postoperative appearance in our patients, who were followed up for 8 to 36 months.
All 32 skin grafts were successful. There was only one recurrence, which was treated using reoperation, and postoperative appearances were good.
Our new procedure incorporating artificial dermis appears to be a good treatment option for advanced hidradenitis suppurativa.
化脓性汗腺炎是一种慢性且常难治愈的皮肤疾病，可能需要彻底切除病变下的全层脂肪组织。使用断层皮片移植进行闭合通常会导致凹陷畸形和组织缺乏柔韧性。我们开发了一种两阶段手术方法，在彻底切除过程中保留脂肪组织并应用人工真皮移植物，我们已经对 18 名患者（33 处病变）进行了该手术。
描述我们的两阶段手术并报告我们患者系列的手术结果。
在第一阶段，切除所有病变皮肤，包括浅皮下脂肪组织；保留正常的深皮下脂肪组织。然后将人工真皮移植到保留的脂肪组织上。两周后，将断层皮片应用于皮肤缺损处。我们评估了患者的移植物成功率、任何复发情况以及术后外观，患者的随访时间为 8 至 36 个月。
32 处皮肤移植物全部成功。仅发生 1 例复发，经再次手术治疗后得到治愈，术后外观良好。
我们的新手术方法结合了人工真皮，似乎是治疗化脓性汗腺炎的一种良好选择。
