University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Department of Internal Medicine, Atrium Health's Carolinas Medical Center, Charlotte, North Carolina.
Dermatol Surg. 2021 Mar 1;47(3):349-354. doi: 10.1097/DSS.0000000000002892.
Hidradenitis suppurativa (HS) is a chronic dermatologic condition that often necessitates surgical treatment. Surgical approaches vary substantially with little data on efficacy and safety.
Summarize the literature on HS surgery with regards to patient characteristics, surgical approaches, and study quality. Compare postsurgical recurrence rates with a meta-analysis.
PubMed, Embase, and Scopus were searched for studies on surgical HS management published after 2004. A random effects meta-analysis of recurrence rates was performed on eligible studies.
Of 715 identified studies, 59 were included in the review and 33 in the meta-analysis. Twenty-two studies of wide excision had the lowest pooled recurrence rate at 8% (95% confidence interval [CI] 2%-16%); local excision had the highest at 34% (95% CI 24%-44%). For studies of wide/radical excision, flap repair had the lowest pooled recurrence rate at 0% (95% CI 0%-4%); delayed primary closure had the highest at 38% (95% CI 20%-59%).
Wide excision and flap-based reconstruction are associated with a lower postsurgical HS recurrence, although this must be balanced against potentially higher morbidity of extensive procedures. Heterogeneity and methodological limitations of the evidence limit the ability to make a strong conclusion about the relative recurrence rates associated with surgical techniques.
PROSPERO ID: CRD42020159948.
化脓性汗腺炎（HS）是一种慢性皮肤病，通常需要手术治疗。手术方法差异很大，关于疗效和安全性的数据很少。
总结有关 HS 手术的文献，包括患者特征、手术方法和研究质量。通过荟萃分析比较手术后的复发率。
在 PubMed、Embase 和 Scopus 上搜索了 2004 年后发表的关于 HS 手术管理的研究。对符合条件的研究进行了荟萃分析，以评估复发率的随机效应。
在 715 项已确定的研究中，有 59 项研究被纳入综述，33 项研究被纳入荟萃分析。22 项广泛切除术的研究复发率最低，为 8%（95%置信区间[CI]：2%-16%）；局部切除术的复发率最高，为 34%（95%CI：24%-44%）。对于广泛/根治性切除术的研究，皮瓣修复的复发率最低，为 0%（95%CI：0%-4%）；延迟一期闭合的复发率最高，为 38%（95%CI：20%-59%）。
广泛切除和基于皮瓣的重建与术后 HS 复发率较低相关，但这必须与广泛手术可能更高的发病率相平衡。证据的异质性和方法学局限性限制了对与手术技术相关的相对复发率做出有力结论的能力。
PROSPERO 注册号：CRD42020159948。
