Gierek Marcin, Klama-Baryła Agnieszka, Łabuś Wojciech, Bergler-Czop Beata, Pietrauszka Kornelia, Niemiec Paweł
Dr Sakiel Center for Burns Treatment, Jana Pawła II Street 2, 41-100 Siemianowice Śląskie, Poland.
Department of Dermatology, Medical University of Silesia, Francuska Street, 40-027 Katowice, Poland.
J Clin Med. 2023 Mar 8;12(6):2112. doi: 10.3390/jcm12062112.
(1) Introduction: Hidradenitis suppurativa (HS) is an inflammatory skin disease with recurrent, chronic, painful, and purulent skin lesions. Topical or systemic antibiotics are the most widely used treatments for the management of mild stages of the disease. In chronic cases (Hurley II/III), wide excision of lesions should be considered. During reconstructive surgery, the most problematic aspect is wound closure. Very large excisional wounds require reconstructive techniques such as skin flaps, skin grafts, or both. Surgical methods have their limitations, so reconstructive methods in HS surgery need to be continuously improved through the use of, for example, platelet-rich plasma and acellular dermal matrix; (2) Methods: The aim of this study was to evaluate the clinical outcomes and efficacy of surgical treatment of patients with HS using local skin flaps injected with PRP compared to a group of local skin flaps without platelet-rich plasma injection, an acellular dermal matrix, and split-thickness skin graft co-grafts. Sixty-one patients (29 males and 32 females) were included in the study. Most patients were characterized by Hurley grade III HS; (3) Results: The use of PRP injection in reconstructions (skin flaps) improved healing and reduced the number of complications, a notable trend in this study. A co-graft of acellular dermal matrix and split-thickness skin graft gave better therapeutic results than split-thickness skin graft alone (fewer days in hospital, fewer postoperative complications); (4) Conclusions: PRP injected into skin flaps, co-grafted acellular dermal matrix, and split-thickness skin grafts are good options for the surgical treatment of hidradenitis suppurativa.
(1) 引言:化脓性汗腺炎(HS)是一种具有复发性、慢性、疼痛性和脓性皮肤病变的炎症性皮肤病。局部或全身使用抗生素是治疗该病轻度阶段最广泛使用的方法。在慢性病例(Hurley II/III级)中,应考虑广泛切除病变。在重建手术中,最棘手的方面是伤口闭合。非常大的切除伤口需要皮瓣、皮肤移植或两者结合等重建技术。手术方法有其局限性,因此HS手术中的重建方法需要通过使用富含血小板血浆和脱细胞真皮基质等不断改进;(2) 方法:本研究的目的是评估与一组未注射富含血小板血浆的局部皮瓣、脱细胞真皮基质和中厚皮片联合移植相比,使用注射PRP的局部皮瓣治疗HS患者的临床结果和疗效。61例患者(29例男性和32例女性)纳入研究。大多数患者的特征为Hurley III级HS;(3) 结果:在重建(皮瓣)中使用PRP注射可促进愈合并减少并发症数量,这是本研究中的一个显著趋势。脱细胞真皮基质和中厚皮片联合移植比单纯中厚皮片移植产生更好的治疗效果(住院天数更少,术后并发症更少);(4) 结论:向皮瓣中注射PRP、联合移植脱细胞真皮基质和中厚皮片是化脓性汗腺炎手术治疗的良好选择。