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化脓性汗腺炎的外科治疗进展。

Advances in surgical treatment of hidradenitis suppurative.

机构信息

Department of Burns & Wound Care, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Nov 2;52(6):795-801. doi: 10.3724/zdxbyxb-2023-0326.

Abstract

Hidradenitis suppurative is a chronic, refractory and recurrent dermatological disease. The disease should be managed by targeted surgical intervention on the basis of medical treatment. Currently, the surgical treatment methods include local treatments like incision and drainage, unroofing, laser therapy, intense pulsed light therapy, photodynamic therapy, as well as complete lesion resection such as skin-tissue saving excision with electrosurgical peeling and extended excision. The clearance range, therapeutic effect, postoperative complications, and recurrence risk vary among the different treatment methods. Local treatments cause less damage, but have high recurrence rates, and are mainly for mild to moderate hidradenitis suppurative patients. Complete lesion resections have relatively low recurrence rates, but may bring more surgical injuries, and postoperative reconstructions are needed, which are mainly for moderate to severe hidradenitis suppurative patients. In this article, the surgical treatment principles and various surgical treatment methods of hidradenitis suppurative are reviewed, to provide a reference for the diagnosis and treatment of this disease in clinical practice.

摘要

化脓性汗腺炎是一种慢性、难治性和复发性皮肤病。该病应在药物治疗的基础上,通过有针对性的手术干预来进行治疗。目前,手术治疗方法包括局部治疗,如切开引流、切除顶泌汗腺、激光治疗、强脉冲光治疗、光动力治疗,以及完整皮损切除,如电外科去皮的保留皮肤组织切除术和广泛切除术。不同治疗方法的清除范围、治疗效果、术后并发症和复发风险各不相同。局部治疗造成的损伤较小,但复发率较高,主要适用于轻度至中度化脓性汗腺炎患者。完整皮损切除的复发率相对较低,但可能会带来更多的手术损伤,需要进行术后重建,主要适用于中度至重度化脓性汗腺炎患者。本文回顾了化脓性汗腺炎的手术治疗原则和各种手术治疗方法,以期为该疾病的临床诊断和治疗提供参考。

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