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影响化脓性汗腺炎病变广泛手术切除后伤口愈合的因素。

Factors Affecting Wound Healing after the Wide Surgical Excision of Hidradenitis Suppurativa Lesions.

作者信息

Ezanno Anne-Cecile, Texier Gaëtan, Marchi Joffrey, Fougerousse Anne-Claire

机构信息

Department of Digestive Surgery, Begin Military Teaching Hospital, 94160 Saint-Mandé, France.

Armed Forces Epidemiology and Public Health Center, 13014 Marseille, France.

出版信息

J Clin Med. 2024 Sep 21;13(18):5598. doi: 10.3390/jcm13185598.

DOI:10.3390/jcm13185598
PMID:39337085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11433379/
Abstract

: Hidradenitis suppurativa (HS) is a chronic and inflammatory disease. Its management depends on the stage and extent of the disease. Surgery plays an important role in treatment options. This study explores the factors influencing healing after wide excision. : This study analyzed data from patients who underwent wide excision for HS between 2016 and 2021. : A total of 160 patients (64.4% women) were included, with surgeries performed in the axillae (70), inguinal-ano-genital (73), and other locations (17, including gluteal). The mean TTWC was 74 ± 6 days, varying from 11 to 445 days. Factors negatively influencing TTWC included axillary localization ( < 0.001) and the presence of another inflammatory disease ( = 0.017). Factors positively influencing healing were smoking (<0.001) and previous or ongoing medical treatment (antibiotherapy or biologics) ( = 0.011). Obesity or being overweight did not impact the TTWC in multivariate analysis, although overweight was significant in univariate analysis. : While smoking cessation remains important in the management of HS, it does not appear to be a prerequisite for successful surgical treatment. Conversely, patients with an inflammatory disease or those undergoing surgery for an axillary lesion exhibit slower healing and should be informed of potential healing delays before surgery.

摘要

化脓性汗腺炎(HS)是一种慢性炎症性疾病。其治疗取决于疾病的阶段和范围。手术在治疗选择中起着重要作用。本研究探讨了广泛切除术后影响愈合的因素。:本研究分析了2016年至2021年间因HS接受广泛切除的患者的数据。:共纳入160例患者(64.4%为女性),手术部位包括腋窝(70例)、腹股沟-肛门-生殖器(73例)和其他部位(17例,包括臀部)。平均伤口愈合时间(TTWC)为74±6天,范围从11天到445天。对TTWC有负面影响的因素包括腋窝部位(<0.001)和存在另一种炎症性疾病(=0.017)。对愈合有积极影响的因素是吸烟(<0.001)以及先前或正在进行的药物治疗(抗生素治疗或生物制剂)(=0.011)。在多变量分析中,肥胖或超重对TTWC没有影响,尽管在单变量分析中超重具有统计学意义。:虽然戒烟在HS的管理中仍然很重要,但它似乎不是成功手术治疗的先决条件。相反,患有炎症性疾病的患者或因腋窝病变接受手术的患者愈合较慢,应在手术前告知其可能的愈合延迟情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e40/11433379/c2a3cf78b509/jcm-13-05598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e40/11433379/4af0f097b406/jcm-13-05598-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e40/11433379/c2a3cf78b509/jcm-13-05598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e40/11433379/4af0f097b406/jcm-13-05598-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e40/11433379/c2a3cf78b509/jcm-13-05598-g002.jpg

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本文引用的文献

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S2k guideline for the treatment of hidradenitis suppurativa / acne inversa - Short version.S2k 指南治疗化脓性汗腺炎/反向痤疮 - 简化版。
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Surgical Treatment in Hidradenitis Suppurativa.化脓性汗腺炎的手术治疗
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Nicotine in Inflammatory Diseases: Anti-Inflammatory and Pro-Inflammatory Effects.尼古丁在炎症性疾病中的作用:抗炎和促炎效应。
Front Immunol. 2022 Feb 18;13:826889. doi: 10.3389/fimmu.2022.826889. eCollection 2022.
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Differences in anatomical area-specific wound healing in hidradenitis suppurativa/acne inversa after surgery.化脓性汗腺炎/反向性痤疮手术后特定解剖区域伤口愈合的差异。
Eur J Dermatol. 2021 Oct 1;31(5):623-629. doi: 10.1684/ejd.2021.4148.
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The role of negative-pressure wound therapy in the management of axillary hidradenitis suppurativa.负压伤口治疗在化脓性汗腺炎管理中的作用。
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Efficacy and Safety of Adalimumab in Conjunction With Surgery in Moderate to Severe Hidradenitis Suppurativa: The SHARPS Randomized Clinical Trial.阿达木单抗联合手术治疗中重度化脓性汗腺炎的疗效和安全性:SHARPS 随机临床试验。
JAMA Surg. 2021 Nov 1;156(11):1001-1009. doi: 10.1001/jamasurg.2021.3655.
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A novel c.671_682del NCSTN variant in a family with hidradenitis suppurativa: a pilot study.化脓性汗腺炎家族中一种新的NCSTN基因c.671_682del变异:一项初步研究。
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