Surgical Methods of Management for Hidradenitis Suppurativa: A Narrative Review

Objective Hidradenitis Suppuravita (HS) is a chronic condition that creates a significant burden on a patient’s life, both physical and emotional. While a broad range of medical and dressing treatments exist for HS, surgery is often considered the only curative approach. The aim of this study is to comprehensively review existing and emerging surgical options available for the treatment of HS. Methods Using the key phrase “Hidradenitis Suppuravita” and the MeSH terms “surgery or surgical” and “treatment or procedure”, a search of the Ovid Medline and Pubmed databases was conducted 2012 to 2022. Forty-eight studies meeting criteria were identified and included in the literature review. Results Many methods exist for the treatment of HS and there have been promising small scale series and reports that highlight positive disease and quality-of-life (QoL) outcomes associated with some surgical treatment modalities. Most methods are centred around excision of all diseased tissue followed by varying methods of reconstruction. Some novel methods, such as laser ablation, are also used. Each method has its own strengths and weaknesses. Selection of method is currently made based on a case-by-case basis such as disease severity, disease location and surgeon preference. Conclusion Further randomised control trials with larger patient populations are needed to quantify the efficacy and safety of the various surgical methods available. These approaches to treatment hold tremendous potential for improving patient outcomes globally.