Interruption versus continuation of adalimumab during hidradenitis surgery: secondary wound healing and postoperative complications.

Objective: The combination of adalimumab and surgical interventions plays a crucial role in managing severe hidradenitis suppurativa (HS). However, there is still limited scientific evidence regarding administering adalimumab during the perioperative period. This study aimed to evaluate whether adalimumab could adversely affect postoperative complications and the total time of wound closure (TTWC) in patients undergoing cutaneous surgery for HS.

Method: In this single-centre cohort study, patients with HS were allocated to two groups. Group 1 (biological cohort) consisted of patients with HS who had continuously received adalimumab for at least three months before the procedure. Group 2 (non-biological cohort) patients underwent cutaneous surgery after only four weeks of anti-inflammatory medication. All patients were left to secondary wound healing.

Results: A total of 30 surgical sites in 20 patients were included in the study (Group 1: 15 surgical sites/nine patients; Group 2: 15 surgical sites/11 patients). Disease severity and excised skin areas were significantly higher in Group 1 (p<0.001 and p=0.042, respectively) than in Group 2. While the median TTWC was longer in Group 1 than in Group 2 (p=0.004), multivariate regression analysis showed that TTWC was associated with the excised skin area (p=0.016) and Hurley stage (p=0.032), but was not affected by the use of adalimumab (p=0.076).

Conclusion: In this study, the use of adalimumab around surgery was not associated with an increased risk of postoperative complications or a prolonged course of wound closure. The results in this patient cohort suggest that adalimumab should not be discontinued during the perioperative period of HS surgery.