超越手术刀：评估化脓性汗腺炎手术切除后并发症的患者危险因素。

IF 2.6 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI:10.1016/j.burns.2025.107822

Lily Zhu , Iman F. Khan , Rafael Felix P. Tiongco , Jeffrey Khong , Lisa C. Smith , Rena Atayeva , Tomer Lagziel , Carisa M. Cooney , Julie A. Caffrey

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引用次数: 0

摘要

摘要化脓性汗腺炎（HS）是一种累及三叶间皮肤的慢性炎症性疾病。由于并发症发生率高，严重的HS提出了重建的挑战；然而，并发症的危险因素尚未得到充分研究。本研究探讨了患者水平的并发症增加的危险因素和我们机构使用的手术技术。方法：我们对2015年12月1日至2022年6月2日期间接受原发性或继发性HS大面积局部切除术的患者（≥18岁）进行了一项经irb批准的回顾性研究。采用描述性统计和Fisher精确检验对社会人口学、术中和并发症数据进行分析。采用多元逻辑回归来确定患者人口统计学因素与并发症发生之间的关系。结果：确定的347例患者中，239例符合纳入标准（中位年龄35岁，随访时间13个月）。大多数患者为黑人（76% %）和非西班牙裔/非拉丁裔（95% %）。常见的HS危险因素包括目前吸烟（20% %）、曾经吸烟（18% %）和糖尿病（15% %）。患者分为Hurley期（6 %）、期（23 %）和期（45 %）。总的来说，报告了284例并发症，更严重的并发症（如皮瓣/移植物失败，肥厚性肉芽肿，瘢痕疙瘩形成，肥厚性疤痕）主要发生在III期。Hurley期I、II、III期“其他”并发症发生率差异显著（分别为7 %、2 %、21 %）；p 结论：疾病严重程度和人口统计学因素显著影响HS手术结果。Hurley III期患者的并发症发生率较高。白人与并发症风险降低相关，而先前使用免疫调节剂与并发症风险增加相关，这表明社会人口统计学差异和疾病复杂性导致较差的术后结果。

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Looking beyond the scalpel: Assessing patient risk factors for complications following surgical excision of hidradenitis suppurativa

Introduction

Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting intertriginous skin. Severe HS presents a reconstructive challenge due to high complication rates; however, risk factors for complications are understudied. This study examines patient-level risk factors for increased complications and operative techniques used at our institution.

Methods

We conducted an IRB-approved retrospective review of patients (≥18 years) who underwent primary or secondary wide local excision of HS between 12/1/2015–06/02/2022. Sociodemographic, intraoperative, and complication data were analyzed using descriptive statistics and Fisher’s exact tests. Multiple logistic regression was used to determine the association between patient demographic factors and occurrence of any complications. Significance was set at p < 0.05.

Results

Of the 347 patients identified, 239 met inclusion criteria (median age 35 years, follow-up time 13 months). Most patients were Black (76 %) and non-Hispanic/non-Latino (95 %). Common HS risk factors included current smoking (20 %), former smoking (18 %), and diabetes (15 %). Patients were classified as Hurley Stage I (6 %), II (23 %), and III (45 %). Overall, 284 complications were reported, with more severe complications (e.g., flap/graft failure, hypertrophic granulation, keloid formation, hypertrophic scarring) predominantly occurring in Stage III. Complication rates of “other” complications differed significantly across Hurley stages I, II, and III (7 %, 2 %, 21 %, respectively; p < 0.01), with Stage III having the highest rates. Unplanned reoperations also demonstrated significant differences across stages (27 %, 4 %, 18 %, respectively; p = 0.01). Regression analysis showed White race was significantly associated with lower complication risk (p = 0.039), while prior immunomodulator use increased risk (p = 0.02).

Conclusions

Disease severity and demographic factors significantly impact HS surgical outcomes. Patients in Hurley Stage III experienced higher complication rates. White race was associated with decreased complication risk while prior immunomodulator use was associated with increased complication risk, suggesting sociodemographic disparities and disease complexity contribute to poorer post-operative outcomes.

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.