Hidradenitis Süpürativada Cerrahi Tedavinin Başarısı: Geniş Ve Derin Cerrahi Eksizyon

Year 2018, Volume: 13 Issue: 1, 13 - 18, 25.03.2018

Fatma Bilgen , Alper Ural Mehmet Bekerecioğlu

https://doi.org/10.17517/ksutfd.396944

Abstract

Amaç:
 Hidradenitis süpürativa apokrin ter
bezlerinde yerleşen ağrılı, akıntılı apse oluşumları, sinüs, fistül ve skarlar
ile çevre dokulara yayılan tekrarlayıcı bir hastalıktır. Etyolojisi kesin olarak bilinmemekle birlikte
genetik yatkınlık, hormonal faktörler, obezite ve sigara kullanımı suçlanan
faktörlerdir. Erken dönem lezyonlara medikal tedavi uygulanırken, kronik,
komplike olgularda tedavi cerrahidir. Bununla birlikte nüksler görülebilir ve
reeksizyon gerekebilir. Bu çalışmada farklı anatomik bölgelerde bulunan ve
klinik olarak farklı güvenlik sınırıyla eksizyon uygulanmış hidradenitis süpürativa
olgularındaki nüks ve diğer komplikasyon oranlarının araştırılması
amaçlanmıştır.

Gereç
Ve Yöntemler: Bu çalışmada Ocak 2000- Mart 2017 tarihleri arasında plastik
cerrahi polikliniğine müracat eden, medikal tedaviye dirençli, kronik,
rekürrens gösteren ve cerrahi tedavi uygulanan 45 hasta lezyonların yerleşim
yeri, uygulanan cerrahi yöntemler ve komplikasyonlar açısından retrospesifik
olarak değerlendirildi. Hastaların 25’i erkek, 20’si kadın ve yaş ortalaması 36,7
idi (15–78).  

Bulgular
: Hidradenitis süpürativalı hastaları tedaviye yönlendiren temel sebep yaşam
kalitesinin bozulması ve psikolojik sorunlara kadar uzanan sağlık problemlerine
sebep olmasıdır. Hidradenitis süpürativa’da tedavi hastalığın bulguları ve
derecesine göre belirlenir. Erken evre hastalara genellikle medikal tedaviler
uygulanırken ilerlemiş vakalarda geniş cerrahi eksizyon gerekmektedir.

Sonuç:
İntermammarial bölgede lezyonu olan 2 hastada ve perianal yerleşimli lezyonu
olan 3 hastada lezyon sınırında  yapılan
eksizyonlar sonrası nüks görüldü. Toplamda hastalarda nüks oranı %11,1 olarak
tespit edildi ve bu hastalara daha geniş cerrahi sınırla reeksizyon yapıldı. Bu
çalışmanın amacı hidradenitis süpürativa tedavisinde geniş ve derin cerrahi
eksizyonu önemini vurgulamaktır. 

Keywords

Hidradenit Süpüratif, cerrahi, nüks

Surgical Treatment Success In Hidradenitis Suppurativa: Deep And Wide Surgical Excision

Abstract

Abstract

Objective: Hidradenitis suppurativa is a recurrent disease that spreads to the surrounding tissues with painful, smooth abscess formation, sinus, fistula and scarring located in the apocrine sweat glands. Although etiology is not known precisely, genetic predisposition, hormonal factors, obesity and smoking are the accused factors. While medical treatment is applied to early lesions, it is the treatment surgeon in chronic, complicated cases. However, recurrences may occur and re-escision may be required. In this study, we aimed to investigate the recurrence and other complication rates of hydradenitis suppurativa in different anatomical regions with excision with clinically different safety margin.

Materials and Methods: In this study, 45 patients who were admitted to plastic surgery clinic between January 2000 and March 2017 with medical treatment resistant, chronic, recurrence and surgical treatment were evaluated retrospectively in terms of resection site, applied surgical methods and complications. Twenty-five of the patients were male, 20 were female and the mean age was 36,7 (15-78).

Results: The main reason why patients with Hidradenitis suppuratum leads to treatment is the deterioration of the quality of life and health problems leading to psychological problems. In hydradenitis suppurativa, treatment is based on the findings and the degree of the disease. Early stage disease is usually treated with medical treatments and extensive surgical excision is needed in advanced cases.

Conclusion: In 2 patients with intermammary lesions and 3 patients with perianal lesions, recurrences were observed after excision on the lesion border. In total, the recurrence rate was found to be 11.1% in patients and this disease was re-esced with wider surgical margin. The aim of this study is to emphasize the importance of extensive and profound surgical excision in the treatment of hydradenitis suppurativa. 

Keywords

Hydradenite Suppurative, recurrence, surgery

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