Background:
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that can be severely debilitating. Multiple specialties participate in management, but there is a lack of clear specialty ownership. We aimed to delineate the types of operations performed and the surgical services (general vs plastic surgery) involved in HS patients on a national level.
Methods:
Data was collected through the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) and National Inpatient Sample (NIS) databases from 2008 to 2014. Current Procedure Terminology (CPT) and International Classification of Disease 9th Revision (ICD-9) codes were used for data extraction, and associated complications were assessed.
Results:
In the NISQP database, there were 414 patients diagnosed with HS while the NIS database revealed 12,938 diagnoses over the same duration with 3,903 patients having surgery. In NSQIP, debridement was the most frequently performed procedure (n=106) and the most common complication was surgical site infections, most apparent in the incision and drainage (I&D) group (6.3%). Between plastic surgery and general surgery, complication rates were similar although plastic surgeons had longer operating room times. In the NIS, I&D (n=2,312) was the most commonly performed operation, with 595 skin grafts and 217 local flaps. When controlled for surgical procedures, NIS patients exhibited longer lengths of stay.
Conclusions:
Hidradenitis suppurativa is a condition that remains poorly represented nationally. General surgery and plastic surgery services manage the bulk of operative interventions with comparable outcomes. Further multidisciplinary approaches may be warranted to better define successful treatment approaches for this pathology.
