Plastic surgery: Hidradenitis suppurative — Radical top skin layer removal with plastic reconstruction. Treatment
Hidradenitis is a purulent inflammation of the sweat glands located in the armpits, groin or around the nipples. Today, this pathology is the most common in the surgical practice. It mainly affects women of pubertal and menopausal age. In men, this disease is diagnosed 5 times less frequently. Early treatment of hidradenitis prevents the development of severe septic complications.
The main cause of the problem is infection. The pathogens enter the sweat glands through their channels, microtrauma of the skin or with lymph.
The following factors contribute to disease development:
- excessive sweating,
- thyroid disease,
- various types of dermatitis,
- weakening of immunity,
- failure to comply with hygiene requirements.
When inflamed, the sweat glands form small nodules on the skin surface, which increase several times within 3 to 5 days. The process is accompanied by pain and a feeling of tightness. Often, the patients report a fever.
In women, hidradenitis is often localized in the armpit, and in men in the groin. While growing, the formation are filled with pus and softened. Sometimes, the abscesses are opened on their own and ulcers are formed in their place. In the worst case, the infection can get into the bloodstream, which will lead to sepsis development.
Diagnosis is established based on the clinical examination findings. To select an appropriate antimicrobial therapy, the pus bacteriological inoculation is conducted. Upon disease recurrence, the patient is recommended to make an immunogram.
When the festering is formed, the hidradenitis foci are removed surgically. There are two types of interventions:
- Abscess opening. The skin in the affected areas is dissected, the pus is evacuated and the wound is treated with antibacterial drugs.
- Inflamed gland removal. The glands are dissected within healthy tissues, the wounds are also treated and sutured. This method is more traumatic, but has less relapses.
Upon frequent disease recurrences, the radical approach is practiced, upon which the surgeon makes a complete excision of the skin and subcutaneous adipose tissue in the affected area. The resulting defect is closed with skin-fat grafts taken from healthy parts of the body.
Depending on the scope of interference, the manipulation is performed under local or general anesthesia. After surgery, the patient is prescribed a course of antibiotics. Until the wound is healed, the cloth bandages are applied and physiotherapy is conducted.Hide
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