Surgical treatment of chronic hidradenitis suppurativa: CO2 laser stripping-secondary intention technique

The objective of our study was to evaluate a surgical method of management of patients with hidradentitis suppurativa (HS), using a CO₂ laser technique for stepwise horizontal vaporization and peroperative monitoring of the removal of diseased tissue. Twenty-four patients were selected for treatment, 21 women and three men, who had suffered from HS for a mean of 13 years (range 1–28 years) and experienced more than three recurrences of suppurating lesions during the year prior to entering the study. The mean follow-up time after CO₂ laser surgery was 27 months (range 15–47 months), with clinical follow-up once or twice a week during the wound-healing period, and then at intervals of 1–3 months to evaluate recurrences and assess the end result. The patients' healing time was approximately 4 weeks (range 3–5 weeks). During the follow-up period two patients had recurrences in the treated areas. Twenty-two patients had no recurrences in the treated areas, but in four cases de novo suppurating lesions appeared 5–10 cm beyond the initial sites of surgery. Ten patients had exacerbations of HS lesion(s) in a region other than the treated site. Eight patients did not have any recurrences. Post-surgery results were satisfactory both cosmetically and with regard to quality of life. The CO₂ laser stripping-secondary intention technique is a rapid, efficient, and economical method for the treatment of HS. It allows simple treatment of early lesions which would otherwise have been treated using less effective local conservative remedies.