scholarly journals Surgical treatment of chronic hidradenitis suppurativa in the gluteal and perianal regions

2012 ◽  
Vol 59 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Sokol Bilali ◽  
Vangjel Todi ◽  
Ali Lila ◽  
Valbona Bilali ◽  
Julian Habibaj
Keyword(s):  
Wound Healing ◽  
Successful Treatment ◽  
Hidradenitis Suppurativa ◽  
Surgical Excision ◽  
Healing Time ◽  
Complete Healing ◽  
Sweat Glands ◽  
Apocrine Glands ◽  
Treatment Methods ◽  
Complete Wound Healing

Introduction: Verneuil disease, or perianal hidradenitis suppurativa (HS), is a chronic suppurative disease with a tendency to develop sinus formation, fibrosis, and sclerosis, having a great impact on quality of life. HS affect the apocrine sweat glands or sebaceous glands and may arise in each of the regions where the apocrine glands are prominent: the axilla, breast aureole, umbilicus, perineum, groin, and buttocks. We present here moderate and extensive HS cases, with their respective treatment methods and outcomes. Methods: A retrospective re-view of 6 patients? medical records from January 2001 to December 2010. Results: The 6 patients underwent treatment for HS in the gluteal and perianal regions with surgical excision. Five of the patients were male (83%). The median age was 42.5 years. We performed a total of 8 operations on these patients. In 3 patients, the wound was left open for secondary healing, and the mean time for complete wound healing was 11.3 weeks (range: 9.5-19 weeks). Delayed skin grafting was used for 2 patients in whom the wounds had been left open after the first operation. In this group, complete wound healing took 2 months in total. One patient underwent primary wound closure using rotation flaps, with a complete healing time of 2 weeks. Successful treatment without recurrence was accomplished in 5 (83.3%) of the patients. Conclusion: The conservative treatment methods had little effect, particularly on gluteal and perianal/perineal HS. The only successful treatment was wide surgical excision. Management of the wound after wide excision should be tailored to the individual patient.

Hyperbaric oxygen treatment for University of Texas grade 3 diabetic foot ulcers: a retrospective cohort study

2021 ◽  
Vol 30 (9) ◽  
pp. 722-728
Author(s):  
Rutger C Lalieu ◽  
Willem Mulder ◽  
René D Bol Raap ◽  
Saskia Stolk ◽  
Casper Smit ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Wound Care ◽  
Complete Healing ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
University Of Texas ◽  
Complete Wound Healing ◽  
Grade 3

Aim: Hard-to-heal diabetic foot ulcers (DFUs) may increase the risk of amputation. This study reports the positive influence of hyperbaric oxygen therapy (HBOT) on hard-to-heal DFUs involving underlying bone. Method: A single-centre, retrospective cohort study reporting the results of HBOT and wound care on hard-to-heal University of Texas grade 3 DFUs (i.e., involving underlying bone) between 2013 and 2019. Outcome measures were primarily (near-) complete wound healing (i.e., ≥80% ulcer surface area reduction) and amputation rate (minor or major), and secondarily the number of hyperbaric sessions and improvement in quality of life (QoL) and pain score. Results: The study included 206 patients, of whom 74 (36%) achieved complete wound healing, and 75 (36%) near-complete healing. Amputations were performed in 27 patients (13%): 12 (6%) minor and 15 (7%) major. The median number of HBOT sessions was 42. Participants who achieved complete healing received a median of 43 sessions, compared with 10 for those who required major amputation. Patients with at least 30 sessions were less likely to undergo amputation (odds ratio: 0.08; 95% confidence interval (CI): 0.03–0.21). Mean QoL increased by 7.6 points (95%CI: 3.9–11.3; p<0.01) and median pain score fell from 3 to 1 (0–3) (p<0.01). Conclusions: The addition of HBOT to standard wound care may lead to a decreased amputation risk, improved wound healing and increased QoL for people with a University of Texas grade 3 DFU. An adequate number of HBOT sessions is required to achieve optimal clinical results. Objective selection criteria and shared decision-making are suggested to improve dropout rates.

Application of paste-type acellular dermal matrix in hard-to-heal wounds

2021 ◽  
Vol 30 (5) ◽  
pp. 414-418
Author(s):  
Sang Wha Kim ◽  
Hyung Sup Shim ◽  
Jihye Lee ◽  
Youn Hwan Kim
Keyword(s):  
Wound Healing ◽  
Adverse Events ◽  
Acellular Dermal Matrix ◽  
Complete Healing ◽  
Dermal Matrix ◽  
Wound Area ◽  
Number Of Patients ◽  
Complete Wound Healing ◽  
Zero Baseline ◽  
Acellular Dermal

Objective: The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes. Method: Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment. Results: A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm2 to 12.73±7.60cm2 by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment. Conclusion: The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.

scholarly journals Aminogam® Gel Allows Faster Wound Healing after Oral Surgery by Formation of Mature Connective Tissue with Low Vascular Density and Reducing Inflammatory Infiltration. A Retrospective Study on 580 Cases with Histological and Confocal Laser Investigation

2020 ◽  
Vol 10 (3) ◽  
pp. 1105
Author(s):  
Saverio Capodiferro ◽  
Angela Tempesta ◽  
Sabina Bucci ◽  
Eugenio Maiorano ◽  
Gianfranco Favia ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diode Laser ◽  
Oral Surgery ◽  
Vascular Malformations ◽  
Sodium Hyaluronate ◽  
Healing Time ◽  
Complete Healing ◽  
Confocal Laser ◽  
Vascular Density ◽  
Inflammatory Infiltration

Reduction of the wound healing time after surgical procedures along with good hemostasis, and the reduction of post-surgical edema, pain and infective complications are generally desirable to both clinicians and patients. Recently, a gel compound containing sodium hyaluronate and four synthetic aminoacids (glycine, leucine, proline, lysine) and marketed as Aminogam® (Errekappa Euroterapici, Italy), has been proposed as a medical device promoting faster wound healing after oral surgery procedures. To assess its achievable clinical benefits, we studied retrospectively 580 cases (290 study cases and 290 control cases) undergoing oral surgery and receiving Aminogam ® gel application. More precisely, cases were divided into 7 groups on the bases of the kind of surgery (teeth extraction, oral surgery in patients taking bisphosphonates, surgical treatment of jaw osteonecrosis related to bisphosphonates therapy, placement of endosseous implants, diode laser surgery of oral mucosa lesions with second intention healing without stitches, diode laser photocoagulation of slow flow vascular malformations and bone surgery). In all instances, Aminogam® gel was applied at least five times a day until the wound healed completely. We compared the elapsed time between surgery and complete healing with Aminogam® application compared to control cases receiving no other drug treatment. Our results confirmed that the overall time of healing is certainly reduced in cases receiving Aminogam® gel regardless of the kind of oral surgery.

Sebaceous and sweat gland disorders

2010 ◽  
pp. 4676-4682 ◽  
Author(s):  
Alison Layton
Keyword(s):  
Sweat Gland ◽  
Hidradenitis Suppurativa ◽  
Sweat Glands ◽  
Ear Canal ◽  
Sebaceous Glands ◽  
Apocrine Glands

Cutaneous glands in humans include holocrine or sebaceous glands and merocrine or sweat glands. Merocrine glands are subdivided into apocrine, eccrine, and apoeccrine glands. Disorders of each of these cutaneous glands have been associated with disease. Apocrine glands in adults are found predominantly in the axillae and anogenital regions, with a few located in the ear canal (ceruminous glands) and eyelids (Moll’s glands). Associated disorders include hidradenitis suppurativa, Fox–Fordyce disease, bromhidrosis, trimethylaminuria, and chromhidrosis....

Efficacy of Maggot Debridement Therapy on Refractory Atypical Diabetic Foot Ulcers: An Open-Label Study

2020 ◽  
pp. 153473462092040
Author(s):  
Mansour Siavash ◽  
Ali Najjarnezhad ◽  
Nader Mohseni ◽  
Seyed Mohammad Abtahi ◽  
Azadeh Karimy ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Bacterial Infections ◽  
Healing Time ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Open Label ◽  
Major Health Problem ◽  
Maggot Debridement Therapy ◽  
Complete Wound Healing

Atypical or refractory diabetic foot ulcers (DFUs) are still a major health problem. Maggot debridement therapy (MDT) by larva of Lucilia sericata is an ancient and a modern option for wound healing. It works by debridement, stimulation of wound healing, and disinfection. In this study, we aimed to evaluate the efficacy of MDT for healing atypical and refractory DFUs. Patients with atypical DFUs were selected and further evaluated for some predefined differential diagnoses like atypical fungal, parasitic, or bacterial infections, malignancy, trauma, and so on. Multiple MDT sessions were carried out. Ulcer size was measured before every MDT session. Complete wound healing, time to heal, and adverse effects were recorded as well. Forty-two DFU patients (26 men, 16 women) with 42 nonhealing atypical ulcers participated in this study. Complete wound healing was achieved in 35 patients (83.3%) by MDT. Complete debridement and then healing of the wounds happened in less than 1.79 ± 0.8 months. Four ulcers persisted, and 3 (7.1%) were eventually amputated. MDT may be considered as an effective treatment for atypical DFUs, which are unresponsive to conventional therapies.

Initial Experience Using a Hyaluronate-Iodine Complex for Wound Healing

2011 ◽  
Vol 77 (3) ◽  
pp. 355-359 ◽  
Author(s):  
Robert A. Brenes ◽  
Michael S. Ajemian ◽  
Shady H. Macaron ◽  
Lucian Panait ◽  
Stanley J. Dudrick
Keyword(s):  
Wound Healing ◽  
Surgical Techniques ◽  
Antimicrobial Properties ◽  
Healing Time ◽  
Complete Healing ◽  
The European Union ◽  
Iodine Complex ◽  
Healing Agent ◽  
Lost To Follow Up

Hyaluronate-iodine complex is a wound healing adjuvant approved for use in the European Union. The objective of this study is to validate hyaluronate-iodine as a potential wound healing agent. Patients were recruited from the hospital, the outpatient clinic, and the wound healing center. Hyaluronate-iodine soaked gauze was applied to wounds either daily or every other day depending on the amount of wound exudate. Wounds were measured weekly, and progression was documented with digital photography. All wounds were debrided as needed using standard surgical techniques. Fourteen patients (19 wounds) were entered into this prospective study, and 10 patients completed treatment. Fourteen wounds progressed to complete healing with a mean healing time of 18.1 ± 15.1 weeks. Treatment was interrupted in four patients. One patient discontinued treatment due to pain related to application of hyaluronate-iodine, another patient for transportation issues, and the other two patients were lost to follow-up due to relocation out of state and noncompliance with scheduled appointments. Hyaluronate-iodine was helpful in the healing of all types of wounds treated in this pilot study. The antiadhesive and antimicrobial properties of hyaluronate-iodine create a desirable environment conducive to wound healing without apparent detrimental effects.

scholarly journals Topical Application of Curcumin Augments Healing of Deep Dermal Excision Wound of Mice Exposed To Whole-Body Gamma Radiation

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Wound Healing ◽  
Topical Application ◽  
Wound Care ◽  
Healing Time ◽  
Skin Wound ◽  
Complete Healing ◽  
Wound Contraction ◽  
Whole Body ◽  
The Mean ◽  
Wound Healing Time

Exposures of wounds to ionizing radiations have been found to prolong the healing and also cause defective healing of irradiated wounds. Although, the descriptions of wound care techniques have been found in some of the oldest archeological findings, little attention has been given to capitalize on the conservative wound therapies in the treatment of irradiated wounds. Therefore, the present study was designed to enunciate the effect of topical application of 0.5, 2, 5 and 10 % curcumin ointment on wound contraction and mean wound healing time of excision skin wound in mice whole-body exposed to 6 Gy γ-radiations. The topical application of curcumin ointment increased the wound contraction and reduced mean wound healing time by 2.2 days in normal unirradiated wounds. The irradiation of mice to 6 Gy resulted in the retardation in healing of the wounds, whereas topical application of different concentrations of curcumin ointment resulted in a concentration dependent rise in the wound contraction at different post-irradiation times and a maximum wound contraction was detected in the wounds receiving topical application of 7% curcumin twice a day. A similar effect was observed in the mean wound healing time, which showed a reduction of 1.5 days for 5% curcumin ointment. Observations demonstrated that topical application of curcumin twice daily until complete healing of wound significantly improved contraction of irradiated wound and decreased the mean healing time.

scholarly journals Extensive hidradenitis suppurativa with dorsal foot involvement: a case report

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Saira Nisar ◽  
Jeffrey L Roberson ◽  
Taryn E Travis ◽  
Laura S Johnson ◽  
Jeffrey W Shupp
Keyword(s):  
Smoking Cessation ◽  
Case Report ◽  
Hidradenitis Suppurativa ◽  
Wound Care ◽  
Surgical Excision ◽  
Inflammatory Skin Disease ◽  
Apocrine Glands ◽  
Affected Area ◽  
History Of ◽  
The Right

Abstract Hidradenitis suppurativa (HS) is a highly morbid chronic inflammatory skin disease resulting in painful and purulent lesions classically occurring in areas with a high density of apocrine glands such as the groin and axillae. This is the case of a 53-year-old male with medically refractory Hurley stage III HS affecting multiple anatomical sites including the dorsum of the right foot, an atypical location. Throughout his hospital course, he underwent a series of surgical excision and graft procedures to treat extensive HS lesions on various anatomical locations. In patients with a history of HS, mechanical stress may result in atypical lesion locations. In addition to the standard medical and surgical treatment, management should include optimizing nutritional parameters, smoking cessation, wound care and reducing friction and pressure at the affected area.

scholarly journals Rarely seen accelerated progression of hidradenitis suppurativa

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Aquino Williams ◽  
◽  
Britney Clemen ◽  
Rita Iyer ◽  
Alexandre Shehata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Family History ◽  
Hidradenitis Suppurativa ◽  
De Novo ◽  
Sweat Glands ◽  
Rare Tumor ◽  
Apocrine Glands ◽  
Include Family History ◽  
Nodular Hidradenoma

Malignant nodular hidradenoma, also known as Malignant Hidradenocarcinoma (MHA), is a rare tumor of sweat glands that accounts for less than 0.001% of all tumors [1-3,14]. Although it typically arises de-novo, MHA rarely progresses from hidradenitis suppurativa (HS), a disorder of apocrine glands characterized by chronic inflammation [5,6,9]. HS is due to recurrent follicular occlusion leading to painful debilitating cutaneous/subcutaneous abscesses requiring drainage [5,6,9]. Common sites include axillary, anogenital and inguinal regions [5,6,9]. The worldwide prevalence of HS is 1%-4% [5,6]. Incidence of all eccrine carcinomas is ~ 6% [14]. Risk-factors include family history, obesity, and smoking [5,6,9]. Severe complications associated with HS are squamous cell carcinoma and adenocarcinoma [2,6]. MHA progression is extremely aggressive with 60% cases having metastatic spread within the first 2 years of diagnosis [14].

Sebaceous and sweat gland disorders

2020 ◽  
pp. 5699-5708
Author(s):  
Alison M. Layton
Keyword(s):  
Cystic Fibrosis ◽  
Sodium Chloride ◽  
Hidradenitis Suppurativa ◽  
Sweat Glands ◽  
Systemic Diseases ◽  
Ear Canal ◽  
Apocrine Glands ◽  
Cholinergic Drugs ◽  
Eccrine Glands ◽  
Psychosocial Morbidity

Cutaneous glands in humans include holocrine or sebaceous glands and merocrine or sweat glands. Merocrine glands are subdivided into apocrine, eccrine, and apoeccrine glands. Disorders of each of these cutaneous glands have been associated with disease. Apocrine glands in adults are found predominantly in the axillae and anogenital regions, with a few located in the ear canal (ceruminous glands) and eyelids (Moll’s glands). Disorders associated with apocrine glands include hidradenitis suppurativa, Fox–Fordyce disease, bromhidrosis, trimethylaminuria, and chromhidrosis. Eccrine glands are the sweat-producing glands of the skin. Many drugs and systemic diseases can influence the degree of sweating, such as thyroid disease, infection, carcinoid, and cholinergic drugs. In cystic fibrosis, the concentration of sodium chloride in sweat is increased. Meanwhile, acne is a common inflammatory skin disease often associated with significant psychosocial morbidity.

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