Gluteal-anogenital-perineal reconstruction in patients with chronic hidradenitis suppurativa and related squamous cell carcinoma

OBJECTIVE: Hidradenitis suppurativa (HS) presents a hard-to-heal (chronic) wound environment, which can predispose individuals to squamous cell carcinoma (SCC). This study evaluates the treatment and reconstructive options for patients with HS, who have been cared for at the author's clinic. The aim of this article is to contribute insights into effective treatment methods and to provide a roadmap for wound management for this patient group. METHOD: The evaluation encompassed factors such as age, sex, presence of comorbidities, anatomical location of HS, extent of tissue involvement, incidence of SCC and details of surgical reconstruction methods. RESULTS: Preoperative diagnostic biopsies were conducted on 18 patients with hard-to-heal wounds and SCC was identified in four patients. CONCLUSION: It is essential to take a biopsy of HS lesions before surgical intervention in order to identify potential SCC. This step provides critical information for treatment planning. For patients requiring extensive abdominopelvic resection due to HS-induced SCC, the vertical rectus abdominis myocutaneous flap is an ideal and practical option. Additionally, proactive measures can mitigate complications with the donor area.