Tissue reconstruction techniques after radical excision in advanced hidradenitis suppurativa: an integrative literature review

Objective: To evaluate the impact of different tissue reconstruction techniques following radical excision in patients with advanced HS, comparing outcomes related to recurrence, wound healing, functionality, aesthetics, and quality of life. Methods: This integrative literature review was conducted using the PubMed database and included studies published between 2015 and 2025 in English, Portuguese, or Spanish. Original studies evaluating adult patients with advanced HS undergoing radical excisional surgery were selected, resulting in 22 studies included in the final analysis. Results: The evidence indicates that radical excision is the primary factor associated with lower recurrence rates. Reconstructive techniques such as local flaps and skin grafts were associated with better functional outcomes, shorter healing times, and lower recurrence compared with primary closure and healing by secondary intention. Adjuvant strategies, including biologic therapies and multidisciplinary follow-up, further improved overall outcomes. Conclusion: The combination of radical surgical excision and appropriate tissue reconstruction represents the most effective approach for managing advanced HS, leading to improved functional outcomes and quality of life.