Background/Objectives: Surgical deroofing is an essential part of ongoing management of Hidradenitis Suppurativa tunnels, including persistent lesions non-responsive to medical therapy. Variables associated with delayed wound healing after surgical deroofing are contradictory within the literature due to the inclusion of heterogeneous surgical intervention methods. We aimed to assess predictors of time to wound healing after surgical deroofing in HS.
Methods: Patients who underwent in-office surgical deroofing between 2020 and 2024 at a single tertiary HS referral centre were included in analysis. Demographic, disease and blood variables were collected as per standard of care. Statistical analysis was performed using univariate correlation, with multiple regression performed to explore the interactions between variables and identify variables predictive of time to wound healing.
Results: A total of 270 individuals were included in the analysis. The median time to wound healing was 9.6 weeks with a range from 4 to 22 weeks. Kaplan Meier curves demonstrated significant differences with the log rank test when comparing biologic use vs no use, normal vs abnormal CRP and normal vs abnormal haemoglobin. Cox regression analysis identified biologic use with a significant hazard ratio compared to no biologic therapy (HR=2.512, p<0.0001) along with baseline CRP (HR=0.968 per unit increment, p<0.0001) and baseline haemoglobin (HR=1.052 per unit increment, p<0.001). No differences in post-operative infection was observed with patients on concurrent biologic therapy.
Conclusions: Time to wound healing after in-office deroofing can be decreased with prior biologic therapy, and markers of systemic inflammation in blood are also significantly associated with delays in healing. This correlates well with the existing literature promoting the efficacy and safety of concurrent medical and surgical therapy to improve patient outcomes in HS.