Treating Hidradenitis Suppurativa with Full-Thickness Skin Graft from Previous Surgical Scar-Containing Skin-A Case Report

以包含闌尾切除手術疤痕皮膚全層植皮重建化膿性汗腺炎傷口－病例報告

蔡昇霖(Sheng-Lin Tsai) ； 周余諭(Yu-Yu Chou) ； 劉庭軒(Ting-Hsuan Liu) ； 王志信(Chih-Hsin Wang) ； 陳錫根(Shyi-Gen Chen) ； 曾元生(Yuan-Sheng Tzeng)

《臺灣整形外科醫學會雜誌》 30卷2期 (2021/06) Pp. 101-108

摘要

Background: Hidradenitis suppurativa (HS) is an inflammatory disorder with a high recurrence rate. Patients with HS not only suffer from the physical manifestations of the chronic disease but also are more likely to have associated psychological disturbances. The lesions are difficult to treat and cause considerable frustration for both patients and their physicians. Aim and Objectives: We present a case report of a novel surgical management of HS using a previous surgical scar-containing skin as a full-thickness skin graft to cover the wide excision surgical wound of the affected axilla. Materials and Methods: A 31-year-old man presented with a 3-year history of HS over the right axillary region. We treated the patient with wide excision and closed the wound with a full-thickness skin graft harvested from a previous hypertrophic surgical scar-containing skin from an open appendectomy. We performed both scar revision and wound reconstruction in one surgical sitting. Results: Good healing was achieved with no limitation of range of motion. The patient was satisfied with the scar, and no recurrence of HS was noted 6 months postoperatively. Conclusion: Use of a previous surgical scar-containing skin as a full-thickness skin graft represents a viable new option for wound closure of HS after wide excision.

關鍵字

Hidradenitis suppurativa ； full-thickness skin graft ； appendectomy surgical scar ； hypertrophic scar ； case report

並列摘要

背景：化膿性汗腺炎是一高復發率的發炎性疾病，罹病患者不只因慢性疾病所苦，更比常人容易有心理方面的問題。病灶難以治療，常令患者與醫療端都備感挫折。目的及目標：此篇案例報告針對化膿性汗腺炎提出一種新的處置方式。在廣泛性切除病灶後，以舊的手術疤痕處皮膚取全層植皮，以關閉廣泛性切除後的手術傷口。材料及方法：一名31歲男性受右腋下化膿性汗腺炎所苦，我們廣泛性切除病灶並自病人舊有闌尾炎剖腹後肥厚性疤痕處皮膚取全層植皮，關閉廣泛性切除手術傷口。以一次手術同時完成修疤與傷口重建。結果：傷口癒合良好，肩膀活動正常無受限，患者對疤痕十分滿意。另外，經過六個月追蹤，化膿性汗腺炎皆無復發。結論：自舊有手術疤痕處皮膚取全層植皮重建化膿性汗腺炎廣泛切處後傷口是一種可行的新的選擇。