{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:22:24Z","timestamp":1787721744170,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and subcutaneous tunnels. HS often leads to intractable draining wounds and scarring. Complete regional excision (CRE) is highly effective; however, no consensus exists regarding closure approaches, including primary suture\u2010closure (PSC), split\u2010thickness skin grafting (STSG), flaps, or healing by secondary intention (CRE\/SIH).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed records of 60 patients with advanced HS who underwent CRE\/SIH or suture\u2010closure between February 2009 and April 2025. All patients were treated by a single surgeon. The primary outcome was any postoperative complication. Associations between closure type and complications were estimated using generalized estimating equations to account for multiple surgical sites per patient. Recurrence was a secondary outcome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sixty patients underwent 122 CREs. Seventy\u2010three wounds were managed by CRE\/SIH and 49 by suture\u2010closure (PSC,\n n<\/jats:italic>\n \u2009=\u200922; STSG,\n n<\/jats:italic>\n \u2009=\u200922; flap,\n n<\/jats:italic>\n \u2009=\u20095). Suture\u2010closure patients were older than CRE\/SIH patients (mean [SD], 40.8 [12.6] vs. 33.2 [9.9] years;\n p<\/jats:italic>\n \u2009=\u20090.012). Complication rates were highest for flaps (60%), followed by PSC (31.8%), STSG (22.7%), and CRE\/SIH (12.3%). Primary suture\u2010closure and flap complications were uniformly wound dehiscence; CRE\/SIH complications predominantly involved bleeding. In adjusted analyses, suture\u2010closure was associated with increased odds of complication compared with CRE\/SIH (adjusted odds ratio [aOR] 4.82, 95% confidence interval [95% CI] 1.82\u201312.79;\n p<\/jats:italic>\n \u2009=\u20090.002). One recurrence occurred after STSG.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Among patients undergoing CRE for advanced HS, CRE\/SIH was associated with the lowest complication rate and low observed recurrence rates, supporting its use as an effective and potentially lower\u2010risk reconstructive strategy.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ijd.70645","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:02:16Z","timestamp":1787720536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Management of Hidradenitis Suppurativa: Postoperative Outcomes Following Complete Regional Excision With Secondary Intent Healing Versus Suture\u2010Closure Techniques"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7416-2906","authenticated-orcid":false,"given":"Huongly K.","family":"Do","sequence":"first","affiliation":[{"name":"Weill Cornell Dermatology Center for Hidradenitis Suppurativa Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4724-757X","authenticated-orcid":false,"given":"Owen B.","family":"Sedransk","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Albert Einstein College of Medicine, Montefiore Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9054-3355","authenticated-orcid":false,"given":"Isabel M.","family":"Trenholm","sequence":"additional","affiliation":[{"name":"Weill Cornell Dermatology Center for Hidradenitis Suppurativa Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2480-0482","authenticated-orcid":false,"given":"Hansen","family":"Tai","sequence":"additional","affiliation":[{"name":"Weill Cornell Dermatology Center for Hidradenitis Suppurativa Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anmol","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Albert Einstein College of Medicine, Montefiore Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5756-6609","authenticated-orcid":false,"given":"Isabella J.","family":"Tan","sequence":"additional","affiliation":[{"name":"Weill Cornell Dermatology Center for Hidradenitis Suppurativa Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-0279","authenticated-orcid":false,"given":"Peter Y.","family":"Ch'en","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Albert Einstein College of Medicine, Montefiore Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-3193","authenticated-orcid":false,"given":"Brittany","family":"Lala","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Albert Einstein College of Medicine, Montefiore Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-1825","authenticated-orcid":false,"given":"Steven R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Weill Cornell Dermatology Center for Hidradenitis Suppurativa Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan S.","family":"Garfein","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Albert Einstein College of Medicine, Montefiore Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S0140-6736(24)02475-9","article-title":"Hidradenitis Suppurativa","volume":"405","author":"Sabat R.","year":"2025","journal-title":"Lancet"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jaad.2019.02.068","article-title":"North American Clinical Management Guidelines for Hidradenitis Suppurativa: A Publication From the United States and Canadian Hidradenitis Suppurativa Foundations","volume":"81","author":"Alikhan A.","year":"2019","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.bjps.2015.12.004","article-title":"Wide Excision and Healing by Secondary Intent for the Surgical Treatment of Hidradenitis Suppurativa: A Single\u2010Center Experience","volume":"69","author":"Humphries L. S.","year":"2016","journal-title":"Journal of Plastic, Reconstructive & Aesthetic Surgery"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1097\/DSS.0000000000002815","article-title":"Recurrence Rates Following Reconstruction Strategies After Wide Excision of Hidradenitis Suppurativa: A Systematic Review and Meta\u2010Analysis","volume":"47","author":"Ovadja Z. N.","year":"2021","journal-title":"Dermatologic Surgery"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1001\/jamadermatol.2022.6266","article-title":"Surgical Procedural Definitions for Hidradenitis Suppurativa Developed by Expert Delphi Consensus","volume":"159","author":"Bui H.","year":"2023","journal-title":"JAMA Dermatology"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/ijd.17553","article-title":"Wound Closure Techniques After Wide Excision for Hidradenitis Suppurativa: A Systematic Review and Meta\u2010Analysis","volume":"64","author":"Cucu C. I.","year":"2025","journal-title":"International Journal of Dermatology"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1111\/j.1468-3083.2011.04203.x","article-title":"Mild to Moderate Hidradenitis Suppurativa Treated With Local Excision and Primary Closure","volume":"26","author":"Van Rappard D. C.","year":"2012","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1111\/ijd.13393","article-title":"Comorbidities, Treatment, and Outcome in Severe Anogenital Inverse Acne (Hidradenitis Suppurativa): A 15\u2010Year Single Center Report","volume":"56","author":"Wollina U.","year":"2017","journal-title":"International Journal of Dermatology"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.amjsurg.2020.10.004","article-title":"Surgical Management of Advanced Hidradenitis Suppurativa via a One\u2010Stage Procedure: A Single\u2010Center Experience","volume":"220","author":"Ayala D.","year":"2020","journal-title":"American Journal of Surgery"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/j.bjps.2014.04.032","article-title":"Surgical Treatment of Severe Hidradenitis Suppurativa of the Axilla: Thoracodorsal Artery Perforator (TDAP) Flap Versus Split Skin Graft","volume":"67","author":"Wormald J. C. R.","year":"2014","journal-title":"Journal of Plastic, Reconstructive & Aesthetic Surgery"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/ced\/llae246","article-title":"Surgical Outcomes of Hidradenitis Suppurativa: Evaluating Factors Influencing Recurrence and Complications After 284 Complete Excisions","volume":"49","author":"Chang T.\u2010H.","year":"2024","journal-title":"Clinical and Experimental Dermatology"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1097\/PRS.0000000000010435","article-title":"The Thoracodorsal Artery Perforator Flap for the Treatment of Hidradenitis Suppurativa of the Axilla: A Prospective Comparative Study","volume":"152","author":"La Padula S.","year":"2023","journal-title":"Plastic and Reconstructive Surgery"},{"key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jaad.2017.01.055","article-title":"The Role of Wide Local Excision for the Treatment of Severe Hidradenitis Suppurativa (Hurley Grade III): Retrospective Analysis of 74 Patients","volume":"77","author":"Posch C.","year":"2017","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000527400","article-title":"Patterns of Surgical Recurrence in Patients With Hidradenitis Suppurativa","volume":"239","author":"Cuenca\u2010Barrales C.","year":"2023","journal-title":"Dermatology"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/DSS.0000000000002403","article-title":"Recurrence Rates Following Excision of Hidradenitis Suppurativa: A Systematic Review and Meta\u2010Analysis","volume":"46","author":"Ovadja Z. N.","year":"2020","journal-title":"Dermatologic Surgery"},{"key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/DSS.0000000000002892","article-title":"Current Surgical Management of Hidradenitis Suppurativa: A Systematic Review and Meta\u2010Analysis","volume":"47","author":"Riddle A.","year":"2021","journal-title":"Dermatologic Surgery"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1097\/PRS.0000000000009024","article-title":"Hidradenitis Suppurativa: A Comparison of Institutional Experience and the Tracking Operations and Outcomes for Plastic Surgeons Registry","volume":"149","author":"Steele A. W.","year":"2022","journal-title":"Plastic and Reconstructive Surgery"},{"key":"e_1_2_13_19_1","first-page":"235","article-title":"A Comparison of Skin Grafting and Healing by Granulation, Following Axillary Excision for Hidradenitis Suppurativa","volume":"65","author":"Morgan W. P.","year":"1983","journal-title":"Annals of the Royal College of Surgeons of England"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.surg.2005.06.053","article-title":"Surgical Treatment of Hidradenitis Suppurativa: A 10\u2010Year Experience","volume":"138","author":"Kagan R. J.","year":"2005","journal-title":"Surgery"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/bjd.15939","article-title":"Incidence of Hidradenitis Suppurativa Among Tobacco Smokers: A Population\u2010Based Retrospective Analysis in the U.S.A","volume":"178","author":"Garg A.","year":"2018","journal-title":"British Journal of Dermatology"},{"key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1097\/DSS.0000000000001668","article-title":"Hidradenitis Suppurativa After Radical Surgery\u2014Long\u2010Term Follow\u2010Up for Recurrences and Associated Factors","volume":"44","author":"Walter A.\u2010C.","year":"2018","journal-title":"Dermatologic Surgery"},{"key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000507297","article-title":"Hidradenitis Suppurativa: Surgical and Postsurgical Management","volume":"6","author":"Manfredini M.","year":"2020","journal-title":"Skin Appendage Disorders"},{"key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1001\/jamasurg.2021.3655","article-title":"Efficacy and Safety of Adalimumab in Conjunction With Surgery in Moderate to Severe Hidradenitis Suppurativa: The SHARPS Randomized Clinical Trial","volume":"156","author":"Bechara F. G.","year":"2021","journal-title":"JAMA Surgery"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70645","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.70645","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.70645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:02:20Z","timestamp":1787720540000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.70645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":23,"alternative-id":["10.1111\/ijd.70645"],"URL":"https:\/\/doi.org\/10.1111\/ijd.70645","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijd.70645"}}