TOPLINE:

In a study of 206 surgical procedures for hidradenitis suppurativa (HS), the overall recurrence rate was 18.5%. Two distinct recurrence patterns were identified — tunnel recurrence occurred in 8.3% of cases, and abscess/inflammatory nodule recurrence occurred in 10.2% of cases, and tunnel recurrence more likely reflected true surgical failure.

METHODOLOGY:

• Researchers conducted a retrospective, observational, single-centre study analysing 206 surgical procedures performed on 165 patients with HS (mean age, 37.6 years) between 2018 and 2024 at Virgen de las Nieves University Hospital in Granada, Spain.
• The analysis included wide excision with secondary intention healing in 81.1% of cases, with a mean excised area of 21.4 cm² and a mean depth of 6.5 mm; preoperative ultrasound was utilised in 88.8% of procedures.
• Researchers evaluated recurrence patterns, factors associated with each type of recurrence, complications, and time to complete wound healing. Recurrence was defined as the reappearance of inflammatory HS lesions within 1 cm of the surgical scar, subclassified as tunnel or abscess/inflammatory nodule recurrence.

TAKEAWAY:

• The overall recurrence rate was 18.5% (38/206); tunnel recurrence occurred in 8.3% of procedures, and abscess/inflammatory nodule recurrence occurred in 10.2% of procedures.
• Tunnel recurrence was associated with Hurley stage III disease, larger and deeper excisions, and higher postoperative International Hidradenitis Suppurativa Severity Score System scores, and abscess/inflammatory nodule recurrence was linked to BMI > 30 and limited preoperative ultrasound use.
• The overall complication rate was 11.16%. The mean time to complete wound healing was 46.4 days, with longer healing times observed in patients with BMI > 30, those treated with adalimumab, and those with larger excised areas (P < .001).
• In the multivariate analysis, a larger excised area was an independent predictor of overall recurrence (adjusted odds ratio per cm², 1.03; P = .021). Patients not receiving systemic therapy at surgery showed significantly higher recurrence rates than those receiving systemic therapy (26.3% vs 11.4%; P = .021).

IN PRACTICE:

"Our findings reinforce the importance of preoperative ultrasound and adequate inflammatory control to reduce the risk of postoperative recurrence and optimize long-term outcomes. Further studies with standardized definitions and longer follow-up are needed to refine surgical outcome metrics and improve comparability across techniques," the authors of the study wrote.

SOURCE:

This study was led by Carmen García‑Moronta, Hospital Universitario Virgen de las Nieves, Granada, Spain. It was published online on December 27, 2025, in Dermatology and Therapy.

LIMITATIONS:

The observational single-centre design may have limited the generalisability of the results. The relatively small subgroup of patients experiencing surgical recurrence potentially limited statistical power. Additionally, the lack of standardised postoperative medical management, particularly regarding systemic therapy adjustments, may have influenced postoperative inflammatory control and abscess/inflammatory nodule-type recurrence rates.

DISCLOSURES:

This study did not receive any funding. One author reported being an editorial board member of Dermatology and Therapy, receiving support for attending meetings, serving as an advisory board member, and participating in clinical trials from AbbVie, Novartis, Moonlake, MSD, Sanofi, Incyte Almirall, and UCB. García‑Moronta and some other authors reported receiving support from UCB and Novartis to attend scientific congresses. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.