{"id":6372,"date":"2026-04-05T12:38:20","date_gmt":"2026-04-05T09:38:20","guid":{"rendered":"https:\/\/avrupacerrahi.net\/en\/?p=6372"},"modified":"2026-05-01T17:55:59","modified_gmt":"2026-05-01T14:55:59","slug":"surgical-treatment-for-hidradenitis-suppurativa-when-and-how-is-it-performed","status":"publish","type":"post","link":"https:\/\/avrupacerrahi.net\/en\/surgical-treatment-for-hidradenitis-suppurativa-when-and-how-is-it-performed\/","title":{"rendered":"Surgical Treatment for Hidradenitis Suppurativa"},"content":{"rendered":"
\n
\u270d\ufe0f Written by:<\/strong> Avrupa Cerrahi Medical Editorial Team
\n\ud83c\udfe5 Medical Review:<\/strong> General Surgery \/ Proctology Team \u00a0|\u00a0 \ud83d\udcc5 Published:<\/strong> May 1, 2026 \u00a0|\u00a0 \ud83d\udd04 Last Updated:<\/strong> May 1, 2026<\/span><\/div>\n<\/div>\n

Surgical Treatment for Hidradenitis Suppurativa: When and How Is It Performed?<\/h1>\n
\ud83d\udea8 Important Medical Notice:<\/strong> Surgical treatment for hidradenitis suppurativa must be planned after medical examination. A rapidly growing abscess, fever, spreading redness, severe pain, foul-smelling heavy discharge, uncontrolled bleeding<\/a><\/b>, or worsening swelling may require urgent evaluation. Do not try to drain, cut, squeeze, or puncture HS lesions at home.<\/div>\n
\n

\ud83d\udca1 Quick Answer<\/strong><\/p>\n

Surgical treatment for hidradenitis suppurativa may be considered when HS causes recurrent abscesses, chronic drainage, painful tunnels under the skin, scarred diseased tissue, or symptoms that do not respond well to medical treatment.<\/strong> Surgery is not the first option for every patient. Depending on the stage and lesion type, procedures may include incision and drainage for urgent abscess relief, deroofing for persistent tunnels, limited excision for localized disease, wide excision for advanced HS, CO2 laser-based tissue removal, or reconstruction with flaps or grafts. The goal is to remove or open diseased tissue, reduce recurrent drainage, improve pain, and support long-term control. However, hidradenitis suppurativa is chronic, so medical treatment, lifestyle changes, wound care, and follow-up may still be needed after surgery.<\/p>\n<\/div>\n

\u2695\ufe0f Medical Disclaimer:<\/strong> This article is for educational purposes only and does not replace medical examination, diagnosis, or surgical planning. The appropriate treatment must be determined by a qualified physician.<\/div>\n
\n

Table of Contents<\/strong><\/p>\n

    \n
  1. When is surgery considered for hidradenitis suppurativa?<\/a><\/li>\n
  2. Which surgical methods are used?<\/a><\/li>\n
  3. How is the right procedure chosen?<\/a><\/li>\n
  4. What happens before surgery?<\/a><\/li>\n
  5. How is HS surgery performed?<\/a><\/li>\n
  6. What happens after surgery?<\/a><\/li>\n
  7. Can HS come back after surgery?<\/a><\/li>\n
  8. What should not be done?<\/a><\/li>\n
  9. When should you contact a doctor urgently?<\/a><\/li>\n
  10. Frequently asked questions<\/a><\/li>\n<\/ol>\n<\/div>\n

    When is Surgery Considered for Hidradenitis Suppurativa?<\/h2>\n

    Hidradenitis suppurativa<\/strong>, also known as HS<\/strong> or acne inversa<\/strong>, is a chronic inflammatory disease of the hair follicle. It commonly affects friction-prone areas such as the armpits, groin, buttocks, under-breast area, inner thighs, and perianal region. The ICD-10-CM code for hidradenitis suppurativa is L73.2<\/strong>.<\/p>\n

    Surgery is considered when HS becomes structurally established in the skin. This means that the problem is no longer only a short-term inflamed lump. Instead, there may be chronic sinus tracts, tunnels, scarred tissue, recurrent abscesses, or persistent drainage that does not fully respond to medication alone.<\/p>\n

    Not every patient with HS needs surgery. Mild disease may be managed with lifestyle measures, topical treatment, oral medications, antibiotics, biologic therapies, or laser-based approaches. Surgery becomes more relevant when there is a specific diseased area that keeps recurring, draining, or forming tunnels.<\/p>\n

    \ud83d\udc68\u200d\u2695\ufe0f Clinical Note:<\/strong> In HS, the decision for surgery is not based only on the size of one abscess. The key questions are: Does it keep coming back? Is there a tunnel? Is there scarred diseased tissue? Does drainage continue despite medical treatment? These questions shape the surgical map.<\/div>\n

    For a general overview of HS, see What is Hidradenitis Suppurativa? Diagnosis and Treatment Process<\/a>.<\/p>\n

    Which Surgical Methods Are Used?<\/h2>\n

    There are several surgical and procedural options for hidradenitis suppurativa. The best method depends on disease stage, lesion depth, tunnel formation, location, recurrence pattern, and patient health. A tiny urgent abscess and a wide scarred tunnel network are very different creatures; they should not be treated with the same net.<\/p>\n

    Main Surgical and Procedural Options<\/h3>\n\n\n\n\n\n\n\n\n\n\n
    Procedure<\/th>\nWhen It May Be Used<\/th>\nMain Goal<\/th>\n<\/tr>\n<\/thead>\n
    Incision and drainage<\/strong><\/td>\nTense, painful acute abscess<\/td>\nShort-term relief of pressure and pain<\/td>\n<\/tr>\n
    Deroofing<\/strong><\/td>\nPersistent tunnels or localized recurrent lesions<\/td>\nOpen the tunnel roof and allow healing from the base<\/td>\n<\/tr>\n
    Limited excision<\/strong><\/td>\nLocalized chronic diseased tissue<\/td>\nRemove a defined HS area<\/td>\n<\/tr>\n
    Wide excision<\/strong><\/td>\nAdvanced, scarred, recurrent, or extensive disease<\/td>\nRemove broad diseased tissue down to healthy margins<\/td>\n<\/tr>\n
    CO2 laser excision \/ ablation<\/strong><\/td>\nSelected chronic HS lesions or tissue-sparing treatment plans<\/td>\nPrecisely remove or vaporize diseased tissue<\/td>\n<\/tr>\n
    Flap or graft reconstruction<\/strong><\/td>\nLarge defects after wide excision<\/td>\nClose or reconstruct larger surgical wounds<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Incision and drainage may provide fast relief in an acute abscess, but it does not remove chronic HS tissue. Deroofing and excision are more targeted toward persistent tunnels and recurrent sites. Wide excision may be considered in advanced disease, especially Hurley Stage II or III disease with chronic tracts and scarring.<\/p>\n

    How is the Right Procedure Chosen?<\/h2>\n

    The right procedure is chosen after clinical examination. The physician evaluates the body area, number of lesions, depth of disease, presence of sinus tracts, scarring, drainage, previous treatments, pain level, and the patient\u2019s general health.<\/p>\n

    Factors That Influence Surgical Planning<\/h3>\n