Surgical Management of Hidradenitis Suppurativa with Novel Fish Skin Grafts

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that manifests with abscesses and sinuses formations. The management of HS is multidisciplinary including surgical resection and skin reconstruction in advanced and chronic stages. The extent of tissue removal and comorbidities of HS patients put remaining tissues at poor healing capability and lack of vascularization. Thus, it is common that patients with HS underwent multiple operations due to graft failure and poor cosmetic outcomes. Fish skin graft (FSG) is a unique biologic scaffold resembling the dermal extracellular matrix. FSG is rich in Omega3 that anti-inflammatory, promotes cellular ingrowth, neovascularization and aids tissue infill and remodel. We hypothesize that FSG can be used as part of the surgical intervention for HS either as wound bed preparation and closure support that will result in faster and better healing.Methods:A pilot study was conducted with 9 HS patients treated by Dr. Michael Romberg at SAS Surgical LTD. HS defects varied from the axilla, groin, labia and abdominal wall. Patients received excision of the damage tissues, followed by FSG and secondary closure or split thickness skin graft (STSG).Results:Complete healing was achieved in all cases without complications. FSG results in faster granulated tissues that led to successful closure or effective STSG after 1-3 months. Patients also notice scar reduction and less pain.Discussion: FSG is an effective alternative to conventional surgical interventions of HS. The use of FSG is safe, provides no complications and results rapid healing.References: