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Hello Dr. XXXXXXX 4 Months Ago I Had Surgical Excision
Question: Hello Dr. XXXXXXX
4 months ago i had surgical excision of hidradenitis suppurativa in my left groin and then it started healing after taking also combination antibiotic clyndimicin and rifampicin...the antibiotics i took for 3 months and in week ill stop them....but there are two small wounds from the stitches that are not 100% closing which im not sure why...is it because of chronic inflammation under skin?
can you recommend me a special cream or what to do to heal such chronic wound situation?
i am attaching photos of before and recent. thank you.
4 months ago i had surgical excision of hidradenitis suppurativa in my left groin and then it started healing after taking also combination antibiotic clyndimicin and rifampicin...the antibiotics i took for 3 months and in week ill stop them....but there are two small wounds from the stitches that are not 100% closing which im not sure why...is it because of chronic inflammation under skin?
can you recommend me a special cream or what to do to heal such chronic wound situation?
i am attaching photos of before and recent. thank you.
Hello Dr. XXXXXXX
4 months ago i had surgical excision of hidradenitis suppurativa in my left groin and then it started healing after taking also combination antibiotic clyndimicin and rifampicin...the antibiotics i took for 3 months and in week ill stop them....but there are two small wounds from the stitches that are not 100% closing which im not sure why...is it because of chronic inflammation under skin?
can you recommend me a special cream or what to do to heal such chronic wound situation?
i am attaching photos of before and recent. thank you.
4 months ago i had surgical excision of hidradenitis suppurativa in my left groin and then it started healing after taking also combination antibiotic clyndimicin and rifampicin...the antibiotics i took for 3 months and in week ill stop them....but there are two small wounds from the stitches that are not 100% closing which im not sure why...is it because of chronic inflammation under skin?
can you recommend me a special cream or what to do to heal such chronic wound situation?
i am attaching photos of before and recent. thank you.
Brief Answer:
possible sinus around stitches
Detailed Answer:
Hi and welcome.
Thank you for posting your query.
It looks to me that there are subcutaneous stitches and there is obviously small inflammation around which caused skin ulceration.
There is also indurate and minor hypertrophic scar visible, but all in all, It doesn't look bad considering the fact that hidradenitis may be very difficult to treat. If there is no pus secretion and there is no discharge in these skin fistulas, I would not insist on another surgery at this point.
I suggest to wait for several more weeks and you can apply some anti-keloid ointment such as Dermalean HC, NewGel+E or Repavar.
These small wounds are caused by thin skin and bad circulation which is common after skin surgeries so it may take some long time to close completely. But just be patient, I am sure it will be good at the end.
Regards
possible sinus around stitches
Detailed Answer:
Hi and welcome.
Thank you for posting your query.
It looks to me that there are subcutaneous stitches and there is obviously small inflammation around which caused skin ulceration.
There is also indurate and minor hypertrophic scar visible, but all in all, It doesn't look bad considering the fact that hidradenitis may be very difficult to treat. If there is no pus secretion and there is no discharge in these skin fistulas, I would not insist on another surgery at this point.
I suggest to wait for several more weeks and you can apply some anti-keloid ointment such as Dermalean HC, NewGel+E or Repavar.
These small wounds are caused by thin skin and bad circulation which is common after skin surgeries so it may take some long time to close completely. But just be patient, I am sure it will be good at the end.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
possible sinus around stitches
Detailed Answer:
Hi and welcome.
Thank you for posting your query.
It looks to me that there are subcutaneous stitches and there is obviously small inflammation around which caused skin ulceration.
There is also indurate and minor hypertrophic scar visible, but all in all, It doesn't look bad considering the fact that hidradenitis may be very difficult to treat. If there is no pus secretion and there is no discharge in these skin fistulas, I would not insist on another surgery at this point.
I suggest to wait for several more weeks and you can apply some anti-keloid ointment such as Dermalean HC, NewGel+E or Repavar.
These small wounds are caused by thin skin and bad circulation which is common after skin surgeries so it may take some long time to close completely. But just be patient, I am sure it will be good at the end.
Regards
possible sinus around stitches
Detailed Answer:
Hi and welcome.
Thank you for posting your query.
It looks to me that there are subcutaneous stitches and there is obviously small inflammation around which caused skin ulceration.
There is also indurate and minor hypertrophic scar visible, but all in all, It doesn't look bad considering the fact that hidradenitis may be very difficult to treat. If there is no pus secretion and there is no discharge in these skin fistulas, I would not insist on another surgery at this point.
I suggest to wait for several more weeks and you can apply some anti-keloid ointment such as Dermalean HC, NewGel+E or Repavar.
These small wounds are caused by thin skin and bad circulation which is common after skin surgeries so it may take some long time to close completely. But just be patient, I am sure it will be good at the end.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you doctor for your feedback. It is more realistic than dermatologists answers.
You right in previous months it was more painful than now and had a hard time walking now its better....I think my wound is actually closed in a way but because it is inflamed the skin got overlapped it makes it look that its not completely closed...i feel some pain and irritation due to the chronic inflammation under that part...that happens after i touch it to monitor my wound...would these meds reduce the inflammation?
You right in previous months it was more painful than now and had a hard time walking now its better....I think my wound is actually closed in a way but because it is inflamed the skin got overlapped it makes it look that its not completely closed...i feel some pain and irritation due to the chronic inflammation under that part...that happens after i touch it to monitor my wound...would these meds reduce the inflammation?
Thank you doctor for your feedback. It is more realistic than dermatologists answers.
You right in previous months it was more painful than now and had a hard time walking now its better....I think my wound is actually closed in a way but because it is inflamed the skin got overlapped it makes it look that its not completely closed...i feel some pain and irritation due to the chronic inflammation under that part...that happens after i touch it to monitor my wound...would these meds reduce the inflammation?
You right in previous months it was more painful than now and had a hard time walking now its better....I think my wound is actually closed in a way but because it is inflamed the skin got overlapped it makes it look that its not completely closed...i feel some pain and irritation due to the chronic inflammation under that part...that happens after i touch it to monitor my wound...would these meds reduce the inflammation?
Brief Answer:
follow-up consultation
Detailed Answer:
You're welcome.
I need to say that hidradenitis is more surgical disease than dermatological...In most cases, it can be solved only with appropriate surgery. I have a lot of experience with hidradenitis in the groin, axilla and perianal area...this is benign but sometimes very complicated disease and it commonly recur so it is important to have skilled doctor to treat it.
I don't know if local flaps or just excision was done, but such problems in wound closure may happen if there is too much tension on skin edges or if there are inflamed sweat glands left in subcutaneous tissue. However, as I said, I would not hurry with another surgery since the skin is now too sensitive and too thin to allow good results.
These meds have an antiinfalmmatory effect. These are available in Europe and the US. However, you can find any silicone + steroid based cream and this should help at some degree. If this won't help there are options such as laser or steroid injections.
Thanks
follow-up consultation
Detailed Answer:
You're welcome.
I need to say that hidradenitis is more surgical disease than dermatological...In most cases, it can be solved only with appropriate surgery. I have a lot of experience with hidradenitis in the groin, axilla and perianal area...this is benign but sometimes very complicated disease and it commonly recur so it is important to have skilled doctor to treat it.
I don't know if local flaps or just excision was done, but such problems in wound closure may happen if there is too much tension on skin edges or if there are inflamed sweat glands left in subcutaneous tissue. However, as I said, I would not hurry with another surgery since the skin is now too sensitive and too thin to allow good results.
These meds have an antiinfalmmatory effect. These are available in Europe and the US. However, you can find any silicone + steroid based cream and this should help at some degree. If this won't help there are options such as laser or steroid injections.
Thanks
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
follow-up consultation
Detailed Answer:
You're welcome.
I need to say that hidradenitis is more surgical disease than dermatological...In most cases, it can be solved only with appropriate surgery. I have a lot of experience with hidradenitis in the groin, axilla and perianal area...this is benign but sometimes very complicated disease and it commonly recur so it is important to have skilled doctor to treat it.
I don't know if local flaps or just excision was done, but such problems in wound closure may happen if there is too much tension on skin edges or if there are inflamed sweat glands left in subcutaneous tissue. However, as I said, I would not hurry with another surgery since the skin is now too sensitive and too thin to allow good results.
These meds have an antiinfalmmatory effect. These are available in Europe and the US. However, you can find any silicone + steroid based cream and this should help at some degree. If this won't help there are options such as laser or steroid injections.
Thanks
follow-up consultation
Detailed Answer:
You're welcome.
I need to say that hidradenitis is more surgical disease than dermatological...In most cases, it can be solved only with appropriate surgery. I have a lot of experience with hidradenitis in the groin, axilla and perianal area...this is benign but sometimes very complicated disease and it commonly recur so it is important to have skilled doctor to treat it.
I don't know if local flaps or just excision was done, but such problems in wound closure may happen if there is too much tension on skin edges or if there are inflamed sweat glands left in subcutaneous tissue. However, as I said, I would not hurry with another surgery since the skin is now too sensitive and too thin to allow good results.
These meds have an antiinfalmmatory effect. These are available in Europe and the US. However, you can find any silicone + steroid based cream and this should help at some degree. If this won't help there are options such as laser or steroid injections.
Thanks
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks Dr. XXXXXXX ..I am glad to know that you are experienced with HS, if you dont mind i would like to give you the detailed history of my condition before and after surgery.
4 months ago a general surgeon consultant whos had some experience with HS conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...he didnt remove any inflamed sweat glands i think...any after two weeks of removing the stitches it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel so there was alot of walking which i wasnt informed that this shearing/skin to skin rubbing would damage my groin skin...that casued some of the areas where there was stitches before to get inflamed and some pus came with some previous stitches from the inside...then when i saw the doctor again i started applying repavar and placed a sterile gauze dressing every time of the day...this really helped in healing all the areas which were inflamed except two places where the wound wouldnt close properly...the antibiotics clyndimicne and rephampicin helped alot with managing these two areas which closed up eventually i guess by controlling the inflammation...that ofcourse till today where i showed you my updated pics...one time i went for a 10 min run and noticed and the bottom part inflammation opened a little bit and blood came out, then little pus came out after and then it closed. this was a month ago. i am not sure if this was a healing process or because of that work out...anyways no secretion happened after that day.
I am attaching now the pics of my skin stages from before the surgery then right after and some time after that till today...please let me know doctor your opinion after these images.
is there any tests doctor that i can perform just to know the condition of my skin groin currently? like for any inflamed sweat glands as u mentioned.
4 months ago a general surgeon consultant whos had some experience with HS conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...he didnt remove any inflamed sweat glands i think...any after two weeks of removing the stitches it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel so there was alot of walking which i wasnt informed that this shearing/skin to skin rubbing would damage my groin skin...that casued some of the areas where there was stitches before to get inflamed and some pus came with some previous stitches from the inside...then when i saw the doctor again i started applying repavar and placed a sterile gauze dressing every time of the day...this really helped in healing all the areas which were inflamed except two places where the wound wouldnt close properly...the antibiotics clyndimicne and rephampicin helped alot with managing these two areas which closed up eventually i guess by controlling the inflammation...that ofcourse till today where i showed you my updated pics...one time i went for a 10 min run and noticed and the bottom part inflammation opened a little bit and blood came out, then little pus came out after and then it closed. this was a month ago. i am not sure if this was a healing process or because of that work out...anyways no secretion happened after that day.
I am attaching now the pics of my skin stages from before the surgery then right after and some time after that till today...please let me know doctor your opinion after these images.
is there any tests doctor that i can perform just to know the condition of my skin groin currently? like for any inflamed sweat glands as u mentioned.
Thanks Dr. XXXXXXX ..I am glad to know that you are experienced with HS, if you dont mind i would like to give you the detailed history of my condition before and after surgery.
4 months ago a general surgeon consultant whos had some experience with HS conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...he didnt remove any inflamed sweat glands i think...any after two weeks of removing the stitches it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel so there was alot of walking which i wasnt informed that this shearing/skin to skin rubbing would damage my groin skin...that casued some of the areas where there was stitches before to get inflamed and some pus came with some previous stitches from the inside...then when i saw the doctor again i started applying repavar and placed a sterile gauze dressing every time of the day...this really helped in healing all the areas which were inflamed except two places where the wound wouldnt close properly...the antibiotics clyndimicne and rephampicin helped alot with managing these two areas which closed up eventually i guess by controlling the inflammation...that ofcourse till today where i showed you my updated pics...one time i went for a 10 min run and noticed and the bottom part inflammation opened a little bit and blood came out, then little pus came out after and then it closed. this was a month ago. i am not sure if this was a healing process or because of that work out...anyways no secretion happened after that day.
I am attaching now the pics of my skin stages from before the surgery then right after and some time after that till today...please let me know doctor your opinion after these images.
is there any tests doctor that i can perform just to know the condition of my skin groin currently? like for any inflamed sweat glands as u mentioned.
4 months ago a general surgeon consultant whos had some experience with HS conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...he didnt remove any inflamed sweat glands i think...any after two weeks of removing the stitches it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel so there was alot of walking which i wasnt informed that this shearing/skin to skin rubbing would damage my groin skin...that casued some of the areas where there was stitches before to get inflamed and some pus came with some previous stitches from the inside...then when i saw the doctor again i started applying repavar and placed a sterile gauze dressing every time of the day...this really helped in healing all the areas which were inflamed except two places where the wound wouldnt close properly...the antibiotics clyndimicne and rephampicin helped alot with managing these two areas which closed up eventually i guess by controlling the inflammation...that ofcourse till today where i showed you my updated pics...one time i went for a 10 min run and noticed and the bottom part inflammation opened a little bit and blood came out, then little pus came out after and then it closed. this was a month ago. i am not sure if this was a healing process or because of that work out...anyways no secretion happened after that day.
I am attaching now the pics of my skin stages from before the surgery then right after and some time after that till today...please let me know doctor your opinion after these images.
is there any tests doctor that i can perform just to know the condition of my skin groin currently? like for any inflamed sweat glands as u mentioned.
Brief Answer:
hi again
Detailed Answer:
Hi.
I went through all these reports and images.
There was obviously extensive hydradenitis.
It is always difficult to treat and deep subcutaneous channels cant be reached with ointments or creme.
this is why almost always surgery is required.
I am not sure who performed this surgery, but it would be a case for plastic surgeon amd here in Europe, we would cover it with local rotational flap which covers the defect with healthy tissue. Second, it could have been treated with open excision and VAC system application. Third, at this point it is still to early to have reoperation. I am not sure if these holes will close spontanously but it is worth of trying to treat it conservatively for some time.
The photo of gorin area from some distance would be beneficial for me to give better comment.
hi again
Detailed Answer:
Hi.
I went through all these reports and images.
There was obviously extensive hydradenitis.
It is always difficult to treat and deep subcutaneous channels cant be reached with ointments or creme.
this is why almost always surgery is required.
I am not sure who performed this surgery, but it would be a case for plastic surgeon amd here in Europe, we would cover it with local rotational flap which covers the defect with healthy tissue. Second, it could have been treated with open excision and VAC system application. Third, at this point it is still to early to have reoperation. I am not sure if these holes will close spontanously but it is worth of trying to treat it conservatively for some time.
The photo of gorin area from some distance would be beneficial for me to give better comment.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
hi again
Detailed Answer:
Hi.
I went through all these reports and images.
There was obviously extensive hydradenitis.
It is always difficult to treat and deep subcutaneous channels cant be reached with ointments or creme.
this is why almost always surgery is required.
I am not sure who performed this surgery, but it would be a case for plastic surgeon amd here in Europe, we would cover it with local rotational flap which covers the defect with healthy tissue. Second, it could have been treated with open excision and VAC system application. Third, at this point it is still to early to have reoperation. I am not sure if these holes will close spontanously but it is worth of trying to treat it conservatively for some time.
The photo of gorin area from some distance would be beneficial for me to give better comment.
hi again
Detailed Answer:
Hi.
I went through all these reports and images.
There was obviously extensive hydradenitis.
It is always difficult to treat and deep subcutaneous channels cant be reached with ointments or creme.
this is why almost always surgery is required.
I am not sure who performed this surgery, but it would be a case for plastic surgeon amd here in Europe, we would cover it with local rotational flap which covers the defect with healthy tissue. Second, it could have been treated with open excision and VAC system application. Third, at this point it is still to early to have reoperation. I am not sure if these holes will close spontanously but it is worth of trying to treat it conservatively for some time.
The photo of gorin area from some distance would be beneficial for me to give better comment.
Above answer was peer-reviewed by :
Dr. Raju A.T
thanks doctor. have you had any patients recover from HS without recurrence?
I heard that excision with co2 laser seems to be very effective. attached are groin pics.
I heard that excision with co2 laser seems to be very effective. attached are groin pics.
thanks doctor. have you had any patients recover from HS without recurrence?
I heard that excision with co2 laser seems to be very effective. attached are groin pics.
I heard that excision with co2 laser seems to be very effective. attached are groin pics.
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Hi, I have provided some attachments. Please review them.
Brief Answer:
Hi
Detailed Answer:
Hi and welcome
Well, these photos don't look bad, it seems like there is good response to therapy. It is hard to talk about numbers, but the success of Surgery as permanent solution is around 60%. It depends on type of Surgery but generally it is around 60%
Hi
Detailed Answer:
Hi and welcome
Well, these photos don't look bad, it seems like there is good response to therapy. It is hard to talk about numbers, but the success of Surgery as permanent solution is around 60%. It depends on type of Surgery but generally it is around 60%
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Hi
Detailed Answer:
Hi and welcome
Well, these photos don't look bad, it seems like there is good response to therapy. It is hard to talk about numbers, but the success of Surgery as permanent solution is around 60%. It depends on type of Surgery but generally it is around 60%
Hi
Detailed Answer:
Hi and welcome
Well, these photos don't look bad, it seems like there is good response to therapy. It is hard to talk about numbers, but the success of Surgery as permanent solution is around 60%. It depends on type of Surgery but generally it is around 60%
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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