First Clinical Experience of FiLaC TM in Hidradenitis Suppurativa: Is it a Safe and Feasible Treatment Modality?

Abstract

Aim:Hidradenitis suppurativa (HS) is a disabling and suppurative disease affecting primarily the apocrine-bearing areas. Although wide surgical excision can be performed in later stages, minimally invasive surgical techniques have been developed to limit tissue loss. Fistula-tract Laser Closure (FiLaC™) has been used to shrink the fistulous tracts of perianal fistula, pilonidal sinus and urethroperineal fistula. However, its usefulness in HS is not yet established.Method:A retrospective analysis of 14 consecutive patients with HS located at the perianal/perineal and axillary regions was performed. All patients underwent surgery with the FiLaC™ technique. After treatment, patients were evaluated for the type of clinical response as complete, partial and no response. At the 3rd month control, wound healing without drainage and closure of all external orifices was considered complete response, slight drainage with minimal symptoms was regarded as partial response and persistent and painful symptomatic drainage was evaluated as no response.Results:There were 12 (85.7%) male and two female patients (14.3%) with a mean age of 40.3±8.4 years. Perianal/perineal and axillary HS was detected in 12 (85.7%) and two (14.3%) patients, respectively. No intra- and post-operative complications were recorded. Complete and partial responses were seen in four (28.6%) and eight (57.1%) patients, respectively. No clinical response was observed in two patients (14.3%).Conclusion:The FiLaC™ technique for the treatment of HS is shown to be safe and feasible. Given the complete and partial responses in most patients, this technique may be used as an adjunctive step in patients with HS with the previous failure of medical and surgical treatments.

Keywords

• hidradenitis suppurativa
• laser
• fistula-tract laser closure
• minimally invasive surgery