Radical surgical resection combined with lymphadenectomy-directed antimicrobial therapy yielding cure of severe axillary hidradenitis.
Identifieur interne : 001C12 ( PubMed/Corpus ); précédent : 001C11; suivant : 001C13Radical surgical resection combined with lymphadenectomy-directed antimicrobial therapy yielding cure of severe axillary hidradenitis.
Auteurs : Richard B. Nesmith ; Kim L. Merkel ; Bruce A. MastSource :
- Annals of plastic surgery [ 1536-3708 ] ; 2013.
English descriptors
- KwdEn :
- Adult, Anti-Bacterial Agents (therapeutic use), Axilla, Combined Modality Therapy, Female, Follow-Up Studies, Hidradenitis Suppurativa (microbiology), Hidradenitis Suppurativa (therapy), Humans, Length of Stay (statistics & numerical data), Lymph Node Excision, Lymph Nodes (microbiology), Lymph Nodes (surgery), Male, Middle Aged, Reconstructive Surgical Procedures (methods), Recurrence, Retrospective Studies, Severity of Illness Index, Surgical Flaps, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Anti-Bacterial Agents.
- methods : Reconstructive Surgical Procedures.
- microbiology : Hidradenitis Suppurativa, Lymph Nodes.
- statistics & numerical data : Length of Stay.
- surgery : Lymph Nodes.
- therapy : Hidradenitis Suppurativa.
- Adult, Axilla, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lymph Node Excision, Male, Middle Aged, Recurrence, Retrospective Studies, Severity of Illness Index, Surgical Flaps, Treatment Outcome.
Abstract
The current gold standard therapy for hidradenitis suppurativa (HS) is surgical resection. However, despite complete resection, the reoperation rate is reported as high as 54% due to wound infections and disease recurrences. Our hypothesis is that this high recurrence rate is related to retained disease and infected tissue not included in soft tissue resection, namely the lymph nodes. Therefore, performing a superficial lymphadenectomy with nodal microbacterial analysis would remove all infected tissue, eradicate the disease, and allow more specific targeted antibiotic therapy.
DOI: 10.1097/SAP.0b013e31828ea7cb
PubMed: 23542862
Links to Exploration step
pubmed:23542862Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Radical surgical resection combined with lymphadenectomy-directed antimicrobial therapy yielding cure of severe axillary hidradenitis.</title><author><name sortKey="Nesmith, Richard B" sort="Nesmith, Richard B" uniqKey="Nesmith R" first="Richard B" last="Nesmith">Richard B. Nesmith</name><affiliation><nlm:affiliation>Division of Plastic Surgery, and †Department of Dermatology, University of Florida, Gainesville, FL, USA. rbnesmith@uams.edu</nlm:affiliation></affiliation></author><author><name sortKey="Merkel, Kim L" sort="Merkel, Kim L" uniqKey="Merkel K" first="Kim L" last="Merkel">Kim L. Merkel</name></author><author><name sortKey="Mast, Bruce A" sort="Mast, Bruce A" uniqKey="Mast B" first="Bruce A" last="Mast">Bruce A. Mast</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23542862</idno><idno type="pmid">23542862</idno><idno type="doi">10.1097/SAP.0b013e31828ea7cb</idno><idno type="wicri:Area/PubMed/Corpus">001C12</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001C12</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Radical surgical resection combined with lymphadenectomy-directed antimicrobial therapy yielding cure of severe axillary hidradenitis.</title><author><name sortKey="Nesmith, Richard B" sort="Nesmith, Richard B" uniqKey="Nesmith R" first="Richard B" last="Nesmith">Richard B. Nesmith</name><affiliation><nlm:affiliation>Division of Plastic Surgery, and †Department of Dermatology, University of Florida, Gainesville, FL, USA. rbnesmith@uams.edu</nlm:affiliation></affiliation></author><author><name sortKey="Merkel, Kim L" sort="Merkel, Kim L" uniqKey="Merkel K" first="Kim L" last="Merkel">Kim L. Merkel</name></author><author><name sortKey="Mast, Bruce A" sort="Mast, Bruce A" uniqKey="Mast B" first="Bruce A" last="Mast">Bruce A. Mast</name></author></analytic><series><title level="j">Annals of plastic surgery</title><idno type="eISSN">1536-3708</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Anti-Bacterial Agents (therapeutic use)</term><term>Axilla</term><term>Combined Modality Therapy</term><term>Female</term><term>Follow-Up Studies</term><term>Hidradenitis Suppurativa (microbiology)</term><term>Hidradenitis Suppurativa (therapy)</term><term>Humans</term><term>Length of Stay (statistics & numerical data)</term><term>Lymph Node Excision</term><term>Lymph Nodes (microbiology)</term><term>Lymph Nodes (surgery)</term><term>Male</term><term>Middle Aged</term><term>Reconstructive Surgical Procedures (methods)</term><term>Recurrence</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Surgical Flaps</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Bacterial Agents</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Reconstructive Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Hidradenitis Suppurativa</term><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Length of Stay</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Hidradenitis Suppurativa</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Axilla</term><term>Combined Modality Therapy</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision</term><term>Male</term><term>Middle Aged</term><term>Recurrence</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Surgical Flaps</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The current gold standard therapy for hidradenitis suppurativa (HS) is surgical resection. However, despite complete resection, the reoperation rate is reported as high as 54% due to wound infections and disease recurrences. Our hypothesis is that this high recurrence rate is related to retained disease and infected tissue not included in soft tissue resection, namely the lymph nodes. Therefore, performing a superficial lymphadenectomy with nodal microbacterial analysis would remove all infected tissue, eradicate the disease, and allow more specific targeted antibiotic therapy.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23542862</PMID><DateCreated><Year>2013</Year><Month>04</Month><Day>12</Day></DateCreated><DateCompleted><Year>2013</Year><Month>10</Month><Day>25</Day></DateCompleted><DateRevised><Year>2013</Year><Month>04</Month><Day>12</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-3708</ISSN><JournalIssue CitedMedium="Internet"><Volume>70</Volume><Issue>5</Issue><PubDate><Year>2013</Year><Month>May</Month></PubDate></JournalIssue><Title>Annals of plastic surgery</Title><ISOAbbreviation>Ann Plast Surg</ISOAbbreviation></Journal><ArticleTitle>Radical surgical resection combined with lymphadenectomy-directed antimicrobial therapy yielding cure of severe axillary hidradenitis.</ArticleTitle><Pagination><MedlinePgn>538-41</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/SAP.0b013e31828ea7cb</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The current gold standard therapy for hidradenitis suppurativa (HS) is surgical resection. However, despite complete resection, the reoperation rate is reported as high as 54% due to wound infections and disease recurrences. Our hypothesis is that this high recurrence rate is related to retained disease and infected tissue not included in soft tissue resection, namely the lymph nodes. Therefore, performing a superficial lymphadenectomy with nodal microbacterial analysis would remove all infected tissue, eradicate the disease, and allow more specific targeted antibiotic therapy.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">From 2004 to 2009, 11 patients underwent 15 wide en bloc resections including superficial lymphadenectomy with flap reconstruction for axillary HS. A retrospective review was performed with the following outcomes assessed: culture results, hospital stay, and recurrences of HS.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients were followed up for an average of 4.3 years. During this time, there were no wound complications or disease recurrences. Positive bacterial cultures occurred in 12 of 14 nodes with results that differed from the soft tissue purulence. This led to a 75% change in antibiotic regimen. Superficial abscess cultures were uniformly covered, whereas only 3 of 12 nodal cultures where sensitive to our empiric antibiotic coverage. No patients developed lymphedema or any loss of function in the involved upper extremity.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Axillary HS has traditionally been a challenge due to the morbidity of care and high recurrence. Our data show that an en bloc resection with a superficial lymphadenectomy and subsequent antimicrobial therapy based on both the soft tissue and the lymph nodes can provide a definitive cure.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nesmith</LastName><ForeName>Richard B</ForeName><Initials>RB</Initials><AffiliationInfo><Affiliation>Division of Plastic Surgery, and †Department of Dermatology, University of Florida, Gainesville, FL, USA. rbnesmith@uams.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Merkel</LastName><ForeName>Kim L</ForeName><Initials>KL</Initials></Author><Author ValidYN="Y"><LastName>Mast</LastName><ForeName>Bruce A</ForeName><Initials>BA</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Plast Surg</MedlineTA><NlmUniqueID>7805336</NlmUniqueID><ISSNLinking>0148-7043</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017497" MajorTopicYN="N">Hidradenitis Suppurativa</DescriptorName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="Y">Lymph Node Excision</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008198" MajorTopicYN="N">Lymph Nodes</DescriptorName><QualifierName UI="Q000382" MajorTopicYN="Y">microbiology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019651" MajorTopicYN="N">Reconstructive Surgical Procedures</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013524" MajorTopicYN="Y">Surgical Flaps</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>4</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>4</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>10</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23542862</ArticleId><ArticleId IdType="doi">10.1097/SAP.0b013e31828ea7cb</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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