Abstract
BACKGROUND: Tunnels of hidradenitis suppurativa (HS) are one of the most challenging aspects to manage, and different surgical techniques have been proposed for their treatment. CO 2 laser and surgical deroofing are 2 of the most widely used techniques, but no studies have compared them directly. OBJECTIVE: The objective of this study was to compare the efficacy and outcomes of CO 2 laser treatment versus surgical deroofing for HS tunnels, with a focus on healing time, complication rates, pain perception, and cosmetic outcomes. MATERIALS AND METHODS: The authors performed a multicentric retrospective analysis of 20 patients with HS tunnels who were treated with either CO 2 laser ( n = 10) or surgical deroofing ( n = 10). The primary end point was to compare the 2 procedures in terms of healing time, complication rates, pain, and cosmetic outcome. Outcome measures included Visual Analog Scale for pain, the Vancouver Scar Scale for scar evaluation, and the relapse rate at 6 months. Secondary end point included the identification of variables associated with the healing time. RESULTS: The mean time to healing was 4.7 ± 1.9 weeks in the CO 2 laser group and 10.9 ± 4.1 weeks in the surgical deroofing group ( p < .01). Pain score at the first dressing change was lower in the CO 2 laser group, with a mean Visual Analog Scale score of 1.7 ± 0.8 in the CO 2 laser group and 4.9 ± 1.7 in the surgical deroofing group ( p < .01). The mean scar evaluation score using the Vancouver Scar Scale at 6-month follow-up was 2.5 ± 1.3 in the CO 2 laser group and 3.4 ± 1.1 in the surgical deroofing group. The number of postprocedural complications was low in both groups (1 in the CO 2 laser group and 3 in the surgical deroofing group). The proportion of patients achieving complete healing of the tunnels at 6 months was similar among the CO 2 laser and the surgical deroofing group (90% in the CO 2 laser group vs 80% in the surgical group). CONCLUSION: CO 2 laser is a safe and effective treatment for HS tunnels, with fast healing rates and low pain perception.