Surgical management of hidradenitis suppurativa abroad

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory dermatosis associated with pain, scarring and diminished quality of life. Surgical excision offers durable disease control, but in Ireland, limited access to specialized surgical services challenges timely intervention. In Ireland, the Health Service Executive (HSE) Travel Abroad Scheme offers a unique opportunity for patients to receive expert surgical care overseas. The aim of this study was to evaluate a cross-border surgical referral pathway for patients with advanced HS within a publicly funded healthcare system. We conducted a retrospective chart review of six patients with HS who underwent surgical management abroad between 2022 and 2024. A comprehensive review of both charts and electronic records was performed, gathering data on patient demographics, comorbidities, prior treatments, wait times, length of stay abroad and postoperative complications. The cohort comprised three men and three women, with a mean age of 46 years. All six patients had Hurley stage III disease. Five patients were receiving biologic therapy, which was held prior to surgery. A wide local excision with secondary intention healing was performed in all cases. Time from referral to surgery ranged from 2 to 6 months. Postoperative surgical-site infections occurred in two patients, one requiring emergency department attendance; both were successfully treated with antibiotics. The length of stay abroad ranged from 6 to 28 days. All wounds were documented to have healed well. This case series demonstrates that the HSE Treatment Abroad Scheme can facilitate timely access to specialist surgical management for patients with advanced HS, with acceptable complication rates and good wound-healing outcomes. These findings highlight the potential value of cross-border referral pathways in addressing gaps in specialist HS surgical provision within publicly funded healthcare systems.

Abstract from Crossref