Study Highlights Impact of Smoking on Surgical Outcomes for HS

Study Highlights Impact of Smoking on Surgical Outcomes for HS

December 20, 2024 Catherine Williams - Chief Editor Health

This review was authored in part by Akash Rau, an MD candidate from the department of medicine at Michigan State University College of Human Medicine. The investigators noted that there is a range of surgical treatments for individuals with HS, from deroofing to surgical excision.2

These surgeries can also vary in extent, from lesional to regional. Rau et al. also highlighted prior data suggesting smoking and obesity are closely linked to HS.3

“There are limited studies assessing this relationship,” Rau and colleagues wrote. “Therefore, we conducted a systematic review to identify randomized controlled trials, observational studies (cohort, case–control, and cross-sectional), or case series with ≥5 patients that assessed the impact of tobacco on surgical outcomes in HS.”1

Trial Design

Findings

Among the 16 analyses that involved use of statistical analyses, data from 2831 patients were included. The investigative team found that smokers made up 51.6%. Notably, none of these studies found a statistically significant link between poor surgical outcomes and smoking.

Conversely, the researchers noted that the 6 studies without statistical analyses, the subjects of which were 61.8% smokers, resulted in higher rates of complications in those labeled as smokers compared to those who did not smoke.

The team specifically found that delayed HS recurrence rates had been 20.6% for smokers versus 5.45% for those who did not. Additionally, healing of wounds was found to have occurred among 3.1% versus 0%, respectively. They also found that dehiscence rates were 5.2% versus 0%, respectively.

Importantly, the research team did note that none of the studies controlled for factors such as participants’ sex, age, race, the size and location of HS lesions, or HS stagning. They also found that other variables, such as comorbidities, had also not been accounted for.

“Limitations include a lack of standardized definitions of surgical outcomes in HS, for example, local recurrence or disease recurrence at a distant site,” they wrote. “Further studies with matched patients can further analyze the association between smoking and surgical wound healing in HS patients.”1

References

  1. Rau A, Bazzi M, Elhage KG, Daveluy S. The association between smoking and wound healing after surgical treatment of hidradenitis suppurativa: a systematic review. Int J Dermatol. 2024 Dec 13. doi: 10.1111/ijd.17613. Epub ahead of print. PMID: 39670527.
  2. Bui H, Bechara FG, George R, Goldberg S, Hamzavi I, Kirby JS, et al. Surgical procedural definitions for hidradenitis suppurativa developed by expert Delphi consensus. JAMA Dermatol. 2023; 159(4): 441–447. https://doi.org/10.1001/jamadermatol.2022.626.
  3. Alotaibi HM. Incidence, risk factors, and prognosis of hidradenitis suppurativa across the globe: insights from the literature. Clin Cosmet Investig Dermatol. 2023; 16: 545–552. https://doi.org/10.2147/CCID.S402453.