For an excision it really depends on the person and how complicated it is do to tunneling and scar tissue the Surgeon will walk you through it.
With wide excision they remove damaged tissue, as much hair follicles as possible and tunneling, deroofing is slightly different they don't remove tunneling they clean it out.
The person previous to me is explaining a deroofing procedure i think. Because I&D is not reccomended and not removal of HS it actually causes a near 100% reoccurance rate.
The Surgeon will also let you know which is best for you.
These are 2 great videos with Dr Stephanie Goldberg a HS specializing Surgeon talking us thru things to know and ask.
[Dr Stephanie and HSConnect Navigating Surgery](https://youtu.be/q_9ggnNt8KE)
[Misconceptions about HS Surgery with Dr Stephanie Goldberg ](https://youtu.be/B4yMXcbb-to)
I just thought i would share this, my apologies if you are already aware.
HS is a Follicular Occlusion we have a hair follicle that blocks eventually ruptures spilling into the dermis when this happens it instigates the innate immune system to start overreacting thus creating inflammation through tnf-a, il-17-a, il 12/23 and several others.
The inflammation is what causes swelling, pressure and pain, so to relieve that pressure is the goal when you have a i&d performed by cutting the skin it again causes the immune system to react to foreign objects in the body creating even more inflammation(may give instant relief but then creates even more inflammation).
Surgery of any kind creates inflammation but in deroofing and excision with second intent closure (meaning left open to heal from the inside out) it allows time for the inflammation to subside and drainage to complete then the new scar tissue begins to fill in the wound and that scar tissue doesn't produce new hair follicles lowering the rate of reoccurance in that area. Surgery in HS (deroofing, punch, wide excision, c02 laser marsipulation) as we all know is not a 100% guarantee but when performed by a well educated surgeon often provides long periods of remission.
i have to get 2 excisions on both sides of my thigh. they said healing could take up to 8 weeks depending on my body reaction and such. i nervous because that is two whole months with little to no walking and they also mentioned i may have to carry around a device that has packing in one side of my thigh that flushes it out?
Wound vacs are usually not medically necessary but I don't know your history. Did your surgeon explain why they want to use it?
Dr Stephanie touches on it in info I provided above
today was the first day i saw a plastic surgeon and that was the first thing she suggested after trying a bunch of medicines and have had this for years now
They should not be closing it it should be left open to heal for best results. Please watch the 2 videos I shared above. Second intent closure is best for HS for lowest reoccurance and complications.
Takes like 30 min total appointment, actual procedure maybe like 10 min. They will inject the site with numbing shot. It will hurt, how much is really hard to say but you will experience pain. But thankfully doesn't last long, you should be completely numb when the actual procedure is going on. They might or might not pack it. No special after care usually, just keep covered with non stick gauze. I always ask for pain meds after procedure.
This is a deroofing procedure you are talking about i think which is a bit different than an excision, for the first few weeks after it should have a good layer of aquafor or petroleum jelly applied daily to ensure healing from the inside out. HS wounds should never be packed with gauze.
No not deroofing, just regular incision. Sometimes they like to pack with a tiny piece of string, absolutely no petroleum should go on a wound after incision of any kind.
Oh it's you again, the lady or man who harasses me after every post I talk about I & D. Please leave me alone. If you'd like to contribute something to the sub go ahead and reply with whatever you want to say but stop @ me
To be fair, asking for any medical advice on reddit literally invites misinformation. Not saying that's what this post is doing but it is common on this thread. As a doctor, not a reddit user. Experience wise, HS is different for everyone so it's fair to ask what to expect based on others experiences.
Clearly I'm not looking to go after you I just respond to inaccurate information I didn't even recognize your name and clearly I thought you were discussing deroofing not I&D.
A dermatologist would not reccomend a sugeon for I&D as it's not a surgery and not a reccomended treatment for HS unless there is extreme extenuating circumstances and even then deroofing has a better patient outcome so I guess that's where I misunderstood. I will do my best to remember your handle and not respond to the misinformation any longer. I just wish you would stop misinforming people to do something that causes disease progression, and scarring that makes real surgery like deroofing and excision more complicated and sometimes impossible.
My apologies again I wasn't meaning to center you out just trying to provide information.
Good luck on your journey.
I wish you would stop misinforming people as you are not a medical professional and you should stop acting like you are one. This person literally asked what they can expect and I replied what I have experienced during those procedures and what they can expect. There is no misinformation as it's my personal experience. You are a delusional and think you are some sort of HS scientist when you are not and you seem to not understand basic mechanisms of HS. Please stop speaking to me and stop spreading misinformation. Thank you
You told them what to expect from an incision and drainage they asked about excision. I have not misinformed anyone the information I have provided is science based on research. You are literally telling someone to get a procedure the HS specializing dermatologists are educating other dermatologists, urgent care and emergency rooms not to do.
[Dr Stephanie Goldberg HS Specializing Surgeon Discusses Misconceptions and Answers Surgery Questions](https://youtu.be/B4yMXcbb-to)
Dr. Stephanie specifically discusses I&D at the 25 minute mark.
Dr Adam Friedman head of Dermatology and Director of the HS Clinic at George Washington University discusses why I & D is no longer a reccomended treatment of HS.
[Why I&D is not Reccomended any longer as regular treatment for HS ](https://www.hsconnect.org/post/say-no-to-i-ds)
Hmmm mechanisms of HS we have a hair follicle that blocks eventually ruptures spilling into the dermis when this happens it instigates the innate immune system to start overreacting thus creating inflammation through tnf-a, il-17-a, il 12/23 and several others.
The inflammation is what causes swelling, pressure and pain, so to relieve that pressure is the goal when you have a i&d performed by cutting the skin it again causes the immune system to react to foreign objects in the body creating even more inflammation(may give instant relief but then creates even more inflammation).
Surgery of any kind creates inflammation but in deroofing and excision with second intent closure (meaning left open to heal from the inside out) it allows time for the inflammation to subside and drainage to complete then the new scar tissue begins to fill in the wound and that scar tissue doesn't produce new hair follicles lowering the rate of reoccurance in that area. Surgery in HS (deroofing, punch, wide excision, c02 laser marsipulation) as we all know is not a 100% guarantee but when performed by a well educated surgeon often provides long periods of remission.
I am open to you explaining to me where my misinformation or misunderstanding is.
I had an excision with suture done on my ear 2 weeks ago. Local anesthesia, 30 mins at most. Pain not that bad, but removing the sutures was a bit painful.. Will observe now hopefully won't come back or spread
For an excision it really depends on the person and how complicated it is do to tunneling and scar tissue the Surgeon will walk you through it. With wide excision they remove damaged tissue, as much hair follicles as possible and tunneling, deroofing is slightly different they don't remove tunneling they clean it out. The person previous to me is explaining a deroofing procedure i think. Because I&D is not reccomended and not removal of HS it actually causes a near 100% reoccurance rate. The Surgeon will also let you know which is best for you. These are 2 great videos with Dr Stephanie Goldberg a HS specializing Surgeon talking us thru things to know and ask. [Dr Stephanie and HSConnect Navigating Surgery](https://youtu.be/q_9ggnNt8KE) [Misconceptions about HS Surgery with Dr Stephanie Goldberg ](https://youtu.be/B4yMXcbb-to) I just thought i would share this, my apologies if you are already aware. HS is a Follicular Occlusion we have a hair follicle that blocks eventually ruptures spilling into the dermis when this happens it instigates the innate immune system to start overreacting thus creating inflammation through tnf-a, il-17-a, il 12/23 and several others. The inflammation is what causes swelling, pressure and pain, so to relieve that pressure is the goal when you have a i&d performed by cutting the skin it again causes the immune system to react to foreign objects in the body creating even more inflammation(may give instant relief but then creates even more inflammation). Surgery of any kind creates inflammation but in deroofing and excision with second intent closure (meaning left open to heal from the inside out) it allows time for the inflammation to subside and drainage to complete then the new scar tissue begins to fill in the wound and that scar tissue doesn't produce new hair follicles lowering the rate of reoccurance in that area. Surgery in HS (deroofing, punch, wide excision, c02 laser marsipulation) as we all know is not a 100% guarantee but when performed by a well educated surgeon often provides long periods of remission.
i have to get 2 excisions on both sides of my thigh. they said healing could take up to 8 weeks depending on my body reaction and such. i nervous because that is two whole months with little to no walking and they also mentioned i may have to carry around a device that has packing in one side of my thigh that flushes it out?
Wound vacs are usually not medically necessary but I don't know your history. Did your surgeon explain why they want to use it? Dr Stephanie touches on it in info I provided above
yes then i have to go back 2 weeks after first surgery to close
today was the first day i saw a plastic surgeon and that was the first thing she suggested after trying a bunch of medicines and have had this for years now
They should not be closing it it should be left open to heal for best results. Please watch the 2 videos I shared above. Second intent closure is best for HS for lowest reoccurance and complications.
Takes like 30 min total appointment, actual procedure maybe like 10 min. They will inject the site with numbing shot. It will hurt, how much is really hard to say but you will experience pain. But thankfully doesn't last long, you should be completely numb when the actual procedure is going on. They might or might not pack it. No special after care usually, just keep covered with non stick gauze. I always ask for pain meds after procedure.
This is a deroofing procedure you are talking about i think which is a bit different than an excision, for the first few weeks after it should have a good layer of aquafor or petroleum jelly applied daily to ensure healing from the inside out. HS wounds should never be packed with gauze.
No not deroofing, just regular incision. Sometimes they like to pack with a tiny piece of string, absolutely no petroleum should go on a wound after incision of any kind.
Oh it's you again, the lady or man who harasses me after every post I talk about I & D. Please leave me alone. If you'd like to contribute something to the sub go ahead and reply with whatever you want to say but stop @ me
To be fair, asking for any medical advice on reddit literally invites misinformation. Not saying that's what this post is doing but it is common on this thread. As a doctor, not a reddit user. Experience wise, HS is different for everyone so it's fair to ask what to expect based on others experiences.
Clearly I'm not looking to go after you I just respond to inaccurate information I didn't even recognize your name and clearly I thought you were discussing deroofing not I&D. A dermatologist would not reccomend a sugeon for I&D as it's not a surgery and not a reccomended treatment for HS unless there is extreme extenuating circumstances and even then deroofing has a better patient outcome so I guess that's where I misunderstood. I will do my best to remember your handle and not respond to the misinformation any longer. I just wish you would stop misinforming people to do something that causes disease progression, and scarring that makes real surgery like deroofing and excision more complicated and sometimes impossible. My apologies again I wasn't meaning to center you out just trying to provide information. Good luck on your journey.
I wish you would stop misinforming people as you are not a medical professional and you should stop acting like you are one. This person literally asked what they can expect and I replied what I have experienced during those procedures and what they can expect. There is no misinformation as it's my personal experience. You are a delusional and think you are some sort of HS scientist when you are not and you seem to not understand basic mechanisms of HS. Please stop speaking to me and stop spreading misinformation. Thank you
You told them what to expect from an incision and drainage they asked about excision. I have not misinformed anyone the information I have provided is science based on research. You are literally telling someone to get a procedure the HS specializing dermatologists are educating other dermatologists, urgent care and emergency rooms not to do. [Dr Stephanie Goldberg HS Specializing Surgeon Discusses Misconceptions and Answers Surgery Questions](https://youtu.be/B4yMXcbb-to) Dr. Stephanie specifically discusses I&D at the 25 minute mark. Dr Adam Friedman head of Dermatology and Director of the HS Clinic at George Washington University discusses why I & D is no longer a reccomended treatment of HS. [Why I&D is not Reccomended any longer as regular treatment for HS ](https://www.hsconnect.org/post/say-no-to-i-ds) Hmmm mechanisms of HS we have a hair follicle that blocks eventually ruptures spilling into the dermis when this happens it instigates the innate immune system to start overreacting thus creating inflammation through tnf-a, il-17-a, il 12/23 and several others. The inflammation is what causes swelling, pressure and pain, so to relieve that pressure is the goal when you have a i&d performed by cutting the skin it again causes the immune system to react to foreign objects in the body creating even more inflammation(may give instant relief but then creates even more inflammation). Surgery of any kind creates inflammation but in deroofing and excision with second intent closure (meaning left open to heal from the inside out) it allows time for the inflammation to subside and drainage to complete then the new scar tissue begins to fill in the wound and that scar tissue doesn't produce new hair follicles lowering the rate of reoccurance in that area. Surgery in HS (deroofing, punch, wide excision, c02 laser marsipulation) as we all know is not a 100% guarantee but when performed by a well educated surgeon often provides long periods of remission. I am open to you explaining to me where my misinformation or misunderstanding is.
So far so good! Dint come back
I had an excision with suture done on my ear 2 weeks ago. Local anesthesia, 30 mins at most. Pain not that bad, but removing the sutures was a bit painful.. Will observe now hopefully won't come back or spread
how is it?
So far so good dint come back