HS ABSCESSES: I&D VS PUNCH DEBRIDEMENT (HSPUNCH)

Erasmus University

Status: Not yet enrolling

Conditions: Hidradenitis Suppurativa (Acne Inversa)

Treatments: Procedure: Punch Debridement; Procedure: Incision and Drainage

Study type: Interventional

Funder types: Other

Identifiers

NCT06731309

EMCD_12304

Details and patient eligibility

About

This randomized-control trial is designed to determine the recurrence rate of HS abscesses following drainage via two methods: I&D with a linear incision and PD with an 8mm punch biopsy. In this context, recurrence is a newly described HS abscess adjacent to or within the previously operated area, for which a second intervention is deemed necessary. We hypothesize that PD may yield a more favorable recurrence rate. In addition to comparing recurrence rates, this randomized-control trial will also evaluate postprocedural pain, the occurrence and type of complications, and patients' quality of life associated with both procedures. These additional factors are crucial in assessing the overall effectiveness and patient satisfaction associated with each method, further informing the potential establishment of PD as the new gold standard for draining small, painful, acute HS abscesses.

Enrollment: 72 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosed with HS
• Has an abscess requiring drainage with a maximum diameter of 5 centimeters.
• Age 16 years or older
• Willing and able to provide informed consent

Exclusion criteria

• Has other conditions that could interfere with the study, as estimated by physician
• Unable to comply with follow-up visits
• Allergic to lidocaine and/or adrenaline.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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72 participants in 2 patient groups

Punch Debdridement

Experimental group

Description:

After local anesthesia, a punch biopsy tool is positioned over the inflamed follicular unit, and a small circle of skin (4 to 8 mm in diameter) is excised. A firm twisting motion is necessary to ensure adequately deep excision. Similar to I\&D, this is followed by applying digital pressure and gauze scraping to eliminate the fluid contents. The wound is then left open to allow free drainage and heal by secondary intention.

Treatment:

Procedure: Punch Debridement

Gold standard: Incision and Drainage

Active Comparator group

Description:

Incision and Drainage is a minimally invasive surgical procedure often employed for the treatment of intensely painful, tense, and fluctuant abscesses that are too deep to drain spontaneously. After administration of a broad circumferential local anesthetic, a small linear incision is made using a standard scalpel blade. Digital pressure is applied to expel the fluid collection. Saline rinses can be used to flush out the remaining contents. This method offers instant pain relief, commonly performed in acute settings by dermatologists, emergency department physicians and general practitioners.

Treatment:

Procedure: Incision and Drainage