What to expect from hidradenitis surgery for hidradenitis suppurativa

Hidradenitis suppurativa can create painful nodules, draining openings and interconnected tunnels under the skin. A surgeon may drain a tense lesion, remove a limited area, or excise a wider area containing established tunnels. The planned approach depends on the site, depth and amount of involved skin. Some wounds are closed; others are left to heal gradually or covered with a skin graft or nearby tissue, depending on the operation.

Beforehand, discuss medicines, allergies, smoking or vaping, diabetes, previous wound-healing problems and practical help at home. You may receive instructions about washing the area, eating and drinking before anaesthesia, and pausing or continuing medicines. Surgery treats the selected diseased tissue, but new hidradenitis lesions can still develop elsewhere, so dermatology care may remain part of the plan.

Arrange transport if sedation or anaesthesia is planned, loose clothing that will not rub the wound, and help with dressing changes if movement is difficult. Follow the surgical team’s instructions for keeping the area clean, changing dressings, showering and using prescribed pain relief. Do not squeeze, pick or apply unapproved products to the wound. Keep follow-up appointments so the team can check healing, manage drainage and adjust dressings.

Recovery varies with the procedure and body site. Tenderness, swelling, drainage and limited movement can occur early on. Ask when you can return to work, exercise, swimming, shaving or deodorant use, particularly when the wound is near the armpit or groin. Contact your team if you are unsure whether a dressing change or wound appearance is expected.

Seek prompt medical advice for fever, rapidly increasing redness or swelling, worsening pain, foul-smelling drainage, bleeding that does not settle with firm pressure, wound edges opening unexpectedly, or feeling faint or very unwell. Breathing difficulty, facial swelling or another sudden severe reaction after a medicine requires emergency care. Use the contact number supplied by your surgical team when possible, because wound-specific advice is most useful.

Ask which lesions or tunnels will be treated, whether the wound will be closed, how dressing changes will work, what pain relief is suitable, and which activities need to pause. Clarify who to contact after hours, what healing changes are expected, and how surgery fits with medicines or other treatment for hidradenitis suppurativa.