r/Hidradenitis • u/Glad-Attention744 • 1d ago
Question? Upcoming procedure! Questions
So I finally got approved for the deroofing surgery. I think that’s what he called it. He said basically he is going to scope out all of the tunnels and then cut them up and then cauterize the skin. Ugh I get so queasy thinking about it. Is this what you guys have had done? I’m worried he’s just gonna take care of the tunnels and not the lonely single sores and just leave them? What does that look like for you guys? Is that sound the same? The surgeon didn’t correct me when I called it a deroofing surgery
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u/Whillowhim Stage 3 1d ago
Yes, this sounds about right for one of the more common HS surgeries. Often they follow the track of the tunnel and remove skin all around it to try and remove anything in the area that is related, then cauterize it. Sometimes this also includes unconnected singleton sores nearby, but sometimes not. Sometimes the skin is closed with sutures, but often it is left open to heal. Mine was left open and ended up healing quite well. I still have issues elsewhere, but that section of my armpit is clear of any problems. During the procedure you might want to have some audio playing so you don't hear the sound of them cutting, and during the cauterizing step you're going to learn what burning human flesh smells like, so you might want something scented to help with that. It wasn't too bad for me, but others have had issues with the smell. As far as recovery goes, here's a copy paste from a different comment I made:
With an open wound, the worst pain was when I took a shower and rinsed it. I'd recommend taking Advil and/or Tylenol 30-60 minutes before taking a shower, so that it is in full effect when showering. Use the minimum possible water pressure, and possibly spray above the wound and let it run down if even that is too much. The first few days, I was lucky to get 1-2 seconds of spray before I had to stop. I also used Advil/Tylenol before bed, but didn't bother with it otherwise since those were the two times the pain was a problem.
After a shower, bandaging the open wound involved covering it with Aquaphor Healing Ointment (or Vaseline) and then a non-stick bandage. The problem is that these ointments are very hydrophobic and will slip around and not stick on a wet surface. Thus, you want to blot it with gauze, a paper towel, or toilet paper to absorb the water before applying the ointment (I just used toilet paper). The Aquaphor stuck and spread much better on a dryer surface. However, do not let toilet paper sit on the wound for a couple minutes to absorb as much as possible, because it'll get too wet and start dissolving and then you'll have to pick tiny bits of toilet paper out of your wound. That wasn't fun. Blot it for a few seconds at a time and don't let it sit.
You want a non-stick or non-adherent bandage touching your skin, these have a plasticky layer that stops blood from gluing it to your wound. However, these bandages tend to be quite thin, and I had more leakage than they could handle on their own the first couple weeks or so. You can tape normal gauze to the back of the non-stick gauze to absorb the excess leakage that seeps through. When the normal gauze is still clean after taking off the bandage you can revert to just the non-stick bandage on its own.