Hidradenitis suppurative is characterized by recurrent, painful, inflamed nodular lesions in apocrine- gland bearing areas of the body (axillae, groin, inguinal area). These are frequently complicated by abscess formation. Medical and surgical treatment regimens used in combination include: antibiotics, steroids, I&D, local excision and unroofing of sinus tracks, and aggressive Woundcare.

This patient is a 48 year old female diabetic who underwent operative incision and drainage of multiple abscesses in the groin and bilateral axillas secondary to severe Hidradenitis suppurativa. I&D sites/ ulcers had large seropurulent drainage in the immediate post-op period. Culture-directed IV antibiotics were given. Topical antimicrobial dressing Cadexomer iodine gel* was used to decrease bacterial bioburden, decrease exudates and remove slough immediately post- I&D. After ten days on Cadexomer iodine gel*, exudates and slough have decreased, with increasing granulation. Patient was switched to a novel collagen matrix dressing with silver**. This novel collagen matrix dressing is a blend of triple helix and denatured porcine collagen, mixed with sodium alginate, carboxymethyl cellulose, EDTA and silver. This dressing acts by targeted control of MMPs, facilitates fibronectin activation, and promotes cell migration. Enhanced granulation, tissue regeneration and increased epithelialization were achieved within ten days of Biostep use. Ulcers completely healed in three weeks.

*IODOSORB Gel – Smith & Nephew Wound Management Inc., Largo, Fl.

**BIOSTEP Ag – Collagen matrix dressing with silver – Smith & Nephew Wound Management Inc., Largo, Fl.