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Case Series/Study

(CS-090) Repurposing Excised Hidradenitis Suppurativa Tissue for Autografting and Skin Cell Suspension Autograft: A Case Study of Innovation in Complex Reconstruction

Friday, April 10, 2026
Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that can be refractory to medical therapy and profoundly impair psychological well-being. Surgical excision remains a cornerstone for severe Hurley stage III disease; however, reconstruction often requires donor skin harvesting, which may be contraindicated in patients with significant pain sensitivity, scarring, or psychosocial fragility. Emerging laboratory and clinical evidence suggest that inflamed HS tissue may retain viability for use in grafting and autologous skin cell suspension procedures. We present a novel case in which excised HS tissue itself served as the donor source for both split-thickness autografting and Skin Cell Suspension Autograft (SCSA)*, eliminating the need for a separate donor site in a vulnerable patient with recalcitrant disease.

Methods: A 25-year-old woman with longstanding Hurley stage III HS involving the axillae, abdomen, chest, groin, and medial thighs presented with severe disease unresponsive to multiple biologics and with significant psychological distress, including suicidal ideation. Given her inability to tolerate additional donor site morbidity, a recycled-skin technique was employed. Resection margins were marked preoperatively, the operative field was infiltrated with tumescent solution, and diseased tissue was excised with a plasma blade. The most viable portions of the removed HS skin were harvested to create meshed autograft and processed concurrently for SCSA, which was applied to the wound bed following graft placement. This approach eliminated the need for a separate harvesting site while maintaining autologous cellular application capability.

Results: The grafts demonstrated early adherence and robust epithelialization. At one week, the wound beds showed organized graft take; at one month, substantial re-epithelialization was evident, and by six months the surgical sites were fully healed with soft, pliable tissue and minimal scarring. The patient experienced significant symptomatic and psychosocial improvement.

Discussion: This case highlights a feasible and innovative surgical strategy for HS: repurposing excised inflamed tissue as an autologous donor source for both meshed autografting and SCSA. By eliminating additional donor-site morbidity, especially critical for high-burden, high-pain, high-risk patients - this technique may expand reconstructive options in advanced HS. Further study is warranted to validate outcomes and refine patient-selection criteria.