Without surgery, fistulas caused by Hidradenitis suppurativa (HS) are likely to recur. When treated with venous insufficiency, hypertonic saline (HTS) acts as a venous sclerosant, disrupting the endothelial lining and causing occlusion and fibrosis. The goal of this study is to assess the safety and effectiveness of HTS sclerotherapy for HS fistulas. Participants in this non-randomized clinical trial received HTS injections into their fistulas every 2 weeks for a total of 4 injections, with a follow-up period of 4 weeks. Participants had to have been diagnosed with HS and have at least 1 confirmed HS fistula. The research was conducted at two Boston, Massachusetts, academic dermatology outpatient clinics between the years 2016 and 2019. Primary outcomes included changes in HS fistula characteristics between the last and first visits and changes in HS as evaluated by physicians. About 21 patients took part in the study. Between Visits 2 and 3, there was a statistically significant increase in overall HS as assessed by physicians (P=.036). From the initial visit to the last, there was a statistically significant increase in drainage (P=.035), a decrease in erythema (P=.008), and a stabilization of swelling (P=.025). From the 1st visit to the 2nd (P=.0005), 3rd (P=.0008), and 4th (P=.011), scores on the dermatology life quality index increased significantly. In addition, there was a positive correlation between the amount of sclerosant and the sting scores on the numerical rating scale. The results of this study showed that fistulas improved after receiving serial HTS injections, as reported by both doctors and patients. Injections of HTS were generally safe.
