A simple video demonstrating the deroofing technique for hidradenitis suppurativa

Incision and drainage (I&D) is commonly performed on fluctuant abscesses during acute flares of hidradenitis suppurativa, especially in nondermatological settings such as the emergency room and primary care clinics. While the procedure can temporarily alleviate symptoms, the recurrence rate is 100%.1 Deroofing can be utilized for chronic tunnels as well as acute abscesses, with a low recurrence rate (4%-19%), few complications, and high patient satisfaction.1,2 The technique can be easily adapted from an I&D with the additional step of removal of the roof of the cavity, requiring the same local anesthesia and instruments.