HS Wound Care & Dressing Guide

Why this happens

Inflamed HS lesions and sinus tracts (tunnels) can produce wound fluid (exudate) — sometimes in substantial amounts. The amount often fluctuates: quieter phases alternate with flares in which noticeably more fluid drains.

Heavy drainage is one of the most common reasons daily wound care feels overwhelming. International HS guidance explicitly recognises exudate management as an important part of care.

General wound-care principles

• Managing moisture is a core aim: dressings that take up fluid and hold it away from the skin protect the wound edge and surrounding skin from softening (maceration).
• Absorbent dressing categories exist specifically for larger amounts of exudate. Which category fits depends on body site, amount and skin condition — that is a professional assessment.
• Protecting the surrounding skin matters just as much as covering the wound itself.
• A dressing that is regularly soaked well before the next change is an important observation — note it down for your care team.

Why this happens

Leaks usually happen when the amount of fluid exceeds what the dressing can hold, when movement shifts the dressing, or when the fixation does not suit the body area. A working day adds hours between changes and often more movement.

General wound-care principles

• Capacity, wear time and fixation interact: HS guidance emphasises that dressing selection should consider body site, amount of exudate and secure fixation.
• Planning changes around the working day (before leaving, during a break) is a legitimate question for your care team — you do not have to solve it alone.
• A small kit with spare supplies and discreet disposal bags reduces stress away from home.
• Clothing that does not press on the dressing can prevent fluid from being squeezed out.

Why this happens

Pain at dressing changes is very common in HS — in an international survey, the large majority of respondents reported pain during changes. Frequent causes are dressings sticking to the wound surface and repeated removal of adhesives from already inflamed skin.

General wound-care principles

• Non-adherent dressings and silicone contact layers were developed for exactly this: reducing sticking to the wound and trauma on removal.
• Protecting the surrounding skin from repeated adhesive damage is a recognised wound-care principle.
• Gentle technique and the timing of changes are topics for a professional conversation — silently enduring severe pain is not a solution.
• Pain at every change is a signal worth raising — not a normal cost of wound care.

Why this happens

HS typically affects regions where skin rests on skin — armpits, groin, under the breast, buttocks. These areas move constantly: dressings can wrinkle, shift or rub. Friction increases discomfort and makes fixation harder still.

General wound-care principles

• Reducing friction is a core wound-care aim: conformable dressings and suitable fixation are considered for mobile body areas.
• Anatomical location is one of the main factors professionals weigh when suggesting a dressing category.
• Breathable, loose-fitting clothing layers can reduce shear over the dressing.
• Skin folds also need attention to moisture — sweat softens skin and makes it more fragile.

Why this happens

Travel changes routines: fewer opportunities for changes, heat, movement, and limited access to your usual supplies. With a little planning, wound care stays predictable away from home.

General wound-care principles

• Pack more supplies than the trip should mathematically need — and split them between bags where possible.
• Think through where and when a change is possible for each leg of the journey (hygiene, privacy).
• Heat and activity can temporarily increase drainage — a plan for heavier days helps.
• Good travel planning also includes knowing when and where you would seek medical help while away.

Why this happens

Worries about staining and odour are among the most common daily burdens with draining lesions — they affect what people feel able to wear. This is a practical problem with discussable solutions, not a reason for shame.

General wound-care principles

• Sufficient absorbency and secure fixation are the two main technical levers against stains on clothing.
• Odour usually arises from the interaction of wound fluid, bacteria and time. Regular changes and suitable dressing categories are the general levers — a sudden new, strong odour should be raised with a clinician.
• Dark, patterned and layered clothing are simple everyday strategies many people with HS use.
• Washable protective layers (for example on bedding) can ease worries at night.

Why this happens

After HS surgery (such as deroofing or excision), wounds often heal open from the base upwards (secondary intention). This takes weeks and needs different care from everyday HS lesions — and it always follows the operating team's individual instructions.

General wound-care principles

• Your surgical team's instructions always come first — general information never replaces them.
• Post-surgical wounds change week to week; care needs change with them.
• Structured follow-up — who checks the wound, and when — is part of good surgical care.
• Signs of infection after surgery are a reason to contact the treating team promptly.

Why this happens

Consultation time is short — and research shows that wound-care counselling varies considerably between clinicians. Arriving with concrete observations and questions makes it more likely your daily wound-care burden is actually addressed.

General wound-care principles

• Concrete numbers help: changes per day, minutes per day, leaks per week, pain intensity during changes.
• Some people bring their current dressing supplies or photos of them — so the care team sees immediately what you are working with.
• Actively ask whether a referral to a wound clinic or wound-care nurse is possible.
• Use the discussion checklist further down this page and bring it printed.