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This video tutorial is an educational resource for health care professionals on performing D-roofing of sinus tracts (skin tunnels) for patients with Hidradenitis Suppurativa (HS). It covers selecting appropriate patients, having the right equipment, obtaining informed consent, preparing the patient, understanding the procedure steps, and providing post-operative care. HS is a chronic skin condition with inflammatory lesions, boils, skin tunnels, and scarring. D-roofing involves removing the roof of the tunnel to allow for a stable scar to form.