经小切口皮下修剪联合浅筋膜切除治疗腋臭

Subcutaneous shearing combined with superficial fascia resection through a mini-incision for the treatment of osmidrosis

目的:介绍一种创伤小、效果确切的治疗腋臭的手术方法。方法:术前标记手术范围,超过腋毛分布范围1.0～1.5cm,采用局部肿胀麻醉,经腋窝顶部皱褶内长1～1.5cm的皮肤切口先后进行皮下修剪与腋窝浅筋膜的剪除,术区加压包扎。结果:在37例(74侧)采用此方法治疗的患者中,有32例(64侧)于术后6～18个月获得随访,有效率100%,治愈率98.44%,无局部皮肤坏死、腋下明显瘢痕及上肢活动受限等情况发生。术后病理检查证实在腋窝浅筋膜层内存有大量汗腺及毛囊结构。结论:采用本方法治疗腋臭症具有简便、安全、创伤小、效果确切的优点并最大限度地符合了整形美容外科学的要求。

Objective To introduce a new surgical method that can improve the effect of treatment of osmidrosis. Methods Marking line beyond the area of armpit hair lcm to 1.5cm had been drawn before operation. In this marked area, 0.25 percent lidocaine with 1：200 000 epinephrine was used for local tumescent anesthesia, then a lcm to 1.5cm length mini-incision was made at the fold in the axillary vertex. Through this incision, undermining and subcutaneous shearing were done at the first surgery step to snip the conduits of axillary apocrine sweat gland and remove a majority of hair follicles and axillary apocrine sweat gland, the skin in the marked area had became full- thickness graft-liked. At the second surgery step, the superficial fascia in the axillary area in which a large amount of hair follicles and axillary apocrine sweat gland remain（it was proved by pathology ） was removed by means of scissors. It is necessary to give a pressure dressing to the operative area. Results From Jun. 2005 to Jul. 2007, 37cases were treated with this method, 32cases of them were followed up from the postoperative 6th month to the postoperative 18th month, everyone declared that he had obtained a satisfactory result with no any complication and unconspicuous scar. Conclusion This surgery method is effective, safe and simple to treat osmidrosis, as well as it can meet the requirement of the surgery of plastic and aesthetic better.