皮瓣法微创腋臭切除术135例分析

A CONTRAST ANALYSIS OF 135 CASES OF OSMIDROSIS TREATED BY RESECTING APOCRINE SWEAT GLAND WITH SKIN FLAP METHOD

目的通过历史对照探索微孔引流术在皮瓣法腋臭切除术中的作用。方法腋臭患者76例采用微孔引流行皮瓣法腋臭切除术作为治疗组,去除大汗腺及毛囊后在皮瓣上用尖刀片沿皮纹戳数个长约3mm的微孔进行引流,缝合切口后用弹力绷带包扎压迫手术区敷料。未采用微孔引流术的腋臭患者59例作为对照组进行历史对照研究,术后3d及7d换药,10d拆线并观察皮瓣成活情况,术后3～6个月进行随访。结果 2组患者均未发生切口感染。对照组出现血肿7例,其中皮肤坏死5例,出现瘢痕增生18例,腋窝皮肤皱褶9例及腋臭根治不彻底12例。治疗组出现表皮水疱8例,切口瘢痕增生6例,腋窝皮肤皱褶2例,无复发病例。治疗组治愈率明显高于对照组(P<0.01),治疗组血肿、瘢痕形成及复发率明显低于对照组(P<0.01)。结论微孔引流术可提高皮瓣法腋臭切除术疗效,而且并发症较少。

Objective To investigate the effects of resecting apocrine sweat gland with skin flap method in treating osmidrosis. Methods Seventy - six patients with osmidrosis were treated using skin flap method, named treatment group, which was punctured with sharp scalpel. The micropores were used for drainage, and the width was just 3mm. After removing apocrine sweat glands and hair follicles, the incision was sewed up. Gauze under both of axilla were pressed with 8 - shaped elastic bandage. Another 59 cases of osmidrosis, treated in the past with the same method only without micropore drainage, were named as control group. Historical case - control study was conducted. The incisions were examined at the 3d and 7d respectively, and the sutures were removed at the 10d. Follow -up study was carried out in all the patients between 3 and 6 months after the operation. Results No incision infection was found in both groups. There were 7 cases of hematoma,5 cases of skin necrosis, 18 cases of scar,9 cases of wrinkled skin, and 12 cases of osmidrosis residue in the control group. Of the treatment group, all the incisions were healed well, and no hematoma,infection or obvious scars were found after operation, excepting 8 cases of blisters ,6 cases of scar and 2 cases of wrinkled skin. Moreover,there was no recurrence in the treatment group. The cure rate of the treatment group was significantly higher than that in control group （P 〈 0. 01 ）,the hematoma, scar and recurrence rate in the treatment group were significantly lower than those in the control group （P 〈 0.01 ）. Conclusion Skin flap method with micropore as drainage is effectivein treating osmidrosis without obvious complications.