小切口真皮深层剪除大汗腺配合美宝外敷治疗腋臭

Clinical efficacy of treatment of axillary bromidrosis using excision of apocrine units within the dermis by small incision combined with application of MEBO

目的:探讨小切口真皮深层剪除大汗腺配合美宝外敷治疗腋臭的效果。方法:53例腋臭患者采用小切口真皮深层剪除大汗腺配合美宝外敷治疗腋臭,沿三等分标记切开皮肤皮下至脂肪层,以卵圆剪分离形成完整的皮下腔隙,轻轻翻开皮瓣,在直视下剪除大汗腺,间断分层缝合皮肤,选外侧切口处留置柱状橡皮条引流,在术前标记范围内涂布美宝烧伤膏,疏松纱块填盖腋窝,再以纱布绷带"8"字包扎,应用止血药2天,抗生素3天,术后第3天换药,去除引流条,再次给予术区涂布美宝烧伤膏同前一样纱布、绷带稍加压包扎,一般换药2～3次后即10～14天拆线。结果:53例患者,经术后6～12月随访,治愈者49例,显效4例,无无效者。部分病例在第1次换药时出现瘀血及皮瓣颜色深暗,给予加用TDP理疗灯照射处理后恢复。6例术后1月出现切口瘢痕增生给予外用康瑞宝等对症处理后恢复。结论:小切口真皮深层剪除大汗腺配合美宝外敷治疗腋臭操作简便,效果满意。

Objectives To observe the clinical efficacy of small incision excision of apocrine glands under the deep dermis with MEBO application on treating bromidrosis. Methods 53 patients were operated on using the method of excision of apocrine units within the dermis by small incision combined with application of MEB~.A full-thickness incision was made along the skin fold in the middle of the procedure area marked preoperatively.Skin flaps were developed by forceps and then been turned over.After the apocrine units were removed under direct vision, the wound was closed in layers with interrupted suture and a rubber drain was inserted. Within the coated MEBO applied to the procedure area,a simple fluffed guaze dressing and ＂8＂ wrap were then applied to the wound. Results With 6-12 months follow-up,49 cases were cured with satisfaction,4 cases got markedly effectiveness, no invalid case. A small proportion of cases turned out ecchymosis and subcutaneous hemorrhage when the first dress changing which could get recovered after received TDP lamp irradiation therapy. 6 cases appeared hypertrophic scar after 1 month postoperatively which turned to be better after related treatments. Conclusions It could be a simple way to use the excision of apocrine units within the dermis by small incision combined with application of MEBO for the treatment of axillary bromidrosis. It also turned out satisfied outcomes.