原位密集式缝合固定法应用于真皮下血管网皮瓣法治疗腋臭的临床研究

Clinical effect of the concentrated suture fixation method on subdermal vascular network flap method for treatment of axillary osmidrosis

目的 探讨密集式缝合固定法在真皮下血管网皮瓣法治疗腋臭,对减少术后并发症、增加伤口包扎舒适度的疗效.方法 选择门诊治疗96例双侧腋臭患者,按随机数字表法分为密集缝合组（A组）和“8”字绷带加压组（B组）,每组48例,均采用清除汗腺保留真皮下血管网皮瓣法治疗腋臭.A组按原位密集式缝合法固定分离后的真皮下血管网皮瓣,B组按常规加压包扎固定分离后的真皮下血管网皮瓣.术后观察皮下血肿、感染、皮肤坏死等并发症;了解包扎的舒适度.术后6个月观察术区瘢痕、异味及腋毛生长情况.结果 术后观察：A组皮下血肿等并发症发生率明显低于B组,发生率1.04％（1/96）比19.79％ （19/96）,差异有统计学意义（P＜0.01）.A组术后包扎舒适度满意率93.75％（45/48）,B组舒适度差,满意率仅10.42％ （5/48）,差异有统计学意义（P＜0.01）.术后6个月观察：两组治疗腋臭异味疗效显著,两组总有效率均为100.00％ （96/96）,差异无统计学意义（P＞0.05）.A组术区瘢痕发生率较B组明显少[3.12％（3/96）比21.88％（21/96）],差异有统计学意义（P＜0.05）.两组术区腋毛及出汗均显著减少,差异无统计学意义（P＞0.05）.结论 原位密集式缝合固定法应用于真皮下血管网皮瓣法治疗腋臭,对腋窝游离后的真皮下血管网皮瓣固定可靠,皮瓣愈合率高,瘢痕等并发症发生率低;术后包扎简单、舒适,生活自如,总体优于“8”字绷带加压包扎.

Objective To investigate the effect of concentrated suture fixation in subdermal vascular network flap method for treatment of axillary osmidrosis in reducing postoperative complications,increase the wound dressing effect of comfort.Methods Ninety-six cases of bilateral axillary osmidrosis patients were randomly divided into concentrated suture group （group A） and ＂8＂ bandage compression group （group B）,48 cases in each group.They were cleared of sweat gland retaining subdermal vascular network skin flap method in treatment of axillary osmidrosis.Group A was treated with concentrated suture fixation after the separation of the subdermal vascular network flap by in situ,group B was treated by routine compression bandage fixation after the separation of the subdermal vascular network flap.Observation of subcutaneous hematoma,infection,necrosis of skin after operation and understood dressing comfort.To observe the peculiar smell and axillary scar,operation area 6 months postoperative growth.Results The postoperative observation：group A subcutaneous hematoma complication rate was lower in group B,the incidence of 1.04％ （1/96） vs.19.79％ （19/96）,the difference was statistically significant （P ＜ 0.01）.Group A postoperative dressing comfort satisfaction rate was 93.75％ （45/48）,group B po or comfort,satisfaction rate was only 10.42％（5/48）,the difference had statistically significant （P ＜ 0.01）.After 6 months of postoperative,the total efficiency of two groups were 100.00％,no significant difference （P ＞ 0.05）.Group A district scar formation rate was higher than that in group B [3.12％（3/96） vs.21.88％（21/96）] （P ＜ 0.05）.The armpit hair and sweat in the two groups was significantly reduced,there was no significant difference （P ＞ 0.05）.Conclusion Concentrated suture fixation method in the treatment of axillary osmidrosis by subdermal vascular network is a reliable fixation of the axillary free after the subdermal vascular network flap,and have flap high healing rate,scar,low rate of complications; postoperative dressing is simple,comfortable,living freely,overall is better than ＂8＂ bandage compression method.