双微切口皮下修剪联合搔刮治疗腋臭

Clinical analysis of treatment on axillary osmidrosis by sub-dermal trimming with shaving via two mini-incisions

目的：探讨双微切口皮下修剪联合搔刮治疗腋臭的技术要点及临床疗效。方法：腋窝后壁做2个约1cm的微小切口,自腋浅筋膜浅层游离皮瓣后紧贴皮下修剪至可见毛囊深度,联合使用腋臭刮匙交叉搔刮皮下。2011年1月-2014年12月,共治疗288例腋臭患者。结果：259例患者双侧Ⅰ期愈合,切口瘢痕微小。26例（42侧,占7.3%）术后表皮糜烂,3例术后第1天出现单侧血肿（占0.5%）,无感染及皮肤全层坏死发生。随访6~12个月,282例患者达治愈,腋部异味消失,6例（8侧,占1.4%）轻微异味残留,二次手术后效果满意。结论：双微切口皮下修剪联合搔刮可有效去除腋部顶泌汗腺,并发症少,复发率低,效果可靠,操作简便,微创并易为患者所接受,值得临床推广。

Objective To investigate the curative effect and related problem about the treatment on axillary osmidrosis by sub-dermal trimming with shaving via two mini-incisions. Methods Two 1cm incisions were made along the posterior axillary crease.A subcutaneous pocket was dissected in the plane between the subcutaneous and the superficial fascia,and subcutaneous tissue attaching to the dermis were trimmed using a pair of scissors until hair follicles were seen.Fanning-crossed curettage below the dermis was then performed with a curette.From January 2011 to December 2013,288 patients with axillary osmidrosis had been treated with the method mentioned. Results 259 patients healed primarily with concealed scar.26 patients（42 sides）showed epidermis erosion（7.3%）,and 3 cases showed lateral subcutaneous hematoma on first day postoperatively（0.5%）.No secondary full thickness skin necrosis and infection happened owing to timely discovery and treatment.After 6-12 months following up,282 cases were satisfied without malodor recurrence. 6 cases（8 sides）had residual malodor and cured well after secondary repair with satisfactory results（1.4%）. Conclusion Sub-dermal trimming with shaving via two mini-incisions can effectively remove the apocrine sweat gland and degrade the incidence of complications and recurrence.It is a effective and acceptable method with simple operation and minimal invasion,therefore,it is worth extending in clinic.