The Clinical Evaluation of Minimally Invasive Treatment for Axillary Osmidrosis

Background: Traditional treatment of axillary odour is the surgical removal of skin and subcutaneous tissue along the edge of the axillary hair in a fusiform shape, which requires the restriction of upper limb activity, has large scars and a high recurrence rate. Minimally invasive methods have developed in recent years. The subcutaneous trimming method with small incision reduces the incision compared to traditional incision, but still requires skin incision, which does not achieve true, minimally invasive treatment. Simple negative pressure suction is difficult to destroy the sweat glands and sebaceous glands in the dermis layer. Thus, we hypothesized that combination of three minimally invasive methods might be more effective. Objective: To explore the clinical effect of combined treatment of axillary osmidrosis by three minimally invasive methods of microwave, scraping & suction and scratching. Methods: From October 2015 to October 2020, 80 patients with underarm odor were enrolled and lacal swelling anesthetic was applied. Microwave was used to treat sweat glands and sebaceous glands in the dermis following the pores. The curettage-aspiration was used to scrape and suck the apocrine sweat glands in the subcutaneous fat layer and the junction between the subcutaneous fat and dermis. To achieve the purpose of minimally invasive and thorough treatment of underarm odor, the spoon scraped the remaining sweat gland tissue. Results: Among 80 patients on 160 sides, all cases (100.00%) were cured on 160 sides at 1 month post-operative follow-up, 75 cases (93.75%) were cured on 150 sides, 5 cases (6.25%) on 5 sides were ineffective at 6-month post-operative follow-up, 74 cases (92.50%) were cured on 148 sides, 6 cases (7.50%) on 5 sides were ineffective at 1-year post-operative follow-up. Complications occurred in 5 cases (6.25%) after operation: 2 cases (2.50%) with skin necrosis on 3 sides, 1 case (1.25%) with uneven skin on 2 sides, 1 case (1.25%) with axillary abscess on 2 sides, and 1 case (1.25%) with keloids on 2 sides. Conclusion: The combination of three minimally invasive methods of microwave, scraping & suction and scratching to treat underarm odor is simple operation, has high cure rate, quick postoperative recovery, and few complications. It is an effective method for minimally invasive and thorough treatment of underarm odor in clinic.

Safety and efficacy of surgical treatments for axillary osmidrosis: a retrospective cohort study comparing conventional open excision with cartilage-shaver closed curettage

Aim:The aim of this study was to evaluate the usefulness of suction-assisted cartilage shaver(SACS)system closed curettage by comparing it with open excision regarding safety and efficacy.Methods:A retrospective chart review was conducted for patients with axillary osmidrosis(AO)who underwent either open excision or SACS closed curettage between 2006 and 2018.We investigated the demographic data of patients and compared the postoperative complications and outcomes of the patients undergoing the two procedures.Results:A total of 91 patients underwent SACS closed curettage and 188 patients underwent open excision.The complication rate in the SACS group(10.4%)was significantly lower than that in the open excision group(20.7%).Each procedure led to unsuccessful outcomes for two patients.Conclusion:SACS closed curettage was safer than open excision for AO.Both procedures were extremely effective.Although decision-making for surgical treatment options for AO is affected by such other factors as discomfort in dressing,recovery time,scar formation,and cost,our results should be helpful for both surgeons and patients.