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作为一个整体切除顶泌汗腺和腋窝浅筋膜治疗腋臭。

Excision of apocrine glands and axillary superficial fascia as a single entity for the treatment of axillary bromhidrosis.

机构信息

Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Eur Acad Dermatol Venereol. 2012 Jun;26(6):704-9. doi: 10.1111/j.1468-3083.2011.04149.x. Epub 2011 Jun 21.

Abstract

BACKGROUND

Surgical excision of apocrine glands is the effective treatment for axillary bromhidrosis. Skin necrosis, the most serious adverse result observed postoperatively, results in a prolonged wound healing and leads to unsightly scars in the axillary fossae. It is mainly caused by the skin damage during the operation and postoperative seroma or haematoma formation.

OBJECTIVE

To investigate the effects and complications of our surgical modality for axillary bromhidrosis.

METHODS

Sixty-three patients with bromhidrosis were treated. An incision about two-thirds of the length of the widest transverse diameter was made on the axillary crease. The loosened layers between the dermis and axillary superficial fascia containing apocrine glands were carefully undermined with an iris scissor. The entire apocrine glands-axillary superficial fascia complex was dissected from the centre to the superior and inferior margins with an electrosurgical pencil.

RESULTS

Of the 126 axillae, malodour was eradicated in 112 axillae and reduced sharply in 14. There were three cases of skin necroses. The Dermatology Life Quality Index score decreased significantly and the quality of life improved after the operation.

CONCLUSION

Our surgical technique can achieve minimal tissue damage and maintain no hematoma postoperatively. The rate of skin necrosis was low. Quality of life improved after the procedure in this patient population.

摘要

背景

外科切除顶泌腺是治疗腋窝多汗症的有效方法。皮肤坏死是术后观察到的最严重的不良后果,导致伤口愈合延长,并在腋窝凹处留下难看的疤痕。它主要是由于手术过程中的皮肤损伤以及术后血清肿或血肿形成引起的。

目的

探讨我们治疗腋窝多汗症的手术方法的效果和并发症。

方法

对 63 例多汗症患者进行治疗。在腋窝折痕处做一个约三分之二最宽横径长度的切口。用虹膜剪小心地从真皮和腋窝浅筋膜之间的疏松层向下挖掘,其中包含顶泌腺。用电外科笔从中心到上、下边缘将整个顶泌腺-腋窝浅筋膜复合体解剖出来。

结果

126 个腋窝中,112 个腋窝的臭味被根除,14 个腋窝的臭味明显减少。有 3 例皮肤坏死。皮肤病生活质量指数评分显著降低,术后生活质量提高。

结论

我们的手术技术可以实现最小的组织损伤,并保持术后无血肿。皮肤坏死率低。该患者人群术后生活质量得到改善。

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