Käufer C, Axnick E
Chirurgischen Klinik, Henriettenstiftung Hannover.
Z Hautkr. 1988 Jul 15;63(7):597-8, 601-4, 609.
On the basis of a 3 years experience with surgical treatment of acne tetrad (acne conglobata, apocrine acne) in 22 patients, we can draw the following conclusions: 1. Radical surgical excision yields better long-term results than local incision. Recurrences are mostly the result of non-radical surgery. 2. In cases of limited acne--especially if it is localized either in the axilla or the groin--primary wound closure may be successfully attained. 3. Gentamycin chains may support the primary wound healing in defect closures of infected areas. 4. In the axilla, we suggest wound closure by myocutaneous island flaps as the best procedure after extensive excision. 5. Specific antibiotic protection, perioperatively, according to previous culture and sensitivity testing can guarantee a postoperative course free from infection. 6. Open wound therapy with secondary healing of the soft tissue defects proved to be the treatment of choice in perineal procedures. 7. In view of the poor prognosis of conservative methods in chronic acne, and because of the risk of subsequent manifestation of chronic septicemia, early surgical excision is desirable.
基于对22例聚合性痤疮（囊肿性痤疮、大汗腺痤疮）患者进行3年手术治疗的经验，我们可以得出以下结论：1. 根治性手术切除比局部切开能产生更好的长期效果。复发大多是手术不彻底的结果。2. 对于局限性痤疮——尤其是局限于腋窝或腹股沟的痤疮——一期伤口缝合可能会成功实现。3. 庆大霉素链可促进感染区域缺损闭合时的一期伤口愈合。4. 在腋窝，我们建议在广泛切除后，采用岛状肌皮瓣闭合伤口是最佳方法。5. 根据术前培养和药敏试验进行围手术期特异性抗生素防护，可确保术后无感染过程。6. 开放性伤口治疗及软组织缺损二期愈合被证明是会阴手术的首选治疗方法。7. 鉴于慢性痤疮保守治疗预后不佳，且存在随后发生慢性败血症的风险，早期手术切除是可取的。
