Department of Plastic and Reconstructive Surgery, Chungbuk National University College of Medicine, 1, Chungdae-Ro, Seowon-gu, Cheongju, Chungbuk, 28644, Korea.
Aesthetic Plast Surg. 2019 Feb;43(1):267-277. doi: 10.1007/s00266-018-1263-2. Epub 2018 Nov 9.
The pinch and turn-over technique was developed to minimize the incision in the manual subdermal excision of apocrine glands in axillary osmidrosis for the best cure and fewest complications.
Through a 2-cm-long incision, peripheral subdermal tissue was excised by the technique under direct vision using intravenous anesthesia and tumescent technique. Ninety-nine axillae in 50 patients including seven secondary cases were operated on from 2009 to 2018. Long-term follow-up (average 30.3 months) could be done on 40 patients with questionnaires consisting of four-point ordinal-scale questions regarding osmidrosis grade, hyperhidrosis grade and satisfaction. For systematic review regarding incision length, 220 articles from 1962 to 2018 were reviewed with the search terms "osmidrosis" or "bromhidrosis."
Thirty-five and 30 of 40 respondents (87.5% and 75.0%) had excellent or good postoperative results in osmidrosis and hyperhidrosis grade. Postoperative improvement of osmidrosis grade (from 2.53 to 0.80) and hyperhidrosis grade (from 1.88 to 0.95) was statistically significant (p < 0.01). Thirty-four patients (85.0%) reported very satisfactory or satisfactory. Hematoma (2.0%), hyperpigmentation (5.0%), infection (5.0%) and noticeable scar (2.5%) were rare. Necrosis of flap margins was frequent (27.3%) but necessitated revision in two cases (2.0%). Among eleven articles found to describe incision length in pure manual subdermal excision, this technique provided the shortest incision compared with eight direct subdermal excision methods with an average incision length of 5.0 cm.
This technique offers an open, direct and selective approach with a short incision. It could maintain the best efficiency while neutralizing negative side effects of conventional manual subdermal excision for axillary osmidrosis.
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为了实现最佳疗效和最少并发症，开发了捏转技术，以最小化腋下顶泌腺手动皮下切除的切口。
通过 2cm 长的切口，在静脉麻醉和肿胀技术下，直接观察下使用该技术切除周边皮下组织。2009 年至 2018 年间，对 50 例患者的 99 例腋窝（包括 7 例二次手术）进行了手术。通过问卷调查对 40 例患者进行了长期随访（平均 30.3 个月），问卷包括腋臭分级、多汗分级和满意度的四点有序量表问题。为了进行切口长度的系统评价，检索了 1962 年至 2018 年的 220 篇文章，检索词为“腋臭”或“臭汗症”。
40 名受访者中的 35 名（87.5%）和 30 名（75.0%）在腋臭和多汗分级方面有极好或良好的术后结果。腋臭分级（从 2.53 到 0.80）和多汗分级（从 1.88 到 0.95）的术后改善有统计学意义（p<0.01）。34 名患者（85.0%）报告非常满意或满意。血肿（2.0%）、色素沉着（5.0%）、感染（5.0%）和明显瘢痕（2.5%）很少见。皮瓣边缘坏死较常见（27.3%），但仅需在两例中（2.0%）修正。在 11 篇描述纯手工皮下切除切口长度的文章中，与平均切口长度为 5.0cm 的 8 种直接皮下切除方法相比，该技术提供了最短的切口。
该技术提供了一种开放、直接和选择性的方法，切口较短。它可以在保持传统手动皮下切除腋部腋臭的最佳效率的同时，中和其负面副作用。
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