Yao Zhihua, Zhu Jifeng, Peng Min, Lei Benxu, Li Min, Yang Jie, Tang Jinyu, Chang Dongfang
From the Department of Burns and Plastic Surgery, the Affiliated Yongchuan Hospital of Chongqing Medical University.
Plast Reconstr Surg. 2025 May 1;155(5):923e-927e. doi: 10.1097/PRS.0000000000011731. Epub 2024 Sep 4.
The purpose of this study was to investigate the clinical effect of treating axillary osmidrosis by trimming the apocrine glands under direct vision after blunt dissection of the axillary flap through double mini-incisions on both sides of the axilla to prevent postoperative hematoma.
The clinical data of 108 patients with axillary osmidrosis were retrospectively analyzed. Treatment involved blunt dissection of the axillary flap through double mini-incisions and trimming of the apocrine glands under direct vision. The surgical duration, hematoma incidence, flap necrosis rate, incision healing rate, incision Vancouver Scar Scale score, comfort level, axillary odor cure rate, and satisfaction rating were all analyzed statistically.
The average surgical duration was 72.45 ± 5.71 minutes. The cure rate of axillary osmidrosis was 100%. Postoperative complications, including delayed incision healing 12 days after surgery (1 patient), a small hematoma (2 patients), and local flap necrosis (1 patient), were minor. No infection, malodor, or recurrence was observed. The visual analog scale scores were 8.53 ± 0.89 for patient comfort, 8.87 ± 0.98 for patient satisfaction, and 0.84 ± 0.99 for the incision.
This retrospective study demonstrated that trimming of apocrine glands after blunt dissection of the axillary flap through double mini-incisions on both sides of the axilla effectively controlled bleeding. This approach significantly reduces the complication rate of axillary osmidrosis surgery and ensures the complete trimming of apocrine glands, eradicating axillary odor and maintaining a good appearance.
本研究旨在探讨通过双侧腋窝微小切口钝性分离腋窝皮瓣后直视下修剪大汗腺治疗腋臭的临床效果，以预防术后血肿。
回顾性分析108例腋臭患者的临床资料。治疗方法为通过双侧微小切口钝性分离腋窝皮瓣并直视下修剪大汗腺。对手术时间、血肿发生率、皮瓣坏死率、切口愈合率、切口温哥华瘢痕量表评分、舒适度、腋臭治愈率及满意度进行统计学分析。
平均手术时间为72.45±5.71分钟。腋臭治愈率为100%。术后并发症轻微，包括术后12天切口愈合延迟（1例）、小血肿（2例）及局部皮瓣坏死（1例）。未观察到感染、异味或复发情况。患者舒适度视觉模拟量表评分为8.53±0.89，患者满意度为8.87±0.98，切口评分为0.84±0.99。
本回顾性研究表明，通过双侧腋窝微小切口钝性分离腋窝皮瓣后修剪大汗腺可有效控制出血。该方法显著降低了腋臭手术的并发症发生率，确保了大汗腺的完全修剪，根除了腋臭并保持了良好外观。
