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[化脓性汗腺炎——采用岛状肌皮瓣或传统方法治疗]

[Hidradenitis suppurativa--treatment with myocutaneous island flap or the traditional method].

作者信息

Gorkisch K, Boese-Landgraf J, Vaubel E

出版信息

Handchir Mikrochir Plast Chir. 1984 Jun;16(2):135-8.

PMID:6745753
Abstract

Inflammations of the apocrine sweat glands are characterized by painful, nodose and often superficially phlogistic infiltrates with a tendency towards abscess-formation and fistulation. These foci of inflammation are situated particularly in the armpit as well as the anal and genital region. The failure of conservative therapy--e.g., application of antibacterial ointments, red light, short-wave therapy or irradiation--is followed by a surgical intervention which involves excising the abscess cavity and leaving the wound open for secondary closure by granulation. The resultant scar is an impairment both functionally and cosmetically, particularly in the axilla; and, in many cases, a new focus of inflammation eventually develops in the immediate vicinity. For multiple occurrence of sudoriparous abscesses in the axilla with undermining of the surrounding cutaneous soft tissue mantle and fistulation, we therefore suggest the following therapeutic concept as an alternative to conventional methods: radical removal of the focus of inflammation far into the healthy tissue with concomitant excision of all sweat glands in the affected area and coverage of the resultant defect with a partial myocutaneous island flap from the latissimus dorsi muscle.

摘要

顶泌汗腺炎症的特征为疼痛、结节状,且常伴有浅表炎性浸润,有形成脓肿和瘘管的倾向。这些炎症病灶尤其位于腋窝以及肛门和生殖器区域。保守治疗(如应用抗菌软膏、红光、短波疗法或照射)失败后,需进行手术干预,包括切除脓肿腔并让伤口开放,通过肉芽组织进行二期缝合。由此产生的疤痕在功能和美观上都会造成损害,尤其是在腋窝;而且在许多情况下,紧邻部位最终会形成新的炎症病灶。因此,对于腋窝部位多次发生的汗腺脓肿,伴有周围皮肤软组织被破坏和形成瘘管的情况,我们建议采用以下治疗方案作为传统方法的替代方案:将炎症病灶彻底切除至健康组织深处,同时切除受累区域的所有汗腺,并用背阔肌的部分肌皮岛状皮瓣覆盖由此产生的缺损。

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