Park D H, Kim T M, Han D G, Ahn K Y
Department of Plastic and Reconstructive Surgery, Catholic University of Taegu Hyosung, College of Medicine, Korea.
Ann Plast Surg. 1998 Nov;41(5):488-97. doi: 10.1097/00000637-199811000-00007.
Between 1986 and 1996, 128 patients underwent surgery for axillary osmidrosis via en bloc removal of subcutaneous cellular tissue. The patients were followed for 6 months to 7 years (average follow-up, 25 months). The authors propose three categories in which they classified shaving procedures: instrumental shavings (N = 84), manual shavings (N = 96), and combined shaving procedures (N = 76). A modified Inaba's shaver was used in instrument shavings. Combined shaving is mixture of instrument and conventional manual shaving. All patients were asked to complete a questionnaire postoperatively. This follow-up demonstrated that 92.9% of patients who underwent instrument shaving, 95.8% of patients who underwent manual shaving, and 97.4% of patients who underwent combined shaving experienced no odor or occasional, very mild axillary odor postoperatively. Postoperative scar formation was either invisible or excellent in 92.9% of instrument shavings, and 92.1% of patients who underwent the combined procedure reported either a hairless axilla or a marked decrease of axillary hair. The total satisfaction rate in the combined procedure was 94.7%, which is a better result than the instrument (92.9%) and the manual (91.7%) shaving procedures. The wound complication rate per patient with the combined procedure was 13.2%. There was no scar contracture or limitation in arm abduction. The combined subcutaneous shaving procedure using the modified Inaba's shaver has the advantages of rapid and accurate shaving, low incidence of hematoma formation, enhanced wound healing, and easy postoperative care. Therefore, en bloc resection of subcutaneous cellular tissue by combined shaving is a viable option for treatment of axillary osmidrosis.
1986年至1996年间，128例患者通过整块切除皮下蜂窝组织接受了腋臭手术。对患者进行了6个月至7年的随访（平均随访25个月）。作者提出了三类剃须手术：器械剃须（N = 84）、手动剃须（N = 96）和联合剃须手术（N = 76）。器械剃须使用改良的稻叶剃须刀。联合剃须是器械剃须和传统手动剃须的混合方式。所有患者术后均被要求完成一份问卷。该随访表明，接受器械剃须的患者中有92.9%、接受手动剃须的患者中有95.8%以及接受联合剃须的患者中有97.4%术后无异味或仅有偶尔、非常轻微的腋下异味。在器械剃须患者中，92.9%的患者术后瘢痕形成不可见或效果极佳，接受联合手术的患者中有92.1%报告腋窝无毛或腋毛显著减少。联合手术的总满意率为94.7%，这一结果优于器械剃须（92.9%）和手动剃须（91.7%）手术。联合手术每位患者的伤口并发症发生率为13.2%。未出现瘢痕挛缩或手臂外展受限。使用改良稻叶剃须刀的联合皮下剃须手术具有剃须快速准确、血肿形成发生率低、伤口愈合加快以及术后护理简便等优点。因此，联合剃须整块切除皮下蜂窝组织是治疗腋臭的一种可行选择。
