小切口大汗腺清除术治疗腋臭的疗效评价

目的:观察小切口大汗腺清除术治疗腋臭的远期疗效和并发症.方法:对腋臭患者应用小切口大汗腺清除术治疗,随访3～23个月后评价疗效.结果:共67例完成随访,创面均Ⅰ期愈合,疤痕细小.臭味清除效果优者64例,良好者3例,没有患者无效或再次手术.并发症有皮下血肿7例,在早期清除血肿后均一期愈合,术后皮下小囊肿15例.所有患者术后都有色素沉着,均在6～ 12月内消失.21例早期出现不同程度皮肤挛缩,但随时间全部恢复.结论:小切口大汗腺清除术治疗腋臭疗效高,不需要特殊设备,术后出现的并发症也较轻,是理想的腋臭手术方法.     

腋窝皱襞小切口治疗腋臭56例疗效观察

目的观察腋窝皱襞小切口治疗腋臭的疗效。方法切口设计在腋窝皱褶处,沿皮纹方向,根据腋毛范围设计(1~2)个长约(2~3)cm长的切口,沿皮下组织浅层分离术区皮肤组织,翻转皮瓣,剪除皮下脂肪组织、大汗腺及毛囊,再缝合切口并加压包扎。结果本组56例患者,其中55例患者切口均一期愈合,51例无皮下血肿、切口感染、皮肤坏死等并发症,4例及时清除血肿后,伤口仍然一期愈合,1例发生切口缘浅表坏死。术后随访6个月,55例痊愈;1例显效。结论小切口大汗腺剪除术治疗腋臭有效率高,此方法既能兼顾美容又能兼顾效果,值得推广。     

汗腺疾病

20052574 小切口潜行清除汗腺治疗腋臭，20052575 32例腋臭剥离搔刮术临床分析，20052576 改良高频电离子治疗腋臭26例疗效观察，20052577 同位素^90锶敷贴治疗腋臭230例疗效观察，20052578 微创剥刮术与消痔灵局部注射治疗腋臭的方法及疗效比较。     

两种切口的顶泌汗腺修剪术治疗腋臭的并发症对比分析

目的采用"W"形切口(A组)及"1"字形腋窝皱襞切口(B组)的顶泌汗腺修剪术治疗腋臭,统计分析两组患者术后并发症的发生率。方法回顾分析2011年5月-2013年12月采用两种切口的顶泌汗腺修剪术治疗腋臭163例,其中A组84例,B组79例,对其术后的并发症进行对比分析。结果 A组术后发生血肿5例、皮瓣坏死3例,切口裂开11例,局部瘢痕增生13例,异味残留3例;B组术后发生血肿4例,皮瓣坏死2例,切口裂开3例,局部瘢痕增生4例,异味残留4例。A、B组在切口裂开、局部瘢痕增生的发生率差异有统计学意义(P0.05)。结论 "1"字形腋窝皱襞切口较"W"形切口的顶泌汗腺修剪术在一定程度上可减轻腋臭术后并发症。     

微孔引流在皮下修剪术治疗腋臭中的作用北大核心CSCD

目的 探讨微孔引流在皮下修剪术治疗腋臭中的作用.方法 48例腋臭患者采用皮下修剪术治疗腋臭,去除大汗腺及毛囊后在皮瓣上用尖刀片沿皮纹戳数个长约3 mm的微孔进行引流,闭合切口后用弹力绷带包扎压迫手术区敷料.术后24 h换药观察伤口,10d拆绷带并观察皮瓣成活情况,术后3个月随访.结果 48例患者术后腋部汗臭均消失,出汗减少,社交正常.皮肤瘢痕不明显.结论 微孔引流可作为皮下修剪术治疗腋臭的有效引流方法.     

顺腋纹平行双切口保留真皮血管网切除顶泌汗腺治疗腋臭

目的：评价肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术根治腋臭的疗效.方法：手术顺腋纹做两个平行切口,于腋浅筋膜浅层向四周锐性分离皮下组织达腋毛边缘,翻转皮瓣直视下逐一修剪顶泌汗腺组织.结果：本组68例共136侧,所有病例切口均I期愈合,无1例发生皮瓣坏死,术后经6～12个月的随访,治愈122侧,治愈率89.71%,显效14侧,显效率10.29%,总有效率100%.术后瘢痕轻微、隐蔽,腋窝皮肤活动性好,上肢功能无影响.结论：肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术治疗腋臭总有效率高,并发症少,瘢痕小,为目前较理想的根治腋臭的手术治疗方法.     

微创手术治疗腋臭98例

目的 观察应用小切口搔刮的方法治疗腋臭效果。方法 在局部麻醉下分离双侧腋毛区皮肤真皮基底层与脂肪层之间，用专用腋臭刮匙刮除附着于真皮的脂肪球，彻底破坏毛囊，用绷带加压包扎。结果 98例患者中，92例臭味完全消失，6例有轻度异味，但均比术前有明显好转，有效率达到100％。结论 微创手术治疗腋臭，具有疗效肯定，创伤小，恢复快，愈合后无明显瘢痕等优点。     

改良式小切口分离法治疗腋臭

腋臭是由于腋部大汗腺分泌的汗液经细菌分解后 ,散发出难闻的异味。对药物及传统治疗效果不满意 ,自 1999年来 ,我科用改良式小切口分离法治疗腋臭 5 6例 ,治疗效果满意 ,报道如下。资料与方法　 1999年 3月～ 2 0 0 3年 6月 ,在我科手术治疗的腋臭患者 112例 ,其中女 84例 ,男 2 8例 ,平均年龄 (2 1.2 3±5 .6 7)岁。有 7例在 2年前曾行激光、电离子治疗。手术方法　术时患者平卧 ,肩胛下垫高 1～ 2cm ,上肢外展 ,曲肘掌心向上置于头顶部 ,常规消毒铺巾。用 0 .2 5 %利多卡因加 0 .1%肾上腺素在术区做皮下浸润麻醉 ,每侧 15～ 2 0ml,切口区…     

汗腺疾病

20120295深浅两层顶泌汗腺处理法治疗腋臭术后并发症的分析和处理/张斌(大连市皮肤病院外科),刘积东,张琪…//实用皮肤病学杂志.-2011,4(2).-99 ～101共治疗317例,其中男98例,女219例,年龄16～48岁.通过2 ～ 3cm皮肤小切口进入皮下,浅层剪除皮下脂肪及毛囊球,深层射频凝固脂肪内残余的腺体.术后随访半年.结果:一次治愈率为96.5％,有效率为100％.出现并发症87例(27.40％),包括血肿、皮下积液、皮肤瘀斑、皮肤坏死、切口裂开、感染、延期愈合、瘢痕、瘢痕挛缩、异味残留等.对其成因及预防处理,逐一进行了全面分析和探讨,经过正确处理后均达到了满意的效果.     

微创切口掏除法治疗腋臭250例临床疗效观察

目的　探讨治疗腋臭的有效方法。方法　美兰在腋毛外缘画线标记 ,腋窝中央为切口线 ,长约 3～ 4cm。局麻后切开皮肤至筋膜 ,纯性分离 ,翻开皮瓣 ,剪除毛囊、汗腺 ,庆大霉素盐水反复冲洗创面 ,1-0线缝合并打包包扎。结果　所有患者腋部切口均Ⅰ期愈合 ,2 48例气味完全消失 ,2例残留轻度气味。随访 15 0例 ,术后瘢痕不明显 ,无牵拉及继发畸形。主要并发症为出血、血肿 ,共 6例。结论　应用微创手术治疗腋臭手术简单 ,疗效确切 ,并发症少。     

Surgical subcision as a cost-effective and minimally invasive treatment for axillary osmidrosis

Background Axillary osmidrosis, characterized by unpleasant odor and occasional staining of clothing, is a personal discomfort and social impairment for people who suffer from it. Various types of surgical procedures involving instrumented‐assisted tools (lasers, ultrasonic, endoscope, and others) have shown relatively positive results; however, for patients in developing countries, especially in China, these treatments are inconvenient and cost‐ineffective. Objective To introduce a minimal incision surgical procedure with skin flap treatment that removes the apocrine sweat glands in the subcutaneous tissue through a 1‐cm‐long incision without instrument‐assisted tools. Method From July 2005 to October of 2007, 108 patients (68 women and 40 men) were treated with the minimal incision and cost‐effective surgical treatment by manual excision. A 1‐cm‐long incision is made in the axillary crease. Subcutaneous tissue and glands were removed with scissors through this incision. This procedure is repeated throughout the entire axilla until the axilla has essentially become a super‐thin flap. Result Malodor elimination was good in 206 out of 215 axillae (95.8%) treated, fair in nine (4.2%), and poor in zero (0%). The resulting scar is small and virtually invisible because it is only 1‐cm long and located in the axillary crease. Conclusion Treatment of axillary osmidrosis by manual excision through a 1‐cm incision is a convenient, efficient, cost‐effective, and relatively safe technique that results in high patient satisfaction and benefits patients and surgeons in developing countries. Axillary osmidrosis, a non‐life‐threatening condition characterized by unpleasant odor and occasional staining of clothing, is an annoying problem, particularly in Asian societies. For many people who suffer from this problem, this condition is a personal discomfort, a social impairment, and discourages patients from enjoying social or personal activities, especially young women. They are usually embarrassed by the smell during their daily activities and communication with other people.     

Etiology and management of axillary bromidrosis: a brief review

Background Axillary bromidrosis is a distressing condition that poses significant social embarrassment in almost all the countries over the world. However, its definite etiology has not been generalized yet. There have been a lot of treatments for bromidrosis, which can be roughly divided into two types: conservative management and radical surgical therapy. In order to summarize the possible causes of axillary bromidrosis, a brief review of the literatures regarding bromidrosis was performed. Methods An English literature search from 1975 to June 2007 was completed with references to treatments for bromidrosis. A total of 29 papers about the treatment were selected to review. After a close reading, all the extracted information was imported into Microsoft Excel. Results Many therapies were carried out to treat bromidrosis, including nonoperative and operative ones. Almost all the authors thought that the nonoperative management, such as topical antiperspirants, systemic agents, and iontophoresis, did not have a permanent effect. Most surgeons (90%) chose surgical methods to remove axillary sweat glands for bromidrosis and 90.69% of the axillae had good results. Conclusion Axillary sweat glands may play the most important role in the etiology of bromidrosis. In addition, axillary microorganism, hormone, and inherent also contribute to bromidrosis.     

小切口修剪术治疗腋臭

目的 探讨小切口顶泌汗腺非暴露修剪术治疗腋臭的可行性。 方法 对58例腋臭患者施行了小切口顶泌汗腺非暴露修剪术。 结果 随访1~12个月,除1例还有轻度异味外,其余57例治愈。每例（双侧）平均手术时间为55分钟。 结论 这是一种可广泛应用的、简便的、安全的、有良好效果的手术方式。     

内镜结合超声刀治疗臭汗症八例

【摘要】 目的 探讨内镜结合超声刀在臭汗症根治术中的应用。 方法 8例双侧臭汗症患者全麻下采用术区外小切口内镜结合超声刀清除大汗腺治疗臭汗症。 结果 8例患者术后6个月疗效评估：0级7例（87.50%）,1级1例。1例女性患者由于术中皮肤局部温度过高造成一侧腋下皮肤表皮脱落,术后加强局部皮肤护理后治愈。1例男性患者由于手术过程中电凝钩灼伤皮肤,缝合后伤口愈合,未影响手术效果及美观。8例患者均未出现皮瓣全层坏死或皮下血肿。术后美容效果好。随访3 ~ 12个月,无复发,患者对治疗效果均满意。 结论 内镜结合超声刀治疗臭汗症具有切口隐蔽、效果满意、术后并发症少的优点。     

腋窝皱襞切口薄皮瓣法治疗腋臭215例并发症分析

目的观察腋窝皱襞切口薄皮瓣法治疗腋臭术后并发症,探讨并发症的原因和预防措施。方法回顾分析2005年5月-2010年12月采用腋窝皱襞切口薄皮瓣法治疗腋臭215例(430侧)中,出现并发症的48例(69侧)患者的临床资料。结果有并发症48例(69侧),即血肿22例(35侧)、皮瓣部分坏死16例(21侧)、瘢痕增生5例(8侧)、上肢牵拉疼痛3例(3侧)、湿疹样皮炎2例(2侧)。结论术后皮瓣下积血可引起皮瓣部分坏死、瘢痕增生和湿疹样皮炎等,减少皮瓣下积血可降低并发症的发生率。     

Selective sweat gland removal with minimal skin excision in the treatment of axillary hyperhidrosis: a retrospective clinical and histological review of 15 patients

BACKGROUND: Limited axillary skin excision and selective sweat gland removal from adjacent skin (Shelley's procedure) is currently rarely used for hyperhidrosis. OBJECTIVES: To determine whether this technique is a good way of permanently reducing axillary sweating. METHODS: This was a prospective, open, nonrandomized trial of the therapy, conducted in a university dermatology department. A small skin ellipse, parallel to the skin crease lines, was excised from the centre of the area of maximal sweating. The wound edges were undermined to the extent of maximal sweating and the skin reflected. Large visible sweat glands attached to the undersurface of the adjacent skin could be readily identified and were snipped off using scissors. We treated 15 axillae in eight patients with axillary hyperhidrosis. Sweat reduction was assessed by the patients who estimated the percentage reduction in sweating postoperatively. The scar appearance was graded by the surgeon. Haematoxylin and eosin-stained transverse sections of eight axillary skin ellipses from five subjects were examined histologically to establish the size, position and depth of the sweat gland tissue. RESULTS: All of the patients responded to treatment: mean sweat reduction was 65% (range 40-90%). Mean follow up was 1.3 years (range 0.1-6) and sweat reduction was maintained over this period. Histological material was available from five patients: sweat glands lay slightly deeper than hair follicles; glandular tissue occupied an average thickness of 3.5 mm in the 5-mm thick piece of skin. Apocrine gland lobules were more numerous and larger than eccrine gland lobules. Both gland types were in close apposition and did not occupy distinctly different depths within the skin. CONCLUSIONS: Local surgery using limited axillary skin excision and selective sweat gland removal remains one of the safest ways of permanently reducing axillary sweating.     

Minimally Invasive Surgery for Axillary Osmidrosis Using a Combination of Subcutaneous Tissue Removal and a 1,444-nm Nd:YAG Laser

Many treatment modalities have been developed for axillary osmidrosis. It is well known that the surgical treatment has the best results. However, there is a high possibility of side effects. The 1,444-nm lipolysis laser has been recently introduced to remove the apocrine glands. So far, subdermal coagulation treatment with a 1,444-nm Nd:YAG laser may be the least invasive and most effective therapy for axillary osmidrosis. However, according to our previous experience, the recurrence rate was 20%~30%. This emphasizes the need for combination of surgical method and non-surgical method and we combined subcutaneous tissue removal and photothermocoagulation with a 1,444-nm Nd:YAG laser. Three patients for bilateral axillary osmidrosis were enrolled. After an incision of about one-third the length of the widest transverse diameter, the apocrine glands were separated from the skin. And then apocrine glands within the marked area were destroyed by irradiation with a 1,444-nm Nd:YAG laser thereafter. All patients exhibited no relapse of axillary osmidrosis and were satisfied with the treatment results. A combination of subcutaneous tissue removal and Interstitial laser photothermocoagulation with a 1,444-nm Nd:YAG laser could be an effective treatment for mild to moderate axillary osmidrosis.     

单小切口与双小切口大汗腺修剪术治疗腋臭对比分析

 目的:对比分析单小切口与双小切口大汗腺修剪术治疗腋臭的疗效及并发症。方法：将111例患者随机分为A、B两组。A组(50例)行单小切口大汗腺修剪术,B组（61例）行双小切口大汗腺修剪术,比较两组治疗效果。结果：A、B两组总有效率均为100%。A组切口内侧表皮糜烂或裂开18例（36.00%）,B组切口内侧表皮糜烂或裂开11例（18.04%）,A组明显高于B组,差异有统计学意义（ X²=4.60,P<0.05）。结论：双小切口大汗腺修剪术术后并发症明显少于单小切口大汗腺修剪术。