大汗腺修剪术与小切口微创搔刮术对腋臭患者术后创面美学效果及并发症的影响

目的探讨大汗腺修剪术与小切口微创搔刮术对腋臭患者术后创面美学效果及并发症的影响。方法选取2018年7月至2019年10月某医院收治的80例腋臭患者,随机分为A组(40例)和B组(40例)。A组采用大汗腺修剪术治疗,B组采用小切口微创搔刮术治疗,比较两组术后创面美学、并发症发生率。结果 B组术后创面美学效果优率高于A组,良率低于A组,差异有统计学意义(P 0.05),两组创面美学差率对比,差异无统计学意义(P 0.05);B组并发症发生率(5.00%)低于A组(20.00%),差异有统计学意义(P 0.05)。结论与大汗腺修剪术相比,腋臭患者采用小切口微创搔刮术治疗术后创面美学效果较优,且术后并发症少,值得临床推广。     

腋窝皱襞小切口皮下剥离术与双平行切口皮下修剪术治疗腋臭疗效比较

目的对比腋窝皱襞小切口皮下剥离术与双平行切口皮下修剪术治疗腋臭患者的应用效果。方法选取我院腋臭患者96例,随机数字表法分为剥离组与修剪组,每组各48例。修剪组行双平行切口皮下修剪术治疗,剥离组行腋窝皱襞小切口皮下剥离术。观察对比腋臭清除率、并发症发生率。结果术后剥离组腋臭清除率100.00%高于修剪组(83.33%,P <0.05);剥离组并发症发生率4.17%低于修剪组(18.75%,P <0.05)。结论相较于双平行切口皮下修剪术,腋窝皱襞小切口皮下剥离术应用于腋臭患者,可显著提高腋臭清除率,降低并发症发生率。     

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。     

“V”形切口皮下修剪术治疗腋臭临床分析

目的:探讨"V"形切口皮下修剪术治疗腋臭的效果及并发症。方法:236例腋臭患者采用"V"形切口皮下修剪术治疗,从腋窝后壁中央腋毛边缘行"V"形切口,向上及两侧分离腋毛区,剪除大汗腺层,闭合切口,弹力绷带包扎压迫。结果:切口愈合时间平均为(11±2.6)d,一期愈合211例(89.41%),二期愈合25例(10.59%)。局限性皮下血肿17例(7.20%),局限性切口感染13例(5.51%),轻度切口糜烂裂开12例(5.08%)。有效率96.71%,复发率3.29%;局部瘢痕不明显,上肢活动均不受影响。结论:"V"形切口皮下修剪术治疗腋臭效果良好,并发症少,是较为理想的根治腋臭的手术方法。     

三种不同切口下大汗腺修剪术治疗腋臭的疗效比较

目的评价三种不同切口下大汗腺修剪术治疗腋臭的临床疗效。方法将入选的182例腋臭患者随机分为3组,分别在腋后壁V形切口皮下修剪法、腋后壁W形切口皮下修剪法和腋皱襞切口皮下修剪法下行大汗腺清除术。结果腋后壁V形切口皮下修剪法、腋后壁W形切口皮下修剪法和腋皱襞切口皮下修剪法下行大汗腺清除术的有效率依次为98.33%,96.72%,85.08%,复发率依次为1.67%,3.28%,4.92%,差异均无统计学意义(P均0.05),但其并发症发生率(依次为8.33%,22.95%和37.70%)差异有统计学意义(P0.01),其中腋后壁V形切口皮下修剪法并发症发生率低于其他两种方法的并发症发生率。结论该三种不同切口下大汗腺清除术治疗腋臭的疗效相当,但腋后壁V形切口皮下修剪法治疗腋臭具有术后并发症少等优点。     

腋后线“N”形切口大汗腺修剪术与微针射频大汗腺热凝术治疗腋臭临床对比分析

目的:对比腋后线"N"形切口大汗腺修剪术及微针射频大汗腺热凝术治疗腋臭的效果。方法:回顾性分析该院2015年10月—2016年5月采用2种方法治疗58例(116侧)腋臭患者的临床疗效。其中A组28例(56侧)予腋后线"N"形切口大汗腺修剪术;B组30例(60侧)予微针射频大汗腺热凝术。结果:治疗轻度患者时,2组疗效差异无统计学意义;治疗中、重度患者时,A组疗效显著优于B组,差异有统计学意义(P0.05)。A组并发症包括血肿2例[3.57%,95%CI(0.62%～13.38%)]、皮瓣或皮肤坏死8例[14.26%,95%CI(6.80%～26.78%)]及局部瘢痕增生11例[19.64%,95%CI(10.67%～32.84%)],合计发生并发症比例为37.50%[95%CI(25.23%～51.48%)]。B组皮瓣或皮肤坏死2例[3.33%,95%CI(0.58%～12.55%)]及局部瘢痕增生6例[10.00%,95%CI(4.13%～21.17%)],合计发生并发症比例为13.33%[95%CI(6.34%～25.14%)]。结论:微针射频热凝术适于轻度腋臭患者,且较腋后线"N"形切口修剪术术后并发症少。     

三切口双平面大汗腺切除术联合负压引流治疗腋臭39例临床分析

目的探讨一种损伤小、效果良好、外观美观的治疗腋臭的适宜方法。方法采用两种微创方法治疗腋臭患者87例,治疗组39例,采用三切口双平面大汗腺切除术联合负压引流治疗;对照组48例,采用腋皱襞小切口皮下修剪法治疗。平均随访32个月。结果治疗组复发率为2.56%,对照组为16.67%,两组比较差异有统计学意义(P0.05),并发症少,两种方法均可一定程度上改善出汗状况。结论三切口双平面大汗腺切除术联合负压引流治疗腋臭,是一种并发症少、术后外形美观、效果确切的根治腋臭的手术方法。     

汗腺疾病

20100622两种手术方法治疗腋臭的疗效比较/蒋屏东(无锡市第二医院皮肤科),翟建新,郑渊…∥临床皮肤科杂志.-2009,38(11).-74171例患者分成2组,A组35例,其中男13例,女22例,A组应用皮下搔刮术。B组(应用小切口皮下大汗腺修剪术)36例,其中男15例,女21例,结果,经随访6月～1年:痊愈率为A组72.56%、B组90.28%,两组差异有统计学意义,P<0.05;有效率A组92.85%、B组95.83%,两组差异无统计学意义,P>0.05。参3(孙泑秦)20100623改良小切口汗腺层搔刮术治疗腋臭的手术技巧/朱礼昆(昆明医学院二附院整形外科),谢华,肖鸿…∥云南医药     

输卵管绝育术中改良抽芯法联合免拆线的临床观察

目的：探索输卵管绝育术的最佳方法,降低并发症的发生。方法：本文将1998年8月～2005年12月在中心自愿要求绝育的育龄妇女2016例,随机分为两组：A组采用传统抽芯包埋法1001例;B组采用改良抽芯包埋法联合免拆线1015例,术中进行两种方法操作比较、术后并发症及切口愈合情况的比较。结果：A组与B组手术操作结果显示,B组操作步骤简单、创伤小,并缩短手术时间,两组有显著性差异（P〈0.05）;A组与B组在术后并发症发生率及切口愈合情况比较,两组无显着性差异（P〉0.05）。结论：采用改良抽芯包埋法联合免拆线应用于输卵管绝育术,简便、安全、可靠,缩短手术时间,临床效果满意,受术者易接受,值得计划生育临床应用。     

小切口剥离修剪法治疗腋臭30例分析

对30例腋臭患者沿腋后线腋毛后缘中部作纵向小切口,真皮与皮下组织间分离,范围至腋毛区外约1.0～2.0 cm,刮匙搔刮皮瓣内侧,再用眼科小剪刀修剪残存脂肪组织、腺体及毛囊组织,术后包扎.随访,本组30例腋臭患者,治愈率93.3%,切口瘢痕不易辨认,双上肢活动均正常.小切口剥离修剪法治疗腋臭,疗效确切,一次性治愈率高.     

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.     

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.     

Local injection of botulinum toxin A: An alternative therapy for axillary osmidrosis

The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6–20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n = 76). The patients were followed up for 1–3 months to analyze the therapeutic effect and complications of the two methods. The curative effect in patients with mild and moderate axillary osmidrosis was not significantly different between the botulinum toxin A injection group and operation group. However, for patients with severe axillary osmidrosis, surgery treatment seemed to be superior to botulinum toxin A treatment (P = 0.005). There was also no significant difference in the modified Dermatology Life Quality Index between the two treatments. Two cases showed complications related to hemorrhage and incision infection in the operation group. In conclusion, local injection of botulinum toxin A is a safe, fast and effective treatment for mild and moderate axillary osmidrosis, but the long‐term effect remains to be further investigated.     

A new method for facial epidermoid cyst removal with minimal incision

Background  Facial epidermoid cyst is a common benign epithelial tumour frequently seen in young or middle-aged people and may cause aesthetic disability. Surgical excision is the most frequently used method but may result in obvious scar.
Objective  To improve cosmetic result of removing facial epidermoid cyst through minimal incision surgery.
Methods  Twenty-two cases of facial epidermoid cysts ranging from 0.5  to 1.4 cm in diameter were treated. The skin above the epidermoid cysts was infiltrated with local 0.1-cc 1% xylocaine anaesthetic by using a 26-gauge needle first, then 3-mm incisions were made with a No.11 surgical blade. The cystic contents and its capsule were then squeezed out through the small incision and the underlying connective tissue was chemically cauterized by 20% trichloroacetic acid. The incision wounds were left unsutured.
Result  Minimal incision method successfully treated 16 out of the 22 epidermoid cyst cases that ranged from 0.5 to 1 cm in diameter. And only one out of six was successfully treated for diameters greater than 1.1 cm.
Conclusion  The proposed method can minimize the scar when treating facial epidermal inclusion cysts that are less than 1 cm and obtained better cosmetic results.

Conflicts of interest

None declared.     

等离子激光术和小切口吸刮术治疗腋臭的疗效及安全性比较

目的 比较等离子激光术和小切口吸刮术治疗腋臭的疗效及安全性.方法 2018年1月-2019年1月第四军医大学西京医院皮肤科纳入68例腋臭患者,将患者随机平均分为两组,实验组34例,采用等离子激光术治疗,对照组34例,采用小切口吸刮术治疗.持续随访12个月,比较两组患者的治疗效果和并发症发生情况.结果 实验组患者治疗有效...     

小切口皮下修剪联合腔镜下点灼治疗腋臭

【摘要】 目的 观察小切口皮下修剪+腔镜下点灼法治疗腋臭的临床效果与并发症的预防。方法 采用小切口皮下修剪+腔镜下点灼法治疗腋臭患者85例并术后回访6-24月。结果 85例患者中,治愈64例,有效16例,无效5例,总有效率为94.12％。结论 小切口皮下修剪+腔镜下点灼法治疗腋臭具有疗效好,复发率低,手术并发症少等优点,值得临床推广应用     

微波和小切口吸刮术治疗腋臭的效果及安全性比较

【摘要】 目的 比较微波和小切口吸刮术治疗腋臭的临床效果和安全性。方法 2017年1月至2018年2月在空军军医大学西京医院皮肤科收集60例腋臭患者，左侧腋窝用miraDry微波治疗仪治疗（微波组），右侧用小切口皮下吸刮术治疗（吸刮组），记录两组的手术时间。随访半年，比较两组的疗效、并发症等。结果 随访6个月，微波组有效率为93.33％（56例），复发率为6.67％（4例），吸刮组分别为96.67％、3.33％，两组间差异均无统计学意义（均P > 0.05 ）。但微波组术后并发症发生率为0，吸刮组为6.67%，差异有统计学意义（χ2 = 4.138，P = 0.042）。结论 对比小切口吸刮术，微波治疗具有非侵入性、手术并发症少等优点。     

Effect of optimizing the use of endoscope on the efficiency of microdynamic bromhidrosis removal operation

Background

Bromhidrosis, also known as body odor, is a common disease in life, which often occurs in young adults. The histological basis of bromhidrosis is the hyperplasia of apocrine sweat glands.

Objective

To compare the effects of different methods of endoscopy in microdynamic axillary osmidrosis removal on curative effect, complications, and surgical efficiency.

Methods

A total of 149 patients with axillary osmidrosis were treated in our hospital from January 2020 to December 2021. They were treated with endoscopic assistance in the whole process of operation (Group A) and endoscope-assisted exploration after blind rotary cutter suction (Group B), respectively, and the curative effect, complication rate, and surgical efficiency were evaluated.

Results

There was no significant difference in the curative effect and complication rate between the two groups, but the endoscope-assisted exploration group after suction with rotary cutter (Group B) had higher surgical efficiency.

Conclusion

On the basis of professional use of rotary cutter, it is efficient to choose endoscope to check the excision of sweat gland in the operation area and stop bleeding in time after blind suction.     

腋臭患者腋区顶泌汗腺的分布特点

【摘要】 目的 检测腋臭患者腋区顶泌汗腺在深度、广度的分布,探讨其范围内的分布差异性。 方法 2010年9 - 12月间的15例腋臭患者,行直视下顶泌汗腺剪除术,切取切口处宽约2 mm的全层皮肤,深度达腋浅筋膜浅层,用于判明顶泌汗腺分布的深度。留取腋中心（点1）、距腋中心1 cm（点2）、距腋毛边缘内1 cm（点3）、腋毛边缘（点4）、距腋毛边缘外1 cm（点5）共5个标记点对应的皮下暗红色粗大的颗粒状组织,用于判明顶泌汗腺的分布范围及分布规律。 结果 顶泌汗腺分泌部主要分布于真皮网状层和皮下脂肪浅层,表皮层、真皮乳头层及腋浅筋膜浅层均无顶泌汗腺分布。顶泌汗腺广度分布与腋毛范围基本一致,腋中心部可见大量顶泌汗腺组织,腋毛边缘处仍有少量顶泌汗腺分布,腋毛边缘外1.0 cm处已无顶泌汗腺分布。5个点顶泌汗腺面积占整块组织面积的百分比平均值分别为74.1%、46.6%、25.3%、2.1%和0,相邻两点进行t检验,点1、2之间t = 29.78,P < 0.01;点2、3之间t = 9.76,P < 0.01;点3、4之间t = 20.83,P < 0.01;点4、5之间t = 1.96,P > 0.05。 结论 手术治疗腋臭时,清除范围深度达真皮网状层和浅层脂肪层,广度到腋毛范围即可,没有必要过度扩大清除范围。