腋臭大汗腺清除术后并发症的探讨

目的总结腋窝皱襞小切口大汗腺清除术的相关技术问题,为进一步提高手术效果,避免腋臭术后并发症的发生提供参考。方法回顾性分析1999年2月一2015年12月山东省济南市章丘区中医医院整形美容烧伤科收治的采用腋窝皱襞小切口大汗腺清除术治疗的1580例腋臭患者的临床资料,归纳总结术中相关技术问题与临床效果,统计术后并发症的发生情况并予以分析讨论。结果 1580例患者中有1516例患者切口一期愈合、37例患者并发皮下血肿、27例患者并发切口皮缘坏死。术后随访3个月~4年,1559例患者异味完全消除,21例患者残留轻度异味;29例患者有假性皮脂腺囊肿形成;10例患者出现轻度瘢痕增生;所有患者均无上肢运动障碍。结论腋窝皱襞小切口大汗腺清除术是目前根治腋臭的首选疗法,手术过程中只要掌握好手术适应症及手术技巧,即可避免术后并发症的发生,且该方法安全可靠,疗效显著,值得临床推广应用。

The Postoperative Complications Following the Apocrine Gland Resection in Patients with Axillary Osmidrosis

Objective: To summarize and discuss the techniques used during the resection of axillary apocrine gland by a small incision, aiming to further improve the clinical outcomes and prevent the post-operative complications. Methods: The clinical data of 1580 patients with axillary osmidrosis treated by the small incision resection of axillary apocrine gland in the Plastic Surgery and Burn Department of Jinan Zhangqiu District Hospital of TCM between February 1999 and December 2015 were retrospectively analyzed to summarize the techniques used during the surgery and the clinical outcomes. A statistical analysis on the occurrence of post-operative complications was also performed. Results: The incision wounds in 1516 patients out of the 1580 patients achieved primary healing. 37 patients developed subcutaneous haematoma and 27 patients suffered skin necrosis around the incision sites. The follow-up of 3 months to 4 years showed complete elimination of body odour in 1559 patients (98.67%) and mild odour in 21 patients (1.33%); pseudo-sebaceous cyst occurred in 29 patients; mild hypertrophic scarring was seen in 10 patients; no upper limb movement impairment was observed in all patients. Conclusion: The small incision resection of axillary apocrine gland is the preferred radical treatment for axillary osmidrosis. The postoperative complications can be avoided as long as the right indications and right techniques of the surgery were followed. The small incision resection of axillary apocrine gland is safe and reliable with excellent clinical efficacy, which can be widely used in clinical practice.