Clincial Analysis Of Three Operative Treatments For Axillary Osmidrosis

Axillary osmidrosis is a common disease of the outpatient plastic and aesthetic surgery, it is a troublesome and distressing problem that causes a serious personal and social handicap, is an annoying, although not life-threatening, problem that includes unpleasant odor and the occasional staining of clothing. People who suffer from this problem are usually embarrassed by the smell during their daily activities and contact with other people.The offensive odor associated with axillary osmidrosis is believed to be caused by secretions from the apocrine. In hyperhidrosis, the eccrine glands, which make up the majority of sweat glands and typically produce thin secretions, become overstimulated. Apocrine glands, which are fewer in number and mainly found in axilla and urogenital regions, produce viscid secretions. An unpleasant odor is generated when bacteria decompose the apocrine secretion. In China, we see mostly patients with osmidrosis rather than hyperhidrosis.In mild cases, topical astringents or aluminum deodorants may be effective but frequent application is necessary. In severe cases, topical antiperspirants or deodorants are inadequate. Systemic medication with anticholinergics, which can block sympathetic nerve supply to sweat glands, may decrease the sweat secretion but cause major side effects, including excessive dryness and drowsiness,and long-term usage is not possible. A more permanent solution is sought. Surgical treatment of axillary osmidrosis was first described in 1962. Several different surgical methods have been proposed, such as subcutaneous shaving or curettage, laser treatment, superficial or ultrasonic liposuction, and excision of cutaneous tissue,and they can be classified into three categories: excision of only the axillary subcutaneous tissue, en bloc excision of the axillary skin and subcutaneous tissue, the subcutaneous tissue aspiration. The purpose of this study was to seek a more effective surgical procedure by comparing excision of cutaneous tissue, tumescent aspiration and subcutaneous tissue removal via small incision.Objective: To analyze the therapeutic effects of three treatments for axillary osmidrosis .Methods: We retrospectively reviewed 82 patients who underwent three procedures for bilateral axillary osmidrosis between september of 2002 and october 2006.these procedures included spindly excision of skin with Z-plasty,tumescent aspiration and subcutaneous tissue removal via small incisons. The results and complictions were compared after the follow-up. Results:Efficiency of procedures of spindly excision of skin with Z-plasty and subcutaneous tissue removal via small incisons were higher than tumescent aspiration, while the rate of complications of subcutaneous tissue removal via small incisons and tumescent aspiration were fewer than spindly excision of skin with Z-plasty.Conclusion :Better procedure should developed for the different case in the treatment of axillary osmidrosis. Subcutaneous tissue removal via small incisons is a good option for treatment of axillary osmidrosis.