Clincial Analysis Of Three Operative Treatments For Axillary Osmidrosis

Objective:The purpose of this study was to seek a more effective surgical procedure by comparing the various elimination methods of preexisting subcutaneous apocrine gland using five parameters:odor,immobilization period,scar,other surgical complications such as hematoma,flap necrosis,wound dehiscence and infection of incisional wound,and relapse rate.Methods:We retrospectively reviewed 97 patients who underwent three procedures for bilateral axillary osmidrosis between October 2008 and October 2010 at outpatient of Plastic Surgery, First Hospital of Shanxi Medical University. These procedures included spindly excision of skin with Z-plasty,subcutaneous tissue removal via two parallel incisions and subcutaneous tissue removal via a small incision on axillary folds.All patients were followed up for 6-24 months and were evaluated by odor, operation time, immobilization period, scar,other surgical complications such as hematoma,flap necrosis,wound dehiscence and infection of incisional wound,and the situation of distant recurrence.And then the results and complications were compared among the three groups.Results:1.The three procedures (spindly excision of skin with Z-plasty,subcutaneous tissue removal via two parallel incisions and subcutaneous tissue removal via a small incision on axillary folds) had similar total efficiency and relapse rate.2.The rate of complications of subcutaneous tissue removal via two parallel incisions was lower than procedures of spindly excision of skin with Z-plasty and subcutaneous tissue removal via a small incision on axillary folds.3.The procedure of spindly excision of skin with Z-plasty had obvious scar,high incidence of scar hyperplasia and contracture, and often had limited mobility of upper arms,while the scars of other two procedures were not obvious.Conclusion:Better procedure should be developed for different cases in the treatment of axillary osmidrosis.Subcutaneous tissue removal via two parallel incisions is a good option for treatment of axillary osmidrosis, because it has lower relapse rate and rate of complications,and the scar of it is not obvious.