改良小切口皮下修剪法腋臭根治术的并发症分析及临床疗效评估

目的:探讨改良小切口皮下修剪法腋臭根治术的手术及术后包扎方法对并发症的发生及临床疗效的影响。方法:对80例腋臭患者采用小切口皮下修剪法根治,根据术后包扎方法分为3组:常规包扎组、常规包扎+负压引流组、弹力绷带包扎组,分析各组出现皮下积血、皮片坏死等并发症的情况,并通过随访评估其临床疗效。结果:负压引流或弹力绷带包扎可明显减少皮下积血及皮片坏死的发生率,减少瘢痕形成,而去除异味效果无显著区别,综合临床疗效提高。结论:改良小切口皮下修剪法腋臭根治术的手术方法、术后包扎及护理方法可明显减少并发症的发生,提高临床疗效。     

小切口中厚皮瓣联合弹力绷带包扎腋臭根治术

目的:探索一种能根治腋臭且能减少并发症的外科手术方法。方法:局部肿胀麻醉下,通过腋后皱襞1.0～1.5cm顺皮纹小切口,于皮下脂肪层潜行剥离一稍大于腋毛边界1.0cm的完整腔隙,把带有汗腺及毛囊的皮肤修剪成中厚皮片厚度,术毕放置引流条,自粘性弹力绷带加压包扎。结果:本法共治疗61例腋臭患者,术后无皮下血肿,无皮瓣坏死等并发症。术后3～12个月随访,腋窝无异味,切口无明显瘢痕,上肢活动无影响。结论:腋窝横皱襞小切口中厚皮片法治疗腋臭,具有满意的临床疗效和良好的美容效果。     

小切口腋臭根治术并发症原因探讨及其防治

对于腋臭的治疗临床上一直在探索创伤小、术后切口隐蔽、复发率低的治疗方法。我科室从2006～2009年6月,开展＂腋部小切口＋皮下修剪大汗腺法＂治疗腋臭135例,将腋部皮肤及皮下组织剪成中厚皮片厚度,皮瓣打包固定,必要时放引流片,弹力绷带＂背心式＂包扎,用于根治腋臭,取得满意效果。     

改良微创法腋臭根治术80例临床回顾分析

目的:探讨改良小切口皮下修剪法腋臭根治术的有效性及安全性。方法:对80例腋臭患者采用小切口皮下修剪法根治术,随访评估其临床疗效。结果:80例患者腋臭完全消失,异味残留1例,再次行此手术后治愈;术后发生皮下瘀血1例,排除瘀血后加压包扎,愈合良好。所有患者术后瘢痕隐蔽,外形美观。结论:本术式是一种微创、简便、安全、有效的腋臭治疗技术,值得临床推广应用。     

负压引流在小切口根治腋臭术中的应用

目的:在众多腋臭治疗方法中,探索出一种能有效根治腋臭且并发症少的治疗方案。方法:利用小切口,肿胀麻醉,把带有汗腺及毛囊的皮肤修剪薄至全厚及中厚皮片厚度,术毕放置负压引流,使皮肤与基底贴合良好,并加压包扎。结果:本法共治疗32例腋臭患者,其中其他方法治疗复发者11例。除2例术后有轻微气味外,其余均得到根治,术后瘢痕不明显。结论:负压引流在小切口根治腋臭中可有效减少并发症,提高治愈率。     

双管多孔高负压引流加弹力绷带包扎在乳腺癌改良根治术中的应用

乳腺癌是我国妇女常见恶性肿瘤之一,近年来其发病率呈逐渐上升趋势。乳腺癌改良根治术作为乳腺癌的一种主流手术方式,其手术方法及技巧已日臻成熟,但其术后皮下积液、积血、皮瓣坏死等并发症及引流时间过长等弊端,仍屡见不鲜。这些并发症的发生,延误了患者后续的放、化疗及功能锻炼等综合治疗,给患者身心健康造成了很大影响。笔者自2006年起采用双管多孔高负压引流和弹力绷带加压包扎，有效减少了这些并发症的发生，总结报道如下。     

综合微创手术治疗腋臭1066例临床疗效观察

目的:探讨联合负压抽吸、小切口直视皮下修剪及电刮勺热灼的综合性微创方法治疗腋臭的临床疗效。方法:2006年1月-2016年12月笔者科室采用微创综合疗法治疗腋臭1 066例,沿腋窝尺侧腋皱襞附近作一长约0.5~1.0cm小切口,在腋窝中央作一长约1cm辅助切口。沿手术切口负压抽吸浅层脂肪,在直视下修剪皮下残余脂肪组织及真皮网状层的毛囊球,电刮勺依次在皮下烧灼静止期毛囊,术后打包加压包扎7d。结果:本组共1 066例患者,随访6~12个月,显效913例,有效142例,无效11例,有效率为98.97%。术后血肿23例,5例发生皮片坏死,植皮后创面愈合,其余均通过换药治愈。结论:联合负压抽吸、小切口直视皮下修剪及电刮勺热灼的综合方法能有效根治腋臭,具有安全、高效、术后并发症少等优点。     

负压抽吸搔刮术联合小切口皮下修剪法治疗腋臭

目的:探讨负压抽吸搔刮术联合小切口皮下修剪法治疗腋臭的临床效果及安全性。方法:选择2015年1月-2017年1月在笔者医院医疗美容科就诊的425例腋臭患者为研究对象,采用负压抽吸搔刮术联合小切口皮下修剪法对腋臭患者进行治疗,术后随访1年,评价临床效果,观察复发率、残留率、术后并发症及患者满意度情况。结果:所有患者切口均一级愈合,切口瘢痕不明显;412例患者对手术效果满意,满意度为96.94%;10例患者发生术后并发症(单侧血肿),并发症发生率为2.35%,经负压引流清除后伤口愈合,无感染及皮肤坏死发生;13例患者发生残留(9例单侧残留,4例双侧残留),残留率为3.06%;9例患者出现复发,复发率为2.12%;残留及复发者均经二次手术,效果满意。结论:负压抽吸搔刮术联合小切口皮下修剪法对于腋臭是一种微创、安全、有效的治疗技术。     

改良皮瓣法小儿腋臭治疗体会

目的:探讨改良皮瓣法大汗腺切除术在小儿腋臭治疗中的作用。方法:5例小儿腋臭患者采用改良皮瓣法大汗腺切除术进行治疗,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2~3mm的微孔进行引流,皮肤切口用3-0丝线缝合后再用"8"字弹力绷带包扎压迫手术区敷料。术后7天换药,10天拆线并观察皮瓣情况,术后3~6月进行随访。结果:5例患者术后均未出现皮下血肿、皮肤坏死及感染等并发症。随访全部患者腋部辛辣汗臭均消失、出汗减少,瘢痕不明显,皮肤颜色及质地均正常,腋毛基本消失、社交正常。结论:改良皮瓣法治疗小儿腋臭疗效确切并发症不明显。     

一次性负压引流球预防小切口根治腋臭术后血肿的临床研究

目的:探索出一种能够有效预防小切口根治腋臭术后血肿的方法.方法:在局部肿胀麻醉下,沿腋皱襞做一长3.5～5cm的切口,皮下组织浅层分离至腋毛区外1cm,翻转皮瓣,剪除附着于真皮基底下的腺体及毛囊,形成全厚皮片.在切口上缘内上方1.5cm处置入一次性负压引流球,捏瘪塑料球,塞紧球塞,使皮瓣与皮下组织紧密贴合,弹力绷带加压包扎.结果:112例患者手术切口Ⅰ期愈合,瘢痕不明显;1例患者单侧出现皮下血肿,经换药处理后愈合.所有患者的臭味均消失.结论:一次性负压引流球应用于小切口根治腋臭中可有效降低血肿并发症,提高治疗效果,值得推广使用.     

微创负压抽吸术治疗腋臭的临床效果

目的 探究微创负压抽吸术治疗腋臭的可行性。方法 选取烟台市奇山医院医疗美容科2022年 6月-2023年8月收治的60例腋臭患者为研究对象,采用随机数字表法分为参照组和研究组,各30例。参照 组予以小切口汗腺切除术治疗,研究组予以微创负压抽吸术治疗,比较两组临床疗效、手术指标、日常活 动评分及并发症发生情况。结果 研究组治疗总有效率为96.67%,高于参照组的76.67%,差异有统计学意 义（P＜0.05）;研究组手术用时、术后固定时间、切口愈合时间以及术后住院天数短于参照组,差异有统 计学意义（P ＜0.05）;研究组HDSS评分低于参照组,差异有统计学意义（P ＜0.05）;研究组术后并发症 发生率为3.33%,低于参照组的26.67%,差异有统计学意义（P＜0.05）。结论 腋臭治疗中应用微创负压抽 吸术的效果较小切口汗腺切除术更优,可促进康复,降低并发症发生几率,临床应用价值较高。     

可视剪除法治疗腋臭的临床观察

目的:探讨一种既可以治疗腋臭,又达到腋窝手术部位外形美观,瘢痕增生不明显,且无功能影响及并发症发生的治疗腋臭的方法。方法:手术以切除的皮肤及皮下组织中的病理检查结果为指导,去除手术范围内一层皮下脂肪组织,翻转皮瓣剪除大汗腺、打孔引流,加压包扎。结果:本方法用于37例病例,大汗腺清除较为彻底,效果持久,并发症较少,切口美观瘢痕不明显。结论:此腋臭治疗方法,疗效肯定、腋窝外观满意。     

微创单纯抽吸术与皮下组织剥离剪除术治疗腋臭的临床效果对比

目的 通过对腋毛区两种术式治疗腋臭的疗效对比,探索一种更好地治疗腋臭的手术方法.方法 对72例腋臭患者随机分为两组,36例行微切口单纯抽吸术（A组）,另36例经腋皱襞切开行皮下组织剥离剪除术（B组）,对两组的手术时间、疗效、并发症、瘢痕、恢复时间等进行总结对比分析.结果 经6～12个月随访,两组患者腋臭治疗总有效率100％.A组在手术时间、术后并发症、恢复时间、瘢痕、腋毛存活等方面明显优于B组,两组差异有统计学意义（P＜0.05）.结论 微创单纯抽吸术治疗腋臭疗效可靠,安全便捷,瘢痕更小而隐匿,并发症少,恢复快,更易被患者接受.     

改良的顺腋纹小切口法腋臭根治术

目的:探讨一种改良的小切口腋臭根治术的方法。方法:从2006年1月至2007年1月我们改良了顺腋纹小切口法腋臭根治术,治疗50例腋臭患者,所有患者均进行随访。结果:49例I期愈合,切口隐蔽,瘢痕不明显,气味消失。1例切口中间裂开1mm,加强换药一次后愈合。结论:改良的小切口腋臭根治术是一种切口隐蔽,无附加痕迹,操作方便,效果确切,并发症发生率低的术式。     

Very Superficial Ultrasound-Assisted Lipoplasty for the Treatment of Axillary Osmidrosis

Treatment of axillary osmidrosis has been mainly concerned with surgical excision of glandular tissues and involved major surgical procedures with high morbidities and many complications. Search for a less invasive procedure for axillary osmidrosis resulted in the use of liposuction. However, there have been controversies over the efficacy of this method. The problem was that liposuction could not effectively remove the apocrine gland located in the dermis and dermosubcutaneous junction. A high rate of residual malodor and dissatisfaction were reported. The author used ultrasound-assisted lipoplasty (UAL) in the very superficial plane to remove the apocrine gland located in the dermis and dermosubcutaneous junction. The purpose of this study was to prove the efficacy of the very superficial UAL (VSUAL) for the treatment of axillary osmidrosis. From December 1998 to December 1999, 21 consecutive patients underwent UAL in their axilla for axillary osmidrosis. The follow-up period ranged from 2 to 12 months (mean: 8 months). UAL was performed in the very superficial plane with an amplitude of 40%. The very superficial UAL (VSUAL) was done mainly in a withdrawing manner with the tip of the cannula against the skin. The UAL (VSUAL) was done aggressively until the skin changed slightly erythematous. The results were assessed subjectively and objectively, and classified as excellent, good, fair, and poor. Nineteen patients were graded as excellent and one patient as good. The total satisfaction rate was 95.2%. One patient complained of residual malodor in her left axilla. There were no cases of skin necrosis, hematoma, or seroma. Histology showed partial removal of the subcutaneous layer and deep dermis, and degenerative epithelial changes in the apocrine glands in the residual deep dermis. These microscopic findings meant near-total functional ablation of the apocrine gland in the axilla comparable to ``flap-to-graft conversion' or surgical excision of axillary skin. The UAL (VSUAL) for axillary osmidrosis has the advantages of a high success rate with minimal complications. Rapid recovery, less restriction of movement, and tiny scars were other major benefits of this technique. Therefore, UAL (VSUAL) is a viable option for treatment of axillary osmidrosis.     

Endoscopy-assisted ultrasonic surgical aspiration of axillary osmidrosis: a retrospective review of 896 consecutive patients from 1998 to 2004.

Axillary osmidrosis is a distressing and troublesome problem that causes a serious handicap in personal and social life. Many different methods have been introduced to treat axillary osmidrosis, however, they are often accompanied by marked complications. We analysed our experiences using endoscopy-assisted ultrasonic surgical aspiration in treating the axillary osmidrosis. From June 1998 to February 2004, a total of 896 patients (562 females, 334 males) were treated for axillary osmidrosis using endoscopy-assisted ultrasonic surgical aspiration. Our method was satisfactory in 815 patients (91%) and recurrence of odour occurred only in 29 (3.2%) patients. It also showed complications in 28 (3.1%) patients. Our method leaves a small inconspicuous scar and no contracture of the axillary skin after a short and comfortable recovery period and maintains normal axillary hair growth patterns. Axillary osmidrosis can be best treated by endoscopy-assisted ultrasonic surgical aspiration and this operation has many advantages with a high success rate, a low complication rate, and a rapid recovery period.     

肿胀麻醉下微创刮吸术治疗腋臭

目的观察肿胀麻醉下微创刮吸术治疗腋臭的效果。方法采用腋部小切口,肿胀麻醉下刮吸去除大汗腺组织治疗腋臭。结果本组82例患者,术后腋部气味消失,效果良好。结论肿胀麻醉下微创刮吸术治疗腋臭的方法简易,效果确切,并发症少,值得临床推广应用。     

Minimally Invasive Surgery for Axillary Osmidrosis: Combined Operation with CO2 Laser and Subcutaneous Tissue Remover

BACKGROUND: Axillary osmidrosis is a distressing problem characterized by unpleasant odor, profuse sweating, and occasionally staining of clothes that may handicap those affected both socially and psychologically. Various types of surgical procedures have been developed for the treatment of axillary hyperhidrosis and osmidrosis. OBJECTIVE: To introduce a new odor measurement method and minimally invasive surgery technique for axillary osmidrosis. METHODS: Eighty-eight patients with axillary osmidrosis were treated by combined operation using a carbon dioxide (CO2) laser and subcutaneous tissue remover. Measurement of axillary odor was done with the cotton-roll method. RESULTS: Eighty-seven of the 88 patients (98.8%) had good to fair results; only one patient (1.2%) had poor results. Complications such as ecchymosis and partial skin necrosis with delayed wound healing occurred in four patients (4.6%). CONCLUSION: A combined technique using a CO2 laser and subcutaneous tissue remover has the advantages of a high success rate, low complication rate, no admission treatment, less scarring, and rapid recovery. This combined approach should become the preferred technique for the treatment of axillary osmidrosis.     

改良微创手术治疗128例腋臭患者临床分析

目的：探讨采用改良微创手术方法治疗128例腋臭患者的临床疗效。方法：2009年1月～2011年5月,对128例腋臭患者256侧腋窝采用改良微创手术治疗。方法为沿腋皱襞lcm切口,剪除术区范围包含大汗腺在内的一定厚度的皮下组织至皮肤近似全厚皮,搔刮冲洗后皮肤打孔并将皮片与基底组织以凡士林油纱布钉固定,棉垫填充腋窝顶部以弹力自粘绷带加压包扎。结果：术后随访6～18个月,256侧腋部中251侧气味消除效果好,5侧为一般,O个为差。所有患者术后效果满意。结论：改良小切口微创手术方法具有外形美观、无功能障碍、操作简便、创伤小、疗效可靠、并发症少的特点,患者满意度高,值得临床推广。