摘要
目的探索简便、创伤小、疗效确切、并发症少、疤痕隐蔽的治疗腋臭的手术方法。方法术前标记手术剥离范围超过腋毛分布区0.5～1.0 cm,采用局部浸润肿胀麻醉,在腋顶部皮纹皱褶处,作1.5～2.0 cm横纹小切口,缝线牵拉切口缘,向切口两侧于浅筋膜层组织剪钝锐结合法分离皮瓣到设定范围,双极电凝止血后,先在皮瓣下周边均匀负压刮吸,后翻转皮瓣直视下修剪残存的与中部的大汗腺组织,皮瓣中部横纹戳孔开窗引流,间断缝合切口,术区缝线打包加压包扎,弹力绷带后"8"字固定包扎。术后1周拆包,10～12 d拆线。结果患者于术后2个月～2年随访,腋下异味消失,无皮瓣坏死,切口及开窗戳孔疤痕不明显,双上肢活动无明显受限,腋毛减少。结论腋顶部皱襞小切口修剪结合负压刮吸法治疗腋臭是一种简单、安全、彻底、疤痕隐蔽的手术方法,符合整形外科学的要求。
Objective To probe a simple,small invasive,effective,surgical method for osmidrosis,this operation is without a readily visible scar and complications.Methods Markings were made around the location of the axillary hair-bearing area（0.5-1.0 cm away） before the operation.The tumescent technique was performed in regional local anesthesia of skin and subcutaneous tissue by direct infiltration.A small incision（1.5-2.0 cm） was made high in the middle portion of the axillary crease;the cut edge was dragged by using suture line;the skin flap was separated on both sides of the cut in fascial layers;the bleeding was topped by bipolar electrocoagulation and then the axillary-suction curettage was performed under the skin flaps followed by the resection of subcutaneous cellular tissue.The drainage was performed through a window opened in the middle part of the skin flaps.Then the incisions were closed with discontinuous sutures.The area of operation was bandaged by compression bandaging with elastic bandage.The bandage was moved one week later,and the suture was taken out 10 to 12 days later.Results All the patients were followed up for 2 to 24 months.Osmidrosis disappeared.There was no flap necrosis.There was no readily visible scar in incision or open window areas.Both upper limb movements were no affected.There was a reduced growth of hair in the armpits.Conclusion The resection of subcutaneous cellular tissue via small incision placed high in axillary region combined with suction curettage is a simple,safe,radical and effective surgical method without readily visible scars in the treatment of osmidrosis.It is consistent with the requirement of orthopaedic surgery.
出处
《中华全科医学》
2013年第8期1233-1234,1259,共3页
Chinese Journal of General Practice
关键词
腋臭
小切口
修剪
负压刮吸
Osmidrosis
Small incision
Resection of subcutaneous cellular tissue
Axillary-suction curettage
