Study of Surgical Treatment for Osmidrosis

Seol, Gyung Deog; Suh, Jae Il; Ihm, Chull Wan

Abstract

The authors evaluated the results of various operative methods for the treatment of axillary osmidrosis in 256 axillae of 132 patients. The methods studied herein are elliptical excision with(without Z-plasty, excision by modified W-plasty, undercutting of apocrine glands with preserving deep dermal vascular plexus (DDP) designed by the authors, undercutting of apocrine glands with ignoring deep dermal vascular plexus. With the undercutting methods, the skin incision was made by three different ways ', single vertical line, double vertical lines or single horizontal line in respect to the long axis of axillary vault. The results were as follows: 1. In the undercutting methods the stitch removals were done earlier than those of the excision methods by 3 to 8 days. The earliest stitch removal was in the undercutting methods with preservation of DDP done by single vertical incision (UPS). 2. Operative complications (wound disruption, flap necrosis or hematoma) occured in 12.9%. The wound disruption was main complication in the excision methods, the hematoma and flap necrosis in the undercutting methods. In the undercutting methods flap necrosis was seen only when DDP was ignored. 3. 123 axillae were followed up for more than 6 months after the operations. Among these the widely extended scars were seen in 94% of simple elliptical excisions(31 cases) and in 100% of excision with Z-plasty(16 cases) or modified W-plasty(3 cases). In the undercutting methods the scars were linear or invisible and best in UPS. 4. Success rate for the eradication of the malodor showed somewhat better results with undercutting methods compared with excisionmethods, but there was no statistical differences between the different groups. 5. In 6 axillae with the undercutting methods, histological examinations were done after more than three months. Apocrine glands were not seen in all the specimens. But some of them showed eccrine glands.