A new type of surgery for the treatment of bromhidrosis

Abstract

It is common to treat bromhidrosis by surgery, but postoperative complications such as subcutaneous exudate and subcutaneous hematoma can occur and lead to delayed healing of the wound and eventually lead to the formation of unattractive scars. In this study, we evaluated our new surgical treatment for bromhidrosis, which we believe improves prognosis over conventional surgery. The new procedure was performed on 22 patients with bromhidrosis. Our procedure is as follows. One centimeter-long incisions are made along the skin and cleaning of the subcutaneous apocrine glands using a special serrated scraping device is completed. Then, several 0.5 cm-long drainage holes are made according to the design of the Sudoku puzzle and 4 anchoring points identified to stabilize the oil gauze. Finally, the incisions were sutured and the wound covered with a bandage. Of 44 axillas, the bromhidrosis of 42 axillas was completely cured, and greatly reduced in 2 axillas. Local epidermal necrosis occurred in 5 axillas, but there was no full-thickness skin necrosis. Subcutaneous hematoma was not observed, and postoperative scarring was minimal. We found that our modified surgery can effectively reduce the occurrence of subcutaneous hematoma, avoid delayed healing of the wound, and minimize postoperative scarring. Level II, therapeutic study.

Impact of Apocrine Gland Residue on Bromhidrosis Clinical Efficacy: A Self-controlled Case Series Study

“…Regarding our surgical technique, removing apocrine sweat gland is much more precise by turning over the skin flap without extra tissue damage. 11,15 Also, the paralleled double incision design better preserves the dermal vascular net than other incision shape manipulations. 10 In summary, this procedure proposes a great combination of satisfactory clinical efficiency and cosmetic incision appearance.…”

“…1,3,[8][9][10][11][12][13] Surgical therapy is generally successful and complete, with up to 90 percent efficiency 14 and good clinical acceptability. However, these techniques bring up various complications (eg, gland scraping and suction curettage remove the apocrine sweat gland in an indirect vision), which induces extra injury on dermal blood vessel net and subcutaneous tissue, 11,15 while small endoscopic incisions usually produce an unsatisfactory scar due to the repeated manipulation through the incision. 16 Our department has been treating bromhidrosis with apocrine sweat gland excision since 2011, by removing the apocrine sweat gland precisely in a direct vision by turning over the axillary skin flap.…”

“…[4][5][6][7] Surgical procedures, such as fat aspiration, apocrine sweat gland scraping, suction curettage, and small endoscopic incisions, are primarily aimed at removing the apocrine sweat glands. 1,3,[8][9][10][11][12][13] Surgical therapy is generally successful and complete, with up to 90 percent efficiency 14 and good clinical acceptability. However, these techniques bring up various complications (eg, gland scraping and suction curettage remove the apocrine sweat gland in an indirect vision), which induces extra injury on dermal blood vessel net and subcutaneous tissue, 11,15 while small endoscopic incisions usually produce an unsatisfactory scar due to the repeated manipulation through the incision.…”

An innovative application of follicular unit extraction technique in the treatment of bromhidrosis

“…1,3 At present, minimally invasive surgery has replaced the traditional open surgery for bromhidrosis, greatly reducing the complications of open surgery. 1,12 However, the minimally invasive surgery still requires one or two longitudinal incisions or several holes in the axillary area, and the use of ophthalmology scissors or a special serrated scraping device or suction device to destroy the apocrine glands. 3,12 No matter which method is chosen, skin necrosis, skin scars or subcutaneous hematomas cannot be completely avoided due to large areas of free skin or multiple holes.…”

“…Bromhidrosis is a common disorder characterized by abnormal body odour arising from apocrine glands. 1 Individuals who suffer from bromhidrosis are often ridiculed or discriminated, which will gradually alienate them from society and lead to serious social and psychological problems. A variety of methods for the treatment of bromhidrosis have been introduced, the principle of that is to eliminate or reduce axillary apocrine glands.…”