Efficacy Analysis Of The Remedy For54Cases Of Axillary Osmidrosis (AO) With Pediculated Skin Grafting

Objective:Axillary osmidrosis (AO) is a serious plagued symptom in people’s daily life, which can also lead to psychologic disorders in some severe cases. This disease is caused by the armpit and genital’apocrine glands secretions that are converted to odouriferous compounds by bacteria, which has an unpleasant smell associated with body odour. There have been various methods for the treatment of AO that can be simply divided into two types,non-surgical treatment and surgical treatment (e.g.,traditional surgery, minimally invasive). In this paper, we examined and explored the clinical efficacy of the remedy for AO with pediculated skin grafting.Methods:54Axillary osmidrosis (AO) patients were treated by pediculated skin grafting..First, we cut the skin and subcutaneous tissue of the axillae into intermediate split thickness skin grafts, while the1-2cm skin beyond borderline of armpit hair with pediculated skin grafting. Second,we removed the superficial fascia of axillary and the secrete ministry of apocrine sweat glands, including the hair follicles close to the reticular layer of dermis. Eventually, we pruninged some skin of the incision area moderately according to the size of the surgical area. The secrete ministry of apocrine sweat glands, however, couldnot be easily removed especially those below the subdermal vascular plexus.Thus, the subdermal vascular plexus, removed or not, was associated with various sites.The subdermal vascular plexus in the armpit central part area (on both sides of the incision) should be removed,which contributed to reducing odor residue and improving the survival of skin grafts. Whereas, the subdermal vascular plexus around axillary (pedicle) was retained because that the secrete ministry of apocrine sweat glands were scattered and subdermal vascular plexus branched coarse.Results:54AO patients in the group were followed up from three months to one year.48cases significantly effective:no obvious odor in bilateral, armpit hair sparse;6cases effective:bilateral slight odor after sweating or strenuous exercise, a small amount of armpit hair;0ineffective:no significant changes in bilateral odor, no significant reduction in armpit hair. Surgical incision:primary healing89sides (82.41%), per secundum intentionem19sides (17.59%). Among which, hematoma2sides (10.53%), effusion3sides (15.79%), fray or partial necrosis of epidermal flaps3sides (15.79%), local synulosis3sides (15.79%), residual odor5sides (26.32%),malunited incision3sides (15.79%). Notably, all patients had no effect on upper limb function, no large-area skin necrosis, no obvious scar of the surgery, no nerve injury,infection and recrudescence.Conclusion:Based on this study, we conclude that axillary osmidrosis (AO) can be cured with pediculated skin grafting.Besides,it takes full advantage of anatomical basis of the axillary apocrine sweat glands and subdermal vascular plexus. Moreover,it can not only ensure the effective removal of the axillary apocrine sweat glands and the intraoperative blood stopping,but also protect the blood supply of the skin to the maximum. Therefore, this surgical treatment is effective for AO and is also a comfortable solution for both the patients and the surgeons with satisfactory results and less complications.