The Treatment of Osmidrosis Axillae by Use of Modified Skoog's Method

Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

The Clinical use of Absorbable Plate and Screw in Mandibular Fracture

Rigid fixation techniques with absorbable plates and screws are recently utilized for the repair of craniofacial skeletal injuries or congenital anomalies. But no domestic literature are presented in treatments of mandible fracture. We present our early experience of absorbable plates and screws in fixation of mandible fracture. Eleven patients underwent fixation procedures for mandible fracture with absorbable plates and screws. Intraoperative stability was satisfactory in all cases. Significant problems, such as nonunion, malunion, delayed union and malocclusion from the use of absorbable plating system were not found, but there were two cases of localized inflammation. We also experienced advantages of absorbable plating system which are biodegradation, radiolucency and enough stability for reduction state. The use of absorbable plating system would eliminate potential effects on skeletal growth- restriction in child, problems associated with long- term palpability and visibility in X-ray, and cold sensitivity caused by traditional metal plating system. There are also several disadvantages of absorbable plates and screws. This plating system takes increased operative time and needs delicate technique relative to the traditional metal plating system. Nevertheless we concluded that absorbable plates and screws are good fixatives for mandibular fracture.

The Effects of Water Soluble Chitin on the Open Wound Healing in Rabbits

The purpose of this study was to evaluate effects of chitin on open wound healing in rabbits. Using 15 rabbits, a round, full thickness defect of skin with 2 cm in diameter was made on the ventral surface of the each ear. The experimental animals were divided into 3 groups: control group untreated group), base ointment group (group treated with base ointment), and chitin ointment group(group treated with water soluble chitin ointment). A total of 30 wounds were made and each subgroup was allocated 10. On the 7th day after initial wounding, each wound site including surrounding tissue was taken for macroscopic and histological observations. The amount of epithelialization and granulation tissue were measured by Image Analysis System. In macroscopic examination, larger amount of exudate and granulation tissue were observed in water soluble chitin ointment group compared to control and base ointment groups. In histological examination, water soluble chitin ointment group showed thick epithelium and larger amount of granulation tissue and fibroblast deposition. The areas of epithelialization and granulation tissue were significantly increased in water soluble chitin ointment group compared to control and base ointment groups. In conclusion, water soluble chitin accelerated open wound healing by accelerating reepithelization and granulation tissue formation.