Clinical observation of small incision surgery combined with multi-point skin fixation in the treatment of axillary osmidrosis / 中国医师杂志

Objective:To evaluate the efficacy and safety of small incision surgery combined with multi-point skin fixation in the treatment of axillary osmidrosis.Methods:104 patients with axillary osmidrosis who were treated in the dermatology department of the Third Hospital of Changsha from January 2017 to December 2020 were retrospectively analyzed. They were divided into the observation group (56 cases) and the control group (48 cases). Both groups were treated with small incision pruning combined with porous drainage. On this basis, the observation group was treated with multi-point skin fixation gauze compression bandage, while the control group was treated with conventional gauze stacking compression bandage. The efficacy, satisfaction, postoperative wound healing time and complication rate of the two groups were compared.Results:The effective rate of the observation group and the control group were 96.43%(54/56) and 95.83%(46/48) respectively, with no significant difference ( P>0.05). Compared with preoperative, the Visual Analogue Scale (VAS) score of patients in the two groups was significantly lower after operation, and the difference was statistically significant (both P<0.05). The satisfaction of patients in the observation group was higher than that in the control group [(4.05±1.15)points vs (3.19±1.00)points], and the difference was statistically significant ( t=4.10, P<0.05). The wound healing time in the observation group was shorter than that in the control group, and the incidence of complications was lower than that in the control group, with statistically significant difference (all P<0.05). Conclusions:Small incision surgery combined with multi-point skin fixation for the treatment of axillary osmidrosis has good curative effect, short postoperative wound healing time and fewer complications, and improved patient satisfaction, which can be popularized in clinical application.

Clinical effect of endoscopy assisted suction-cutter removal of apocrine sweat glands / 中华医学美学美容杂志

Objective To explore the clinical effect of endoscope assisted suction-cutter removal of apocrine sweat glands in treatment of osmidrosis.Methods This study generalized and analyzed the curative effects of 30 patients with axillary osmidrosis,treated with endoscopy assisted suction-cutter removal of apocrine sweat glands.The efficacy was evaluated according to the postoperative results and complications.Results In all the 30 patients,wound healed 7 to 10 days after operation,and they resumed almost normal life after treatment.From May 2015 to April 2017,the follow-up visits showed that none of them had relapse,infection or skin necrosis.Surgical scar was slight,and in all the patients,symptoms disappeared.Conclusions The operation of endoscopy assisted suction-cutter removal of apocrine sweat glands is a minimally invasive surgery.The advantages include direct vision,radical operation,well preserved dermal vascular network and lower risk of complications.

Percutaneous ethanol injection as a promising and minimally invasive treatment for axillary osmidrosis: Double-blinded randomized controlled trial

Background: Axillary osmidrosis is a common problem with a strong negative impact on the professional and social quality of life. Several options are available for its treatment. But there are no treatment guidelines. The objective of this study was to evaluate efficacy and safety of percutaneous ethanol injection for treatment of axillary osmidrosis. Methods: A randomized, double-blind, placebo-controlled clinical trial to assess clinical efficacy and postoperative complications of percutaneous ethanol injection was performed among 60 patients (12–35 years of age) with axillary osmidrosis. The active agent used in the experimental group (n = 30) was sterile 90% ethanol and the placebo used in the control group (n = 30) was sterile normal saline administered in an identical syringe. The results of malodor elimination were graded by the patients as excellent, good, fair, and poor. All patients were followed-up for 10 months. Results: Malodor elimination was graded as good by 15 (50%) patients treated with percutaneous ethanol injection. A significant difference in the improvement of axillary osmidrosis was found between the experimental and control groups (P < 0.001). The most common post-procedure complication was transient subjective skin stiffness in the experimental group, which regressed spontaneously. There were no serious permanent side effects. Limitations: Relatively short duration of follow-up; and lack of histopathological evidence of destruction of the apocrine glands after treatment in most patients. Conclusions: Percutaneous ethanol injection is an effective and safe treatment method for axillary osmidrosis and does not have permanent side effects.

Comparison between Conventional and Modified Superficial Liposuction Techniques in the Treatment of Axillary Osmidrosis / 대한피부과학회지

BACKGROUND: Axillary osmidrosis is caused by abnormal apocrine glands. Although various treatment modalities have been developed for axillary osmidrosis, there have not been sufficient studies to establish a treatment guideline. OBJECTIVE: This study aimed to evaluate the efficacy, safety, and disease recurrence rate of treatment by superficial liposuction with dermal curettage using Fatemi cannula to the level of the dermal-subcutaneous junction (modified technique) compared to dermal curettage to the level of the mid-dermis (conventional technique). METHODS: Fifty-two patients (104 axillae) underwent the modified technique and 54 patients (108 axillae) underwent the conventional technique from April 2007 to September 2014. The patients' demographic data, clinical efficacy of each treatment as evaluated using subjective satisfaction scales, postoperative complications, and recurrence rates were retrospectively reviewed, and procedures compared. RESULTS: Excellent to good outcomes were reported in 46 patients (88.5%) who underwent the modified technique and 50 patients (92.6%) who underwent the conventional technique. Recurrence occurred in 12.5% (13/104) of axillae in patients who underwent the modified technique, and 9.3% (10/108) of axillae in patients who underwent the conventional technique. There was no statistically significant difference in clinical efficacy, safety, or recurrence rates between the two techniques (p>0.05). Skin necrosis was significantly lower using the modified technique (p=0.017). CONCLUSION: Our study found that clinical results of the modified technique were comparable with those of the conventional technique. The modified technique is a convenient treatment for axillary osmidrosis, with high efficacy and low disease recurrence.

Comparative study on clinical efficacy of different surgical methods for axillary osmidrosis / 局解手术学杂志

Objective To investigate the most appropriate surgical methods,different surgical modes of osmidrosis and their clinical effi-cacy were observed. Methods Clinical data was collected from 200 cases of axillary osmidrosis from January 2011 to July 2013. These cases were divided into four groups of the traditional group,minimally invasive group,RF pen-frequency electric cautery group and improved curet-tage group. Results The traditional group(80 cases) has an average healing period of 18. 7 days for operative incision including 78 cured cases(97. 5%)and 2 significant improved cases(2. 5%). The minimally invasive group(60 cases)has an average healing time of 8. 6 days, among which there are 3 cured cases(5%),8 significant improved cases(13. 3%),16 improved cases(26. 7%),4 cases(6. 7%)with weak curative effect and 29 failed cases(48. 3%). In the RF pen-frequency electric cautery group(30 cases),there are 5 significant improved ca-ses(16.7%),8improvedcases(26.7%)and17failedcases(56.6%).Theimprovedcurettagegroup(30cases)withanaverageincision healingtimeof9.8dayscontains28curedcases(93.3%)and2significantimprovedcases(6.7%). Conclusion Thetraditionalgroup shows the best curative effect,nevertheless the incision needs a considerably amount of time to recover. The patients under the treatment of minimally invasive surgery or RF pen-frequency electric cautery can recover in short time but recrudescence always occur. The improved cu-rettage method,which is effective and safe,combines the advantages of traditional surgery and minimally invasive surgery. However,large scar left from this method still remains as its major disadvantage but the overall curative effect is satisfactory. The improved curettage is proved to be the most appropriate method for axillary osmidrosis.

Minimally Invasive Surgery for Axillary Osmidrosis Using a Combination of Subcutaneous Tissue Removal and a 1,444-nm Nd:YAG Laser

Many treatment modalities have been developed for axillary osmidrosis. It is well known that the surgical treatment has the best results. However, there is a high possibility of side effects. The 1,444-nm lipolysis laser has been recently introduced to remove the apocrine glands. So far, subdermal coagulation treatment with a 1,444-nm Nd:YAG laser may be the least invasive and most effective therapy for axillary osmidrosis. However, according to our previous experience, the recurrence rate was 20%~30%. This emphasizes the need for combination of surgical method and non-surgical method and we combined subcutaneous tissue removal and photothermocoagulation with a 1,444-nm Nd:YAG laser. Three patients for bilateral axillary osmidrosis were enrolled. After an incision of about one-third the length of the widest transverse diameter, the apocrine glands were separated from the skin. And then apocrine glands within the marked area were destroyed by irradiation with a 1,444-nm Nd:YAG laser thereafter. All patients exhibited no relapse of axillary osmidrosis and were satisfied with the treatment results. A combination of subcutaneous tissue removal and Interstitial laser photothermocoagulation with a 1,444-nm Nd:YAG laser could be an effective treatment for mild to moderate axillary osmidrosis.

The state of art:the mechanism and factors of axillary osmidrosis / 医学研究生学报

Axillary osmidrosis may have a negative impact on the patient's normal life and social interaction , though it has no obvious harm to health .Such factors as gene , hormone and food are involved in the occurrence and severity of axillary osmidrosis .The pathogenesis mechanism remians unclear .This paper aims to review on the research progress of the pathogenesis mechanism and related factors of axillary osmidrosis in recent years .

Efficacy and Safety of Suction-assisted Cartilage Shaver with Fibrin Glue in Treating Axillary Osmidrosis / 대한피부과학회지

BACKGROUND: Axillary osmidrosis causes significant emotional distress and embarrassment. Although numerous surgical procedures have been developed for the treatment of axillary osmidrosis, there is no decisively effective one. OBJECTIVE: This paper is to assess the efficacy and safety of suction-assisted cartilage shaver with the use of fibrin glue to treat axillary osmidrosis. METHODS: 18 axillary osmidrosis patients were treated with suction-assisted cartilage shaver followed by injection of fibrin glue. The effectiveness of the treatment used in this study was evaluated by measurement of axillary malodor both pre- and postoperatively. Patient satisfaction was surveyed as well. RESULTS: The postoperative test demonstrated that there was remarkable decrease in axillary malodor. Of the 18 patients, 17 patients (94.4%) expressed positive satisfaction. Complications including postinflammatory hyper-pigmentation (27.8%), hematoma and skin necrosis (5.6%), scar (5.6%), infection (5.6%) and hidradenitis suppurativa (2.8%) were reported. CONCLUSION: The use of suction-assisted cartilage shaver with fibrin glue proved itself an effective and safe treatment for axillary ormidrosis.

Mondor's Disease after Operation for Axillary Osmidrosis: A Case Report

Mondor's disease is a benign, self-limited process with spontaneous resolution, which is frequently caused by breast surgery, such as axillary lymph node dissection. We present a case of Mondor's disease that occurred after an axillary osmidrosis operation, which is a less invasive procedure; Mondor's disease may be considered as a possible postoperative complication following an axillary osmidrosis surgery.

Comparison of efficacy and complications among three small incision procedures in treatment of axillary osmidrosis / 中华医学美学美容杂志

Objective To treat axillary osmidrosis by using three procedures (small incision apocrine curettage,cut-off operation and aspiration surgery),to observe the postoperative complications,efficacy and the pathological changes of skin,and to explore the advantages of these three procedures.Methods Seventy-five cases of evere bilateral axillary osmidrosis were involved in this study,totally 150 axillary surgery area,which was randomly divided into different group:Group A (curettage group); Group B (cut-off group) and Group C (aspiration group).Different surgical treatment was conducted in the three groups of operation area.Results Incidence of complications was 28.30 ％ and total effective rate was 94.34 ％ in Group A; in Group B,incidence of complications was 6.38 ％,and total effective rate was 97.87 ％ ; in Group C,incidence of complications was 4.00 ％ and total effective rate was 78.00 ％.The incidence of complications was significantly different between Groups A and B and between Groups A and C,but not significant difference between Groups B and C.The cure rate and efficiency were not significant difference between Groups A and B groups,but significant difference was found between Groups A and C and Groups B and C.HE staining results showed that the dermal tissues were partially destroyed in Group A and B,and no apocrine sweat glands were not seen within the dermis and subcutaneous tissues; in Group C,the dermal tissue was rarely destroyed,and a lot of apocrine sweat glands were reserved within the dermis and subcutaneous tissues.Conclusions Efficacy of curettage and cut-off procedures is better,but that of aspiration is worse in the treatment of axillary asmidrosis.The complications of cut-off surgery and aspiration are less,but urettage has more complications.Therefore,the efficacy of cut-off operation is the best with least complications among the three procedures.

Anatomy and histopathology of apocrine sweat glands in axillary fossa / 中华医学美学美容杂志

Objective To investigate the distribution range and depth of the apocrine sweat glands of the axillary fossa,in order to supply with anatomic and histopathologic basis in the treatment on axillarv osmidrosis.Methods From December 2008 to ()ctober 2010,2 biopsy samples(with axillary osmidrosis),8 biopsy samples(normal,without axillary osmidrosis),were employed into the axillarv anatomy study. 25 patients with severe axillary osmidrosis were observed both maerographicallv and microscopically by using of operation and histopathological methods.Results Secretory portion of apocrine sweat glands was seen clearly,it was pitchy millet-like granules on axillary osmidrosis corpse,and pink millet-like granules in vivo.Secretory portions distributed most within the armpit hair area,exceeded the edge of armpit hair line,but not surpassed the edge of armpit hair line 1.0 cm.The depth of the apocrine sweat glands located vertically at superficial fat tissues between the dermal reticular 1aver and superficial fascia layers which were dissected away easily.Trimming with scissors under dermaIlayer,the secretory portion of apocrine sweat glands was removed cleanly without harms to reticular laver of dermas.Secretory portions became ducts under reticular layer of dermas.White Drominence-like granules were proved to be the compomers of hair follicle and sebaceous glands through Dathological section.Conclusions In order to treat axillary osmidrosis effectively,the secretary portion should be removed away through cutting off the tissues between the dermal reticular layer and suDerficial fastia layers;the ducts of apocrine sweat glands should be handled with removing hair follicle under the reticular layer of dermas．0peration area should not exceed 1.0 cm off the edge.

Comparative Analysis of Tumescent Liposuction according to the Dermal Curettage Level for the Treatment for Axillary Osmidrosis / 대한피부과학회지

BACKGROUND: The efficacy of tumescent liposuction in the treatment of axillary osmidrosis has been widely established. But there have been few studies that have conducted a comparative analysis according to the level of dermal curettage with respect to the efficacy and safety. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and complications of tumescent liposuction according to the degree of dermal curettage. METHODS: From September 2004 through August 2009, a total of 33 patients with axillary osmidrosis (66 axillae) were included in this study. Twelve patients (24 axillae) were treated by tumescent liposuction with dermal curettage at the level of the mid-dermis (the classical technique group), and the other 21 patients (42 axillae) were treated by tumescent liposuction with dermal curettage at the level of the dermo-subcutis junction (the modified technique group). The preoperative and postoperative disease severity was measured as 0, 1, 2 and 3. The improvement of symptoms was graded by the patient as excellent, good, fair and poor. We also evaluated the postoperative complications, including skin necrosis, scar, hematoma, sensory disturbance and infection. Biopsies of the axillary skin were performed in 7 patients to confirm the level of dermal curettage and the reduction of apocrine glands after treatment. RESULTS: The follow-up ranged from 6 to 60 months. Six months after treatment, 95.8% (23/24) of the axillae in the classical technique group and 95.2% (40/42) of the axillae in the modified technique group had reduced disease severity below 1. Among the 12 patients treated with the classical technique, 11 (91.7%) had excellent to good results, while 95.2% (20/21) of the patients treated with the modified technique had excellent to good results by the patients' own grading. The complications included skin necrosis, scar and hematoma. In the classical technique group and the modified technique group, the incidence of skin necrosis was 12.5% (3/24) and 2.4% (1/42), respectively, the incidence of scar formation was 4.2% (1/24) and 0%, respectively, and the incidence of hematoma was 8.3% (2/24) and 0%, respectively. The postoperative histologic examinations confirmed that the dermal curettage level was at the mid-dermis in the classical technique and at the dermo-subcutis junction in the modified technique. Interestingly, the histologic examination from the classical technique group revealed vacuolar alteration of keratinocytes and partial separation of the dermo-epidermal junction. CONCLUSION: The efficacy of the modified technique is compatible with that of the classical technique, but the modified technique offers fewer complications. So, the modified technique may improve the cosmetic outcome without reducing the treatment efficacy for the patient with axillary osmidrosis.

The Treatment Effects of Ultrasonic Surgical Aspiration for Axillary Osmidrosis / 대한피부과학회지

BACKGROUND: Axillary osmidrosis is a distressing and uncomfortable condition that can be a serious handicap in a person's personal and social life. There are many different surgical methods to treat axillary osmidrosis. However, they have caused frequently marked complications. OBJECTIVE: The purpose of this study was to evaluate the effect of ultrasonic surgical aspiration for the treatment of axillary osmidrosis. METHODS: From January 2007 to September 2008, a total of 62 patients was treated for axillary osmidrosis using ultrasonic surgical aspiration. RESULTS: Fifty-three (85.4%) patients had excellent to good results. Postoperative complications were seen in 5 (4.1%) patients out of 124 axillae. All of them were hematoma. The axillary scars are small and nearly negligible. The average recovery period was 5 days. CONCLUSION: Ultrasonic surgical aspiration displayed satisfactory therapeutic efficacy. This operation has many advantages with a high success rate, small and short scars, a low complication rate and a rapid recovery period.

Combination Treatment of Osmidrosis by Liposuction and Rasping

PURPOSE: Excessive apocrine gland secretion and bacterial decomposition cause axillary osmidrosis, which results in physical discomforts and social problems of patients. Many surgical procedures have been introduced such as skin excision and simple closure, local flap, skin graft, subcutaneous shaving and liposuction method, but the results were not satisfactory to patients and several complications, such as symptom recurrence, hematoma, seroma, delayed wound healing, skin flap necrosis and scarring remain as problems. METHODS: For the purpose of reducing these problems, we employed combined treatment of liposuction and rasping method. From January 2006 to February 2008, total of 54 patients were treated with this procedure for bilateral axillary osmidrosis. RESULTS: Follow-up evaluation period was from 2 months to 12 months, and the results were satisfactory. In our method, the length of skin incision is less than 1 cm, so the resultant scar is negligible. Apocrine glands in subcutaneous tissue were mostly removed by liposuction apparatus and remained other glands in subdermal area were mostly removed by rasping. The recurrence rate and postoperative complication were minimal. CONCLUSION: Our method is very simple, short in operation time, and generates excellent results without specific complication.

Comparative Study Between Inaba's Procedure and Modified Inaba's Procedure with Delayed Suture in the Treatment of Osmidrosis Axillae

PURPOSE: The Inaba's procedure, the treatment of osmidrosis axillae, has the advantages of low recurrent rate and easiness in learning, yet it produces early postoperative discomfort and scar formation by tie-over dressing. The authors modified the Inaba's procedure by using delayed suture of the incision wound and omitting tie-over dressing. The comparative study of Inaba's procedure and its modification was performed to confirm the advantages of modified procedure. METHODS: The study contains the retrospective analysis of the medical records of 296 patients with osmidrosis who were treated using the Inaba's procedure from December, 1996 to February, 2007. The study also contains the prospective analysis of 20 patients, from March, 2007 to July, 2008, who were treated by the modified Inaba's procedure with delayed suture of the incision wound and gentle pressure dressing instead of tie-over dressing. The operative results of two groups were compared and verified by Mann-Whitney U test (SPSS 12.0). RESULTS: The incidence of complications was 14.5% in the Inaba's procedure, whereas 6.2% in the modified Inaba's procedure. Both procedures have the same basic surgical procedure in terms of the location of incision site and subdermal shaving of the sweat glands, and therefore similar good results were obtained in the aspect of postoperative axillary odor, recurrent rate and postoperative condition of axillary hair. Certainly, the modified Inaba's procedure had better outcome in each element of PSS (Patient Scar Self-Rating Scale), compared to the Inaba's procedure. In addition, the modified Inaba's procedure showed a statistical significance in dressing-related pain reduction and overall satisfaction. CONCLUSION: The modified Inaba's procedure had advantages of decreasing early postoperative complications such as hematoma, discomfort and pain caused by tie-over dressing, and decreased scar formation. However, the drawback was delayed suture of the incision wound after 48 hours.

Comparision of three methods in treatment of osmidrosis / 中华医学美学美容杂志

Objective To compare the therapeutic effects of three operative procedures,removal of armpit skin,minimally-invasive aspiration and small transverse incision in the treatment of osmidrosis.Methods Retrospective review was conducted in the treatment of osmidrosis for near ten years.Three methods were compared in the indication,feature and effectiveness.Results A total of 459 cases (123 males and 336 females) of osmidrosis were treated with the three methods.Satisfactory rates of the three methods were 98%,96% and 97%.respectively.Recurrence was found in 7 cases.Conclusions Modified procedure of minimally invasive aspiration has advantages of quick recovery,less complications and satisfactory results.It is the first choice for patients with mild and moderate osmidrosis.Bat for male patients with severe or recurred osmidrosis,treatments are surgical removal of the skin with armpit hairs and suture method.

Treatment of Osmidrosis Using Combination Techniques

Elimination of the apocrine glands by a radical surgical procedure has been known to be the best solution for axillary osmidrosis; however, it is often accompanied with a marked scar. Ultrasonic tumescent liposuction is a safe procedure for removal of subcutaneous fat tissue. Herein, we describe our modification of the traditional osmidrosis operation(subdermal excision or superficial liposuction). The first, pre-suction "scrape" could require adequate plane of skin flap; the second, "ultrasound-assisted liposuction"; the third, post-suction "rasp" helped subdermal curettage; the last, "endoscopic approach" could visibly remove remaining apocrine glands. It is named SURE technique. From April 2007 to September 2008, 43 patients underwent our "SURE" method for axillary osmidrosis. All patients were followed up for 3 to 12 months with an average of 6 months. The total satisfaction rate was 91 percent(39/43). The complications(skin slough and subdermal band formation) rate was 14 percent(6 of 43). However these complications were temporary and complete recovery occurred without special cares. We emphasize four components of our SURE method procedures. In conclusion, "SURE" method can be one of alternatives for osmidrosis treatment.

Study of Genetic Inheritance in Osmidrosis Patients Based on Pedigree Analysis

PURPOSE: Bacterial degeneration of sweat and increased secretion of over developed apocrine sweat gland are known causes of osmidrosis. In addition, genetic inheritance must be another important cause, because there are high incidence rates of osmidrosis in familial members. But the research about genetic inheritance has been overlooked. For this reason we studied genetic inheritance in osmidrosis patients based on pedigree analysis. METHODS: We have evaluated pedigree of 52 patients who have diagnosed and treated in our hospital from January 2003 to August 2007. For making pedigrees, we have evaluated 3 generations of affected lineage from osmidrosis patients. Family members having uncertain information or those who are before puberty are excluded. In pedigree analysis, inheritance rate and inheritance pattern from parents, prevalence rate in generations and sexual prevalence are evaluated. RESULTS: In this study, we divided pedigrees into 3 different groups according to inheritance pattern. Group A is genetically unrelated pattern with no prevalence between familial members in 7 families. Group B is weakly expressed pattern with 17 families there are genetically related but no genetic patterns are founded. In group B inheritance rate is 34% and incidence rate is 21% in 2nd generation and 22% in 3rd generation. Group C is autosomal dominant pattern with 31 families. In group C, there are no differences in sexual prevalence. Incidence rate is 43% in 2nd generation and 49% in 3rd generation. CONCLUSION: In this study, we have studied pedigrees of 52 families of osmidrosis patients. 60% of the pedigrees shows autosomal dominant pattern, 33% shows genetically related but no definite autosomal dominant pattern and 7% shows genetically unrelated pattern. In Conclusion, This study can be basic data for future gene analysis study of osmidrosis.

XPS(R) Microresector for Treatment of Axillary

PURPOSE: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used XPS(R) microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. METHODS: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent XPS(R) microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of XPS(R) microresector(Shaver). RESULTS: The average operation time was 61.6 minutes. This results can show that the patients who received XPS(R) microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. CONCLUSION: In brief, XPS(R) microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that XPS(R) microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.

The Effect of Ultrasound Assisted Liposuction for Axillary Osmidrosis on Apocrine and Eccrine Glands

PURPOSE: Axillary osmidrosis is a distressing disorder characterized by unpleasant odor from axillary area and it is mainly associated with apocrine glands but also associated with eccrine glands. For surgical treatment of osmidrosis, recently ultrasound assisted liposuction(UAL) had been performed for many patients. According to the recent studies about ultrasound assisted liposuction for the treatment of osmidrosis, histologic studies about apocrine gland had been applied for 35 cases, but there were rare mention about eccrine gland and the relationship between two glands. The purpose of this article is to evaluate the effect of ultrasound assisted liposuction for the treatment of axillary osmidrosis on apocrine and eccrine glands. METHODS: From January 2004 to January 2007, 35 patients underwent ultrasound assisted liposuction for the treatment of osmidrosis and 5 patients underwent histologic studies. Histologic examinations were performed before and after ultrasound assisted liposuction and each biopsy was performed in central axillary area. The volume ratio of both glands, presence of degeneration were examined. And in aspirates, distribution and density of both glands and their morphological changes were examined. RESULTS: Preoperative biopsy results showed average volume ratio of apocrine glands to eccrine glands was 65:35. According to the postoperative biopsy results, the volume of apocrine glands in dermis were significantly reduced and glands were degenerated, but the volume of eccrine glands were slightly reduced and glands were mildly damaged. And the average volume ratio of two glands was 20:80. According to biopsy results of aspirates, the volume ratio of two glands was 85:15 and apocrine glands had significantly greater proportion. CONCLUSION: By comparison of each biopsy result, apocrine glands were more significantly reduced and degenerated than eccrine glands in all 5 cases. However, further studies with large sample sizes and close examinations are required.