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Objective To evaluate the efficacy of liposuction-curettage under negative pressure combined with Xiaozhiling injection for the treatment of axillary bromhidrosis.Methods The operative field was marked along the border of hair-bearing area of axilla with a distal margin of 0.5-1 cm.Subcutaneous tissue was removed by stroke movement under negative pressure after tumescent anesthesia.Subsequently,Xiaozhiling injection was injected into the subcutaneous space.All the patients were followed for at least 3 months,and therapeutic efficacy was evaluated quantitatively.Results A total of 72 patients (144 sides) with axillary bromhidrosis were treated with this method from March 2009 to May 2012,including 16 males and 56 females aged 14-41 years.All the patients experienced primary healing with no necrosis or hematoma formation within one week after the operation.The follow-up lasted 3 to 18 months (average: 8 months).Among the 144 sides,133 (92.4％) were cured,11 (7.6％) were improved,with the response rate being 100％.Postoperative scar is invisible,and patients were satisfied with the treatment outcomes.Conclusion The combined therapy is a simple and effective approach to the treatment of axillary bromhidrosis with a fast recovery and less complications.
RESUMO
BACKGROUND: Thoracodorsal artery perforator flap can relieve damage to donor site and avoid bulk in the recipient site,but dissociation of perforating branch took time.Some one believed that it should be done by very experienced physicians and some muscle tissues should be reserved.OBJECTIVE: To investigate the method,effectiveness and clinical application of improved latissimus dorsi flap based on perforator flap conception for reconstruction of soft tissue defects of lower extremity.METHODS: A total of 17 patients needing skin flap transplantation were selected.12 latissimus dorsi musculocutaneous/muscle flaps,3 latissimus dorsi flaps with a few muscle and 2 double-leaf segmental latissimus dorsi compound flaps were designed based on perforator flap conception.According to the territory of latissimus dorsi musculocutaneous flap,a skin paddle in which anterior underlying muscle and main perforator was designed,extend about to the anterior edge of the latissimus dorsi muscle.An additional latissimus dorsi muscle flap was selected for soft tissue enlargement if necessary.Sometimes,double-leaf segmental latissimus dorsi musculocutaneous/muscle flap,including one muscle-sparing latissimus dorsi musculocutaneous flap and the other segmental latissimus dorsi muscle flap nourished by the lateral branches of the thoracodorsal vessels was selected to repair two adjacent defects.The harvested tissue area ranged from 12 cm×8 cm to 28 cm×17 cm.Survival state of skin flap,together with shape and function of donor site and recipient site of skin flap were observed.RESULTS AND CONCLUSION: Following skin flap transplantation,one case developed vascular crisis that was relieved following re-exploration for vessel anastomosis.All skin flap survived.Second-stage skin grafting was done on one muscle flap wound.All donor sites were sutured directly.After a follow-up of 3 to 18 months in 15 cases,only two cases received two-stage plastic operation because bulky flaps brought some trouble in wearing shoes.Improved latissimus dorsi flap based on perforator flap conception can reduce damage to the donor site and the receipt area bulk.Double-leaf segmental latissimus dorsi compound flaps can repair both heel and toe wound.The versatile latissimus dorsi flap designed using thoracodorsal artery perforator flap conception is an ideal flap for repairing widespread soft tissue defects in the lower extremity.