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

ABSTRACT

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.