Subdermal Pocket and Suction-Curettage with an Arthroscopic Shaver for Bromhidrosis Treatment

先行皮下組織剝離在狐臭刮刀治療的運用

蘇育敏(Yu-Min Su) ； 方前量(Chien-Liang Fang) ； 蔡忠斌(Chong-Bin Tsai) ； 張簡志炫(Chih-Hsuan Changchien) ； 陳明山(Ming-Shan Chen) ； 楊昕禕(Hsin-Yi Yang) ； 方楷然(Kai-Jan Fang)

《臺灣整形外科醫學會雜誌》 30卷1期 (2021/03) Pp. 10-19

摘要

Background: Suction-curettage is a safe procedure for reduction of apocrine gland with lower complication rates, but has higher risks of skin perforation than liposuction. Tunneling of subdermal plane has been reported to prevent this. In this study, we will induce Spatula single port liposuction cannula to make subdermal tunnels before suction- curettage. Materials and Methods: We retrospectively evaluated data for 30 patients (60 axillae) with bromhidrosis treated with subdermal plane tunneling and suction-curettage using an arthroscopic shaver under tumescent anesthesia infiltration between June 2011 and March 2019. Patient age, gender, suction-curettage shaving time, clinical efficacy, secondary suction-curettage, complications, and pain scores on postoperative day 2 were analyzed. Results: Excellent or good efficacy with improved malodor was achieved in 58 axillae (98%). Age and gender showed no significant differences in efficacy rating. Secondary suction- curettage was performed for one (2.56%) axilla, with excellent results. Complications were observed in 4 axillae (6.66%), including epidermis decortication and skin necrosis, but not skin perforation, hematoma or infection. Skin necrosis showed a significant difference with respect to age. Pain score on postoperative day 2 was 1-3 after local anesthesia with tumescent infiltration. Conclusion: Results suggested that 10 min of suction–curettage using an arthroscopic shaver sufficiently achieved good efficacy for bromhidrosis with few complications. Older age was a risk factor for complications in skin necrosis; tumescent infiltration and the Spatula single port liposuction cannula made it easy to create subdermal tunneling to prevent hematoma and skin perforation in suction-curettage and cause less postoperative pain.

關鍵字

bromhidrosis ； subdermal tunneling ； suction-curettage ； arthroscopic shaver ； tumescent infiltration

並列摘要

背景：旋轉刮刀運用在狐臭治療上行之有年，是低風險且有效的方式。唯一缺點是術式較易造成皮膚破損。我們使用了抽脂的器械（Spatula single port liposuction cannula），先行剝離皮下組織，增加刮刀治療的便利性，並減少併發症產生。材料及方法：在2011年6月至2019年3月使用Spatula single port liposuction cannula後用旋轉刮刀共治療了30位狐臭病人（60個腋下）。分析了年齡、性別、旋轉刮刀使用時間、症狀改善程度、再次手術次數、併發症與術後第二天的疼痛指數。結果：有58個腋下得到良好的症狀改善，只有1個腋下需要二次手術，有4個腋下產生併發症，包括表皮脫落及皮膚部分壞死，但沒有皮膚破損、血腫或感染發生。術後疼痛以10分法評估介於1至3分之間。年齡是皮膚壞死的危險因子。結論：旋轉刮刀治療狐臭是安全有效的方法。以抽脂器械先行剝離皮下組織，可以使手術更順利，並減少皮膚破損的危險，也減少疼痛。