Small Incision in Lower Posterior Axillary Wall Combining Multihole Drainage Technique for the Treatment of Axillary Bromhidrosis

Abstract

Surgical excision of apocrine glands is an effective method for the treatment of bromhidrosis. However, common postoperative complications such as skin necrosis can result in prolonged healing and unsightly scars, which are mainly caused by surgical injuries and seroma or hematoma formation. We have improved the traditional surgical methods, in the hope that the new method can not only ensure the surgical effect, but also minimize the surgical trauma and postoperative complications. Forty-four patients with bromhidrosis were included. A 1-cm incision was made in the posterior wall of the lower axilla. Tissue scissors completely separated the skin from the subcutaneous tissue of glandular distribution. Iris scissors were used to trim subcutaneous glandular tissue, until there was only full-thickness skin left. Residual glandular tissue was removed with serrated edge curettage. After adequate irrigation and hemostasis, a drainage strip was placed in the incision. Then, we evenly divided the surgical area into 8 sections. In the center of each section, a draining hole was made. Of the 88 axillae, malodor was eradicated in 84 and considerably reduced in 4. Although 6 arms had temporary edema, and 10 axillae experienced superficial epidermal necrosis, no full-thickness skin necrosis was observed. Complications like hematoma, seroma, and infection were not present in all cases. All the scars of the incision and drainage holes were inconspicuous. The use of small incisions in the posterior axillary wall could accomplish sweat gland elimination and simultaneously provide excellent drainage. Combining this with porous drainage can effectively prevent hematoma, skin necrosis, and scar formation.