Shortening of Incision by “Pinch and Turn-Over Technique” in the Treatment of Axillary Osmidrosis
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The pinch and turn-over technique was developed to minimize the incision in the manual subdermal excision of apocrine glands in axillary osmidrosis for the best cure and fewest complications.
Through a 2-cm-long incision, peripheral subdermal tissue was excised by the technique under direct vision using intravenous anesthesia and tumescent technique. Ninety-nine axillae in 50 patients including seven secondary cases were operated on from 2009 to 2018. Long-term follow-up (average 30.3 months) could be done on 40 patients with questionnaires consisting of four-point ordinal-scale questions regarding osmidrosis grade, hyperhidrosis grade and satisfaction. For systematic review regarding incision length, 220 articles from 1962 to 2018 were reviewed with the search terms “osmidrosis” or “bromhidrosis.”
Thirty-five and 30 of 40 respondents (87.5% and 75.0%) had excellent or good postoperative results in osmidrosis and hyperhidrosis grade. Postoperative improvement of osmidrosis grade (from 2.53 to 0.80) and hyperhidrosis grade (from 1.88 to 0.95) was statistically significant (p < 0.01). Thirty-four patients (85.0%) reported very satisfactory or satisfactory. Hematoma (2.0%), hyperpigmentation (5.0%), infection (5.0%) and noticeable scar (2.5%) were rare. Necrosis of flap margins was frequent (27.3%) but necessitated revision in two cases (2.0%). Among eleven articles found to describe incision length in pure manual subdermal excision, this technique provided the shortest incision compared with eight direct subdermal excision methods with an average incision length of 5.0 cm.
This technique offers an open, direct and selective approach with a short incision. It could maintain the best efficiency while neutralizing negative side effects of conventional manual subdermal excision for axillary osmidrosis.
Level of Evidence IV
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KeywordsOsmidrosis Bromhidrosis Hyperhidrosis Subdermal excision Pinch and turn-over technique
Compliance with Ethical Standards
Conflicts of interest
No conflicts of interest were declared.
- 2.Kim JR, Cha JH, Na MH, Kim YW, Park HJ, Lee DJ, Kim HJ (2003) Comparison of treatment effect between superficial suction and subdermal excision in osmidrosis. J Korean Soc Plast Reconstr Surg 30:15–19Google Scholar
- 3.Ha SU, Lee KC, Park JH, Park JM, Kim SK, Sohn HS, Baek CY, Jung GY, Song KH (2004) A comparative evaluation of various axillary osmidrosis treatment. J Korean Soc Aesthet Plast Surg 10:84–90Google Scholar
- 5.Kim KY, Cho SD (2008) Long term follow up of surgical treatment of axillary osmidrosis and hyperhidrosis by instrumental shaving and manual shaving. J Korean Soc Plast Reconstr Surg 35:709–715Google Scholar
- 7.Choi MS, Kim WS, Kim HK, Bae TH (2010) A clinical case of axillary web syndrome after glandular tissue and skin removal for axillary osmidrosis. J Korean Soc Plast Reconstr Surg 37:301–303Google Scholar
- 8.Yoo JW (1995) The comparative clinical and histological study of manual and inaba method in osmidrosis axillae. J Korean Soc Aesthet Plast Surg 1:227–232Google Scholar
- 10.Yim YM, Choi JW, Kim GH (2005) The treatment of osmidrosis axillae by use of modified Skoog’s method. J Korean Soc Plast Reconstr Surg 32:245–249Google Scholar
- 22.Lim DW, Park J, You YC, Yang WY, Lee W (2005) The effectiveness of fibrin glue using dermal shaving at osmidrosis. J Korean Soc Aesthet Plast Surg 11:93–98Google Scholar