STUDY ON NEW MODIFIED TECHNIQUES TO REDUCE HEMATOMA RATE ON OSMIDROSIS SURGERY

Abstract

Background. 

The removal of axillary osmidrosis requires a surgical procedure to be totally eradicated. The current surgical treatment includes the minimally invasive surgery by performing a subcutaneous incision and using a liposuction-assisted curettage to excise the apocrine gland and the traditional surgery by removing the apocrine glands through a large subcutaneous incision. The course of operation carries adverse effects such as hematoma, subcutaneous infection, subcutaneous necrosis, etc. The most common and bothersome of which is the subcutaneous hematoma.

Objective: To reduce the occurrence of subcutaneous hematoma by improving the original surgical method in an innovative and easy way.

Methods: This study intends to use a more innovative and improved method to increase the blood drainage channel. In view of the fact that the occurrence of hematoma is closely related to the skill of the surgeon, we used the same clinician throughout the study to put forth a more reliable research. The research was done on two groups of axillary osmidrosis patients: the first group, consisting of 28 patients, received the original method of surgery from September 2015 to August 2016; the second group, consisting of 53 patients, received an improved surgical operation, in addition to the original method, from September 2016 to August 2017. In the research, no. 11 blade was used to make a 2-3 mm incision on the axillary flap of 10 patients from the second group after the Quilting Sutures. Tie over bandages are used to reduce the chance of hematoma.

Results: The second group of patients received a modified small incision method, showing a reduced occurrence of hematoma from 20% (12/56) in the first group to 4.7% (5/106) in the second group. In spite of the fact that the sample size in the study is small, the statistics show a significant difference between the two groups. However, there is no statistical difference found between the two groups with regards to flap ulceration, flap necrosis, and abscess infection. The hematoma statistics show that the new and improved approach is effective and worthy of promotion

Conclusion:  According to the physical principle of capillary action and siphon, exudates and blood are “exuded” from the small incision in the flap through the perforation. The capillary action is the ability of a liquid to flow in a confined space without the aid of an external force such as gravity or even vice versa. The siphon principle is the flow of liquid from a higher level to a lower level. The conclusion of this study is that this new and improved method is effective and worthy of promotion.