摘要
目的分析腋臭术后切口糜烂及延期愈合的原因,探索其处置策略。方法收集2016年6月至2018年1月共92例腋臭患者的临床资料,并进行回顾性分析。A组:小切口大汗腺剪除联合负压抽吸及消痔灵泡洗治疗;B组:小切口大汗腺剪除(保留部分真皮网状层处结缔组织)联合负压抽吸及消痔灵泡洗治疗;C组术式同A组,并于术区采用纱布填塞覆盖打包。结果 3组之间两两比较,A组治疗效果优于B组(P<0.017);B组术后并发症发生率明显低于A组和C组(P<0.017)。其余各组疗效与并发症之间差异无统计学意义(P>0.017)。结论腋毛区宽度影响皮下分离后腋窝中央区皮肤的血供状态,与切口皮肤坏死及延期愈合的发生有关。腋毛区宽度较小的病例采用完全分离修剪的方法清除大汗腺更彻底;腋毛区宽度较大者发生切口糜烂和延期愈合的可能性较大,采用保留部分组织条索有利于减少并发症的发生;打包加压的方法需经验丰富的医师慎重采用合适的压力。
Objective To analyze the causes ofincision erosion and delayed healing after bromhidrosis surgery and to explore the treatment strategy.Methods From June 2016 to January 2018,the clinical data of 92 patients who underwent axillary osmidrosis treatment were collected for retrospective analysis.Postoperative complications were observed.Group A:subcutaneous trimming through a mini-incision combined with negative pressure suction and Xiaozhiling infusion treatment.Group B:subcutaneous trimming through a mini-incision(retaining part of the connective tissue at the reticular dermis)combined with negative pressure suction and Xiaozhiling infusion treatment.Group C:the surgical method was the same as group A,the difference was that gauze packing was placed in the operation area.Results The therapeutic efficacy in group A was better than that in group B(P<0.017).The incidence of postoperative complications in group B was significantly lower than that in group A and C(P<0.017).There was no significant difference in the therapeutic efficacy or complications among the remaining groups(P>0.017).Conclusion The width of the axillary hair area affected the blood supply of the skin in the central area of the axillary after subcutaneous dissection.This was related to skin necrosis and delayed healing of the incision.In patients with a smaller width,complete dissection and pruning to remove the sweat gland was more thorough.A wider axillary hair area may lead to greater incision erosion and delayed healing.Retention of some stripe-like structure was helpful to reduce the incidence of complications.Packing and compression should be carefully applied by experienced doctors.
作者
石青梅
陈星帆
邱凤贞
雷少榕
SHI Qing-mei;CHEN Xing-fan;QIU Feng-zhen;LEI Shao-rong(Department of Plastic Surgery,Xiangya Hospital of Central South University,Changsha 410008,China)
出处
《中国美容整形外科杂志》
CAS
2019年第9期548-551,共4页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
腋臭
联合术式
伤口延期愈合
结缔组织
并发症
Bromhidrosis
Comprehensive procedure
Delayed wound healing
Connective tissue
Complications
