Safety and efficacy of surgical treatments for axillary osmidrosis: a retrospective cohort study comparing conventional open excision with cartilage-shaver closed curettage

Abstract

Aim: The aim of this study was to evaluate the usefulness of suction-assisted cartilage shaver (SACS) system closed curettage by comparing it with open excision regarding safety and efficacy.

Methods: A retrospective chart review was conducted for patients with axillary osmidrosis (AO) who underwent either open excision or SACS closed curettage between 2006 and 2018. We investigated the demographic data of patients and compared the postoperative complications and outcomes of the patients undergoing the two procedures.

Results: A total of 91 patients underwent SACS closed curettage and 188 patients underwent open excision. The complication rate in the SACS group (10.4%) was significantly lower than that in the open excision group (20.7%). Each procedure led to unsuccessful outcomes for two patients.

Conclusion: SACS closed curettage was safer than open excision for AO. Both procedures were extremely effective. Although decision-making for surgical treatment options for AO is affected by such other factors as discomfort in dressing, recovery time, scar formation, and cost, our results should be helpful for both surgeons and patients.

Keywords

Axillary osmidrosis / retrospective chart review / open excision / suction-assisted cartilage shaver system

References

[1] Morioka D,Amikura Y.Clinical features of axillary osmidrosis: a retrospective chart review of 723 Japanese patients..J Dermatol2013;40:384-8

[2] Lee JC,Chen CH,Hong HS.Treatment for axillary osmidrosis with suction-assisted cartilage shaver..Br J Plast Surg2005;58:223-7

[3] Morioka D,Lan L,Kadomatsu K.Axillary osmidrosis: past, present, and future..Ann Plast Surg2019;Epub ahead of print. doi: 10.1097/SAP.0000000000002111

[4] Wang C,Du F,Zheng S.Axillary osmidrosis treatment using an aggressive suction-curettage technique: a clinical study on paired control..Aesthet Plast Surg2015;39:608-15

[5] Yang HH,Chen YT.Minimally invasive approaches to axillary osmidrosis treatment: a comparison between superficial liposuction with automatic shaver curettage, subcutaneous laser treatment, and microwave-based therapy with a modified technique..J Cosmet Dermatol2018;18:594-601

[6] Inaba M.New instrument for hircismus and hyperhidrosis operation: subcutaneous tissue shaver..Plast Reconstr Surg1977;59:864-6

[7] Skoog T.Hyperhidrosis of the axillae, a method of surgical treatment..Acta Chir Scand1962;124:531-8

[8] Li ZR,Zhang JY,Hu JZ.Excision of apocrine glands with preservation of axillary superficial fascia for the treatment of axillary bromhidrosis..Dermatol Surg2015;41:640-4

[9] Dai Y,He J.A refined surgical treatment modality for bromhidrosis: Subcutaneous scissor with micropore..Dermatol Ther2017;30:e12484

[10] Liu Q,Song Y,Zheng J.Surgical subcision as a cost-effective and minimally invasive treatment for axillary osmidrosis..J Cosmet Dermatol2010;9:44-9

[11] Ou LF,Chen IC.Treatment of axillary bromhidrosis with superficial liposuction..Plast Reconstr Surg1998;102:1479-85

[12] Shi Z,Ye X.Modified tumescent superficial suction with curettage treatment for axillary bromidrosis: clinical experience of 280 cases..Aesthet Plast Surg2014;38:151-5

[13] Kim WO,Kil HK,Yoon DM.Suction-curettage with combination of two different cannulae in the treatment of axillary osmidrosis and hyperhidrosis..J Eur Acad Dermatol Venereol2008;22:1083-8

[14] Tung TC.Endoscopic shaver with liposuction for treatment of axillary osmidrosis..Ann Plast Surg2001;46:400-4

[15] Matsuda K.Surgical treatment of axillary osmidrosis with the shaver system..Jpn J Plast Surg2004;47:1253-9(in Japanese)

[16] Wu WH.Ablation of apocrine glands with the use of a suction-assisted cartilage shaver for treatment of axillary osmidrosis. An analysis of 156 cases..Ann Plast Surg2009;62:278-83

[17] Huang YH,Chen YH,Lee SH.Reduction in osmidrosis using a suction-assisted cartilage shaver improves the quality of life..Dermatol Surg2010;36:1573-7

[18] Chern E,Chuang FC.Arthroscopic shaver with refinement for axillary osmidrosis..Int J Dermatol2010;49:813-7

[19] Hsu KC.Sparing subcutaneous septa avoids skin necrosis in the treatment of axillary bromhidrosis with suction-curettage shaving..J Cosmet Dermatol2019;18:892-6

[20] Tseng YJ,Lin SH.Modified suction-assisted cartilage shaver for axillary osmidrosis..Biomed Res Int2019;2019:7314753 PMCID:PMC6530155

[21] Shin JY,Lee NH.Osmidrosis treatment approaches. A systematic review and meta-analysis..Ann Plast Surg2017;78:354-9

[22] Rigg BM.Axillary hyperhidrosis..Plast Reconstr Surg1977;59:334-42

[23] Park YJ.What is the best method for treating osmidrosis?.Ann Plast Surg2001;47:303-9

[24] Chen YT,Chen HJ.Treatment of axillary osmidrosis: a comparison between subcutaneous laser and superficial liposuction curettage..J Eur Acad Dermatol Venereol2015;29:2019-23

[25] Vidal P,Will PA.Managing complications in abdominoplasty: a literature review..Arch Plast Surg2017;44:457-8 PMCID:PMC5621815