A comparison of two different sub-dermal trimming techniques for the treatment of axillary osmidrosis

Background: Axillary osmidrosis is a distressing condition caused by excessive secretion by the apocrine glands. Surgical ablation of the subcutis without skin excision is the most popular solution for axillary osmidrosis. Various special operating instruments have been employed to help remove the subcutis. However, ideal results are not always achieved. This study aimed to present our experience of treating osmidrosis by two different sub-dermal trimming techniques and compare two techniques. Methods: For the study, 150 patients were randomly divided into two groups. Eighty patients of group I were cured using the type I trimming technique: a 1-cm incision and a subcutaneous pocket were made and glandular tissue and subcutaneous tissue attaching to the dermis were removed only using a scissors by experience. Seventy patients of group II were cured using the type II trimming technique: a 4-5-cm incision and a subcutaneous pocket were made, and the elevated axillary flap was turned over with the fingertips; then, the same trimming was performed under direct vision. The post-operation follow-up time was 12-48 months. Operative complications, malodour recurrence and patient satisfaction degree were recorded. Results: The type II trimming technique had significantly lower operative complication rate (2.9% vs. 11.9%) and malodour recurrence rate (2.1% vs. 10.6%), and significantly higher patient satisfaction degree (7.73 + 0.74 vs. 7.19 + 0.72) as compared with the type I trimming technique. Most incision scars were not obvious or were even invisible at the time of follow-up. Shoulder movement was normal in all patients, and most patients' armpit hairs became sparse. Conclusion: Manual sub-dermal trimming is a satisfactory solution for axillary osmidrosis. The type II trimming technique has a higher success rate with few complications. (c) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.