Laser Doppler scanning study of axillary skin before and after liposuction curettage in patients with focal hyperhidrosis.
BACKGROUND
Minimally invasive surgeries are frequently used in patients suffering from focal axillary hyperhidrosis (FAH). Sweat glands are removed surgically and the axillary skin is thinned out, with skin necrosis being a possible complication due to reduced microcirculation. Although of considerable interest, studies evaluating pre- and postoperative skin perfusion are unavailable.


OBJECTIVE
To evaluate the blood flow of axillary skin in patients with severe focal axillary hyperhidrosis before and after liposuction curettage (LC).


METHODS
The blood flow in the axillary skin of 11 patients was measured by laser Doppler perfusion imaging before surgery and on days 1, 7 and 28 after LC with a rasping cannula. Skin perfusion was measured in arbitrary units (AU) with measuring points in the axillary center (AC), the operated skin 2 cm from the center (2C) and the surrounding healthy skin (HS).


RESULTS
No significant differences of preoperative skin perfusion were found (AC: 0.39 +/- 0.08 AU/2C: 0.38 +/- 0.07 AU/HS: 0.39 +/- 0.07 AU; p > 0.05). On the first and seventh postoperative days, AC (0.2 +/- 0.04 AU/0.27 +/- 0.81 AU) and 2C (0.2 +/- 0.03 AU/0.28 +/- 0.06 AU) area were significantly less perfused, whereas the HS showed higher perfusion values (0.59 +/- 0.1 AU/0.53 +/- 0.09 AU). Twenty-eight days after LC the 2C (0.36 +/- 0.07 AU) and HS (0.4 +/- 0.06 AU) skin revealed no significant differences compared to preoperative skin perfusion (p > 0.05). The AC perfusion was still slightly reduced (0.37 +/- 0.09 AU) without significant difference compared to preoperative findings.


CONCLUSIONS
LC reduces the axillary skin blood flow with the axillary center being the least perfused area. However, in our collective, no correlation to possible side effects was observed.
Bechara
F G
FG
Department of Dermatology and Allergology, Ruhr University Bochum, Bochum, Germany. f.bechara@derma.de
Sand
M
M
Stücker
M
M
Georgas
D
D
Hoffmann
K
K
Altmeyer
P
P
D000328:Adult; D001365:Axilla; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D012720:Severity of Illness Index; D012867:Skin / Q000098:blood supply*; D016896:Treatment Outcome