title: A refined surgical treatment modality for bromhidrosis: double w incision approach with tumescent technique.
abstract: BACKGROUND
  Axillary bromhidrosis has a strong negative effect on one's social life. A high success rate and few complications are criteria for an ideal treatment method.
  
  
  OBJECTIVE
  To evaluate a new surgical treatment modality for bromhidrosis: Double W incision with full-exposure excision under tumescent anesthesia.
  
  
  METHODS
  Twenty patients with bromhidrosis were treated. Patients were placed in a supine position with their treated arms abducted to 110 degrees . After injection of 60 mL of tumescent solution into each axilla, two small W incisions were made at the superior and inferior axillary poles of the hair-bearing area. The whole hair-bearing skin was undermined at the level of the superficial fat to obtain adequate skin eversion. The flaps were everted to offer full exposure of the apocrine glands, and meticulous excision of each gland was performed. Finally, the incisions were re-approximated, and bulky compressive dressings were applied to the area for 72 hours.
  
  
  RESULTS
  Of the 40 axillae (20 patients), 32 (80.0%) showed excellent results, and eight (20.0%) had good results. Malodor was significantly decreased. There were no serious complications.
  
  
  CONCLUSIONS
  This technique can produce excellent results with a lower complication rate than most other surgical modalities and can be performed without costly equipment.
authors.affiliation: Department of Dermatology, First Hospital, Peking University, Beijing, China. lihangde@yahoo.com.cn
authors.forename: Hang
authors.initials: H
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Zijun
authors.initials: Z
authors.lastname: Zhang
authors.forename: Malcolm S
authors.initials: MS
authors.lastname: Ke
authors.forename: Shuxia
authors.initials: S
authors.lastname: Yang
mesh_terms: D000772:Anesthesia, Local / Q000379:methods; D001365:Axilla; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult