title: Surgical subcision as a cost-effective and minimally invasive treatment for axillary osmidrosis.
abstract: BACKGROUND
  Axillary osmidrosis, characterized by unpleasant odor and occasional staining of clothing, is a personal discomfort and social impairment for people who suffer from it. Various types of surgical procedures involving instrumented-assisted tools (lasers, ultrasonic, endoscope, and others) have shown relatively positive results; however, for patients in developing countries, especially in China, these treatments are inconvenient and cost-ineffective.
  
  
  OBJECTIVE
  To introduce a minimal incision surgical procedure with skin flap treatment that removes the apocrine sweat glands in the subcutaneous tissue through a 1-cm-long incision without instrument-assisted tools.
  
  
  METHODS
  From July 2005 to October of 2007, 108 patients (68 women and 40 men) were treated with the minimal incision and cost-effective surgical treatment by manual excision. A 1-cm-long incision is made in the axillary crease. Subcutaneous tissue and glands were removed with scissors through this incision. This procedure is repeated throughout the entire axilla until the axilla has essentially become a super-thin flap.
  
  
  RESULTS
  Malodor elimination was good in 206 out of 215 axillae (95.8%) treated, fair in nine (4.2%), and poor in zero (0%). The resulting scar is small and virtually invisible because it is only 1-cm long and located in the axillary crease.
  
  
  CONCLUSIONS
  Treatment of axillary osmidrosis by manual excision through a 1-cm incision is a convenient, efficient, cost-effective, and relatively safe technique that results in high patient satisfaction and benefits patients and surgeons in developing countries. Axillary osmidrosis, a non-life-threatening condition characterized by unpleasant odor and occasional staining of clothing, is an annoying problem, particularly in Asian societies. For many people who suffer from this problem, this condition is a personal discomfort, a social impairment, and discourages patients from enjoying social or personal activities, especially young women. They are usually embarrassed by the smell during their daily activities and communication with other people.
authors.affiliation: Department of Plastic Surgery, Shenyang WeiKang Hospital, Shenyang, China. lqminnow@yahoo.com.cn
authors.forename: Qingyang
authors.initials: Q
authors.lastname: Liu
authors.forename: Quanhong
authors.initials: Q
authors.lastname: Zhou
authors.forename: Yeguang
authors.initials: Y
authors.lastname: Song
authors.forename: Songlin
authors.initials: S
authors.lastname: Yang
authors.forename: Jianghong
authors.initials: J
authors.lastname: Zheng
authors.forename: Zhi
authors.initials: Z
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D001050:Apocrine Glands / Q000601:surgery*; D001365:Axilla / Q000601:surgery*; D002681:China; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006945:Hyperhidrosis / Q000191:economics* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods; D009812:Odorants; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000191:economics*; D016896:Treatment Outcome