A COMPARATIVE-STUDY OF THE SURGICAL-TREATMENT OF AXILLARY OSMIDROSIS BY INSTRUMENT, MANUAL, AND COMBINED SUBCUTANEOUS SHAVING PROCEDURES

Between 1986 and 1996, 128 patients underwent surgery for axillary osm idrosis via en bloc removal of subcutaneous cellular tissue. The patie nts were followed for 6 months to 7 years (average follow-up, 25 month s). The authors propose three categories in which they classified shav ing procedures: instrumental shavings (N = 84), manual shavings (N = 9 6), and combined shaving procedures (N = 76). A modified Inaba's shave r was used in instrument shavings. Combined shaving is mixture of inst rument and conventional manual shaving. All patients were asked to com plete a questionnaire postoperatively. This follow-up demonstrated tha t 92.9% of patients who underwent instrument shaving, 95.8% of patient s who underwent manual shaving, and 97.4% of patients who underwent co mbined shaving experienced no odor or occasional, very mild axillary o dor postoperatively. Postoperative scar formation was either invisible or excellent in 92.9% of instrument shavings, and 92.1% of patients w ho underwent the combined procedure reported either a hairless axilla or a marked decrease of axillary hair. The total satisfaction rate in the combined procedure was 94.7%, which is a better result than the in strument (92.9%) and the manual (91.7%) shaving procedures. The wound complication rate per patient with the combined procedure was 13.2%. T here was no scar contracture or limitation in arm abduction. The combi ned subcutaneous shaving procedure using the modified Inaba's shaver h as the advantages of rapid and accurate shaving, low incidence of hema toma formation, enhanced wound healing, and easy postoperative care. T herefore, en bloc resection of subcutaneous cellular tissue by combine d shaving is a viable option for treatment of axillary osmidrosis.