RESUMEN
Objective To investigate the effect of concentrated suture fixation in subdermal vascular network flap method for treatment of axillary osmidrosis in reducing postoperative complications,increase the wound dressing effect of comfort.Methods Ninety-six cases of bilateral axillary osmidrosis patients were randomly divided into concentrated suture group (group A) and 8 bandage compression group (group B),48 cases in each group.They were cleared of sweat gland retaining subdermal vascular network skin flap method in treatment of axillary osmidrosis.Group A was treated with concentrated suture fixation after the separation of the subdermal vascular network flap by in situ,group B was treated by routine compression bandage fixation after the separation of the subdermal vascular network flap.Observation of subcutaneous hematoma,infection,necrosis of skin after operation and understood dressing comfort.To observe the peculiar smell and axillary scar,operation area 6 months postoperative growth.Results The postoperative observation:group A subcutaneous hematoma complication rate was lower in group B,the incidence of 1.04％ (1/96) vs.19.79％ (19/96),the difference was statistically significant (P ＜ 0.01).Group A postoperative dressing comfort satisfaction rate was 93.75％ (45/48),group B po or comfort,satisfaction rate was only 10.42％(5/48),the difference had statistically significant (P ＜ 0.01).After 6 months of postoperative,the total efficiency of two groups were 100.00％,no significant difference (P ＞ 0.05).Group A district scar formation rate was higher than that in group B [3.12％(3/96) vs.21.88％(21/96)] (P ＜ 0.05).The armpit hair and sweat in the two groups was significantly reduced,there was no significant difference (P ＞ 0.05).Conclusion Concentrated suture fixation method in the treatment of axillary osmidrosis by subdermal vascular network is a reliable fixation of the axillary free after the subdermal vascular network flap,and have flap high healing rate,scar,low rate of complications; postoperative dressing is simple,comfortable,living freely,overall is better than 8 bandage compression method.
RESUMEN
ObjectiveTo establish a rat model of pure sensory nerve injury or pure motor nerve injury combined with skin defect to examine the effect of highly selective nerve injury on skin wound healing.MethodsA total of 90 male Sprague-Dawley rats were randomly and equally divided into three different groups including Group A (posterior rhizotomy + cutaneous excision wounding group),Group B (anterior rhizotomy + cutaneous excision wounding group) and Group C ( sham operation + cutaneous excision wounding group).The wound healing rate was detected at days 2,7,14 and 21 after injury.The CGRP mRNA expression was determined by reverse transcription-polymerase chain reaction (RT-PCR) at days 1,3,7 and 14 after injury.The Bcl-2 protein expression was determined by immunohistochemistry at days 3,7,14 and 21 after injury.ResultsThe wound healing rate in the Groups A and C was significantly higher than that in the Group B at day 2 ( P ＜ 0.05 ),with no statistical difference between Group A and Group C (P ＞ 0.05 ).The wound healing rate in the Group C was higher than that in the Groups A and B at days 7 and 14 (P ＜0.05),with no statistical difference between Group A and Group B (P ＞0.05).The wound healing rate in the Groups B and C was higher than that in the Group A at day 21 ( P ＜ O.05 ),with no statistical difference between Group B and Group C ( P ＞ 0.05 ).The CGRP mRNA was expressed in three groups and the expression was up-regulated after wound.The CGRP mRNA expression in the Groups B and C was significantly higher than that in the Group A at days 1,3 and 7,with no statistical difference between Group B and Group C ( P ＞ 0.05 ).The CGRP mRNA expression was distributed as Group C ＞ Group B ＞ Group A at day 7 ( P ＜ 0.05 ) and Group B ＞ Group A ＞ Group C at day 14 (P ＜ 0.05 ).Immunohistochemistry indicated that there was no statistical difference in Bcl-2 protein expression at day 3 after injury in all groups; that the Bcl-2 protien expression in the Group C was significantly higher than that in the Groups A and B at day 7 ( P ＜ 0.05 ),with no statistical difference between Group A and Group B ( P ＞ 0.05 ) ; that the Bcl-2 protien expression was distributed as Group C ＞ Group B ＞ Group A at day 14 ; that the Bclo2 protien expression in the Group B was higher than that in the Groups A and C at day 21 (P ＜0.05),with no statistical difference between Group A and Group C (P ＞ 0.05).ConclusionsIn wound healing process,the sensory nerve plays a more important role than the motor nerve.Denervation of the nerves ( especially the sensory nerves) is not conducive to wound healing,and complete innervation is necessary for normal wound healing.