Factors Affecting the Efficacy of Suction Curettage Using an Arthroscopic Shaver for Bromhidrosis

Dermatol Surg. 2021 Feb 1;47(2):245-249. doi: 10.1097/DSS.0000000000002768.

Abstract

Background: Suction-curettage using an arthroscopic shaver is the most effective surgical treatment for bromhidrosis; however, information regarding the procedure is limited. This study investigated the factors that affect the efficacy of suction-curettage.

Patients and methods: We retrospectively evaluated data for 215 patients (430 axillae) with bromhidrosis treated with suction-curettage using an arthroscopic shaver between 2011 and 2019.

Results: Excellent or good efficacy with improved malodor was achieved in 418 axillae (97.21%). Secondary suction-curettage was performed for 11 (2.56%), with excellent results. Efficacy and need for secondary suction-curettage were not associated with age, sex, shaving time, and tumescent infiltration use. Complications were observed in 52 (12.09%) axillae, including hematoma or seroma, epidermis decortication, skin necrosis, and infections; 10 (2.33%) required local debridement for wounds. Complications showed a significant difference with respect to age (p < .001). Pain scores on postoperative Day 2 were significantly lower for patients treated using tumescent infiltration than those for the others (1.65 ± 0.84 vs 4.57 ± 1.16; p < .001).

Conclusion: The results suggest that 7 to 15 minutes of suction curettage using an arthroscopic shaver is sufficient to achieve good efficacy for bromhidrosis with few complications. Older age was a risk factor for complications, and tumescent infiltration use achieved good postoperative pain control.

Levels of evidence: II.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia, Local*
  • Anesthetics, Local
  • Axilla / surgery
  • Curettage / adverse effects
  • Curettage / instrumentation*
  • Debridement
  • Epinephrine*
  • Female
  • Hematoma / etiology
  • Humans
  • Hyperhidrosis / surgery*
  • Lidocaine
  • Male
  • Necrosis / etiology
  • Necrosis / surgery
  • Odorants
  • Pain, Postoperative / etiology
  • Reoperation
  • Retrospective Studies
  • Seroma / etiology
  • Skin / pathology
  • Suction / instrumentation
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / surgery
  • Vasoconstrictor Agents*

Substances

  • Anesthetics, Local
  • Vasoconstrictor Agents
  • Lidocaine
  • Epinephrine