Surgical treatment of axillary hyperhidrosis by suction-curettage of
               sweat glands

Rezende, Rebeca Maffra de; Luz, Flávio Barbosa

doi:10.1590/abd1806-4841.20142873

Acessibilidade / Reportar erro

Brasil

Anais Brasileiros de Dermatologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review • An. bras. dermatol. 89 (6) • Nov-Dec 2014 • https://doi.org/10.1590/abd1806-4841.20142873 copy

Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands^* * Study conducted at the Hospital Universitário Antônio Pedro - Universidade Federal Fluminense (HUAP-UFF) - Niterói (RJ), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. Objective: The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities.

Curettage; Hyperhidrosis; Lipectomy

Reference	Surgical Method	Material	No. patients	Complications/Side effects (n patients)
Lee D, 2006⁷⁷77 Lee D, Cho SH, Kim YC, Park JH, Lee SS, Park SW. Tumescent liposuction with dermal curettage for treatment of axillary osmidrosis and hyperhidrosis. Dermatol Surg. 2006;32:505-11.	Liposuction-curettage	Fatemi Cannula	25 (Analysis of 20)	Transient ecchymoses (not specified)
(Hyperhidrosis/Osmidrosis)				Local secondary infection (2)
				Reduction in the number of hairs (20)
Kim, 2008⁹²92 Kim WO, Song Y, Kil HK, Yoon KB, Yoon DM. Suction-curettage with combination of two different cannulae in the treatment of axillary osmidrosis and hyperhidrosis. J Eur Acad Dermatol Venereol. 2008;22:1083-8.	Liposuction-curettage	Fatemi + Cassio	65	Transient ecchymoses (not specified)
(Hyperhidrosis/Osmidrosis)		Cannulae		Focal alopecia (2)
				Partial elimination of osmidrosis (2)
				Recurrrence of osmidrosis within 1 year (2)
				Scar (1)
				Seroma (1)
				Wound dehiscence (1)
				Skin desquamation (2)
				No improvement of hyperhidrosis (1)
				Recurrence of axillary hyperhidrosis (1)
Wollina, 2008⁷¹71 Wollina U, Köstler E, Schönlebe J, Haroske G. Tumescent suction curettage versus minimal skin resection with subcutaneous curettage of sweat glands in axillary hyperhidrosis. Dermatol Surg. 2008;34:709-16	Liposuction-curettage	Fatemi or Sattler	37	Mild hematoma (29)
(Hyperhidrosis)		Cannula		Mild skin irritation near the suture (6)
				Temporary hypoesthesia (21)
				Partial recurrence (6)
				Temporary, mild to moderate subcutaneous cords (4)
Seo, 2008⁸⁶86 Seo SH, Jang BS, Oh CK, Kwon KS, Kim MBJ. Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis. J Eur Acad Dermatol Venereol. 2008;22:30-5.	Liposuction-curettage	Fatemi Cannula	43	Transient ecchymoses (40)
(Osmidrosis)				Focal skin necrosis (4)
				Induration (3)
				Hematoma/seroma (1)
Bieniek, 2005⁸¹81 Bieniek A, Bialynicki-Birula R, Baran W, Kuniewska B, Okulewicz-Gojlik D, Szepietowski JC. Surgical treatment of axillary hyperhidrosis with liposuction equipment: risks and benefits. Acta Dermatovenerol Croat. 2005;13:212-8.	Liposuction-curettage	3- to 4-mm diameter liposuction cannula	15	Hematoma (2)
(Hyperhidrosis)				Recurrence of hyperhidrosis (4)
				Transient fibrosis (3)
				Necrosis (2)
Bechara, 2006³⁴34 Bechara FG, Sand M, Sand D, Altmeyer P, Hoffmann K. Surgical treatment of axillary hyperidrosis: a study comparing liposuction cannulas with a suction-curettage cannula. Ann Plast Surg. 2006;56:654-7.	Liposuction-curettage	1. liposuction cannula with one hole	14	Hematoma (6 / 6 / 8)
(Hyperhidrosis)				Superficial skin erosion (1 / 2 / 2)
				Formation of adherence (3 / 3 / 4)
		2. liposuction cannula with 3 holes	14	Seroma (1 patient in the group using the cannula with 3 holes)
				Paresthesia (6 / 7 / 8)
		3. sharp cannula especially designed for liposuction-curettage	14	Partial alopecia (2 / 2/ 3)
Chern, 2010⁷⁴74 Chern E, Yau D, Chuang FC, Wu WM. Arthroscopic shaver with refinement for axillary osmidrosis. Int J Dermatol. 2010;49:813-7.	Liposuction-curettage	Arthroscopic shaver	30	Surgical wound infection (1 axilla)
(Osmidrosis)				Mild to moderate ecchymoses (28)
Darabaneanu, 2008¹⁰⁶106 Darabaneanu S, Darabaneanu HA, Niederberger U, Russo PA, Lischner S, Hauschild A. Long-term efficacy of subcutaneous sweat gland suction curettage for axillary hyperhidrosis: a prospective gravimetrically controlled study. Dermatol Surg. 2008;34:1170-7.	Liposuction-curettage	Cânula de 12 gauges	28	Mild surgical wound infections (4)
(Hyperhidrosis)				Persistent hypertrophic scar with disfigurement (1)
Arneja, 2007⁷⁵75 Arneja JS, Hayakawa TE, Singh GB, Murray KA, Turner RB, Ross LL, et al. Axillary hyperhidrosis: a 5-year review of treatment efficacy and recurrence rates using a new arthroscopic shaver technique. Plast Reconstr Surg. 2007;119:562-7.	Suction-curettage	Arthroscopic shaver	50	Hypertrophic scar (1)
(Hyperhidrosis)				Recurrence (3)
				Alopocia (1)
				Infection (7)
				Paresthesia (1)
Lee, 2005⁷²72 Lee JC, Kuo HW, Chen CH, Juan WH, Hong HS, Yang CH. Treatment for axillary hyperhidrosis with suction-assisted cartilage shaver. Br J Plast Surg. 2005;58:223-7.	Suction-curettage	Arthroscopic shaver (E9005 System, Linvatec Corporation, Largo, Florida, USA)	89	Hypertrophic scar (1)
(Osmidrosis)				Temporary hyperpigmentation (not specified)
				Temporary induration (not specified)
Bechara, 2008⁷⁸78 Bechara FG, Sand M, Hoffmann K, Boorboor P, Altmeyer P, Stuecker M. Histological and clinical findings in different surgical strategies for focal axillary hyperidrosis. Dermatol Surg. 2008;34:1001-9 79.	Liposuction-curettage	Sharp rasping cannula	15	Hematoma (3)
(Hyperhidrosis)		(Gaedigk GmbH, Bochum, Germany)		Paresthesia (4)
				Focal loss of hairs (9)
				Subcutaneous fibrotic adhesions (8)
				Seroma (1)
				Skin erosion (3)
				Necrosis (1)
Wu, 2009⁸⁰80 Wu WH. Ablation of apocrine glands with the use of a suction-assisted cartilage saver for treatment of axillary osmidrosis: na analysis of 156 cases. Ann Plast Surg. 2009;62:278-83.	Suction-curettage	Arthroscopic shaver (E9005 System, Livatec Corporation, Largo, FL)	156	Hematoma (2)
(Osmidrosis)				Necrosis (10)
				Transient paresthesia (5)
Park, 2001⁸⁹89 Park YJ1, Shin MS. What is the best method for treating osmidrosis? Ann Plast Surg. 2001;47:303-9.	Suction-curettage	Suction cannula with one hole	32	Recurrence of osmidrosis (15)
(Osmidrosis)				No complications
Larson, 2011¹³13 Larson DL. Definitive diagnosis and management of axillary hyperhidrosis: the vapometer and suction-assisted arthroscopic shaving. Aesthet Surg J. 2011;31:552-9.	Suction-curettage	Arthroscopic shaver (Stryker,	45	Infection (1)
(Hyperhidrosis)		Kalamazoo, Michigan)		Hematoma (1)
				Recurrence of symptoms (2)
Huang, 2010¹⁰⁰100 Huang YH, Yang CH, Chen YH, Chen CH, Lee SH. Reduction in osmidrosis using a suction-assisted cartilage shaver improves the quality of life. Dermatol Surg. 2010;36:1573-7.	Suction-curettage	Arthroscopic shaver (E9005 System, Livatec Corporation, Largo, FL)	70	Epidermal cysts (2)
(Osmidrosis)				Scars (5)
				Skin Hyperpigmentation (7)
				New vitiligo lesions at the axilla (1)
Bechara, 2007²⁸28 Bechara FG, Gambichler T, Bader A, Sand M, Altmeyer P, Hoffmann K. Assessment of quality of life in patients with primary axillary hyperhidrosis before and after suction- curettage. J Am Acad Dermatol. 2007;57:207-12.	Suction-curettage	Rasping cannula	51	Ecchymoses (39)
(Hyperhidrosis)				Skin erosion (14)
				Temporary formation of adherences (11)
				Seroma (7)
				Dysesthesia (6)
				Focal loss of hairs (4)
Seo, 2008⁸⁶86 Seo SH, Jang BS, Oh CK, Kwon KS, Kim MBJ. Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis. J Eur Acad Dermatol Venereol. 2008;22:30-5.	Suction-curettage	Fatemi	43	Transient ecchymoses (40)
(Osmidrosis)		Cannula		Focal skin necrosis (4)
				Induration (3)
				Hematoma or seroma (1)
Bechara, 2007⁹⁷97 Bechara FG, Sand M, Tomi NS, Altmeyer P, Hoffmann K. Repeat liposuction-curettage treatment of axillary hyperhidrosis is safe and effective. Br J Dermatol. 2007;157:739-43.	Suction-curettage	Sharp rasping cannula (Gaedigk	19	Superficial skin erosions (6)
(Hyperhidrosis)	(2^nd surgery)	GmbH, Bochum, Germany)		Temporary paresthesia (4)
				Seroma (2)
				Temporary adherences (6)
				Partial alopecia (3)
Rezai, 2009⁸⁴84 Rezai K. Suction curettage of the sweat glands - an update. Dermatol Surg. 2009;35:1126-9.	Suction-curettage	7-mm cannula	168	Seroma (5)
(Hyperhidrosis)				Desquamation similar to scald buns in the central axillary region (25)

Reference	N patients	Follow-up in months (average)	Results
Lee, 2006⁷⁷77 Lee D, Cho SH, Kim YC, Park JH, Lee SS, Park SW. Tumescent liposuction with dermal curettage for treatment of axillary osmidrosis and hyperhidrosis. Dermatol Surg. 2006;32:505-11.	25	10,7	98% of good to excellent in relation to the smell
(Osmidrosis/ Hyperhidrosis)			100% of patients with hyperhidrosis (3) with excellent results
Seo, 2008⁸⁶86 Seo SH, Jang BS, Oh CK, Kwon KS, Kim MBJ. Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis. J Eur Acad Dermatol Venereol. 2008;22:30-5.	43	15,8	72,1% of good to excellent
(Osmidrosis)
Boni, 2006¹¹⁰110 Böni R. Tumescent suction curettage in the treatment of axillary hyperidrosis: experience in 63 patientes. Dermatology. 2006;213:215-7.	63	24	- 49 satisfied patients
(Hyperhidrosis)			- 11 partially satisfied patients
			- 3 dissatisfied patients
Tsai, 2001⁸⁸88 Tsay RY, Lin JY. Experience of tumescent liposuction in the treatment of osmidrodis. Dermatol Surg. 2001;27:446-8.	10	Not mentioned	80% of satisfied patients
(Osmidrosis)			20% of partially satisfied patients
Chern, 2010⁷⁴74 Chern E, Yau D, Chuang FC, Wu WM. Arthroscopic shaver with refinement for axillary osmidrosis. Int J Dermatol. 2010;49:813-7.	30	10	93% from good to excellent
(Osmidrosis)			7% of reasonable results
Wollina, 2008⁷¹71 Wollina U, Köstler E, Schönlebe J, Haroske G. Tumescent suction curettage versus minimal skin resection with subcutaneous curettage of sweat glands in axillary hyperhidrosis. Dermatol Surg. 2008;34:709-16	37	48	83,8% of satisfied patients
(Hyperhidrosis)			5,4% of partially satisfied patients
			10,8% of dissatisfied patients
Arneja, 2007⁷⁵75 Arneja JS, Hayakawa TE, Singh GB, Murray KA, Turner RB, Ross LL, et al. Axillary hyperhidrosis: a 5-year review of treatment efficacy and recurrence rates using a new arthroscopic shaver technique. Plast Reconstr Surg. 2007;119:562-7.	50	28	96% of patient satisfaction
(Hyperhidrosis)			- 2 dissatisfied patients (due to the occurrence of post-operatory infection, not due to recurrence)
			- 3 patients with mild recurrence
Lee, 200572	89	20	- Excellent in 55 patients (61,8%)
(Osmidrosis)			- Good in 27 patients (30,4%)
			- Reasonable in 7 patients (7,9%)
Wu, 2009⁸⁰80 Wu WH. Ablation of apocrine glands with the use of a suction-assisted cartilage saver for treatment of axillary osmidrosis: na analysis of 156 cases. Ann Plast Surg. 2009;62:278-83.	156	16	97,4% of satisfaction
(Osmidrosis)			- 144 satisfied patients
			- 8 partially satisfied patients
			- 4 dissatisfied patients
Bechara, 2007²⁸28 Bechara FG, Gambichler T, Bader A, Sand M, Altmeyer P, Hoffmann K. Assessment of quality of life in patients with primary axillary hyperhidrosis before and after suction- curettage. J Am Acad Dermatol. 2007;57:207-12. (Hyperhidrosis)	51	9	96,1% of satisfied patients
Huang, 20100¹⁰⁰100 Huang YH, Yang CH, Chen YH, Chen CH, Lee SH. Reduction in osmidrosis using a suction-assisted cartilage shaver improves the quality of life. Dermatol Surg. 2010;36:1573-7.	70	18,3	- 24 very satisfied patients
(Osmidrosis)			- 41 absolutely satisfied patients
			- 5 satisfied patients
Bechara, 2007⁹⁷97 Bechara FG, Sand M, Tomi NS, Altmeyer P, Hoffmann K. Repeat liposuction-curettage treatment of axillary hyperhidrosis is safe and effective. Br J Dermatol. 2007;157:739-43.	19	8	- 16 fully satisfied or satisfied patients (84%)
(Hyperhidrosis)			- 2 partially satisfied patients (11%)
			- 1 dissatisfied patient (5%)
Darabaneau, 2008¹⁰⁶106 Darabaneanu S, Darabaneanu HA, Niederberger U, Russo PA, Lischner S, Hauschild A. Long-term efficacy of subcutaneous sweat gland suction curettage for axillary hyperhidrosis: a prospective gravimetrically controlled study. Dermatol Surg. 2008;34:1170-7.	28	12	Patients considered the surgery outcome as:
(Hyperhidrosis)			- Satisfactory 24%
			- Good 14,3%
			- Excellent 25%
			- unsatisfactory 39,3%

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] MAILING ADDRESS: Rebeca Alvares Rodrigues Maffra de Rezende, Av. Marquês de Paraná, 303, Centro, 24030-210, Niterói - RJ, Brazil. E-mail: rebecamaffra@gmail.com

1- Posicioning of the patient
2- Asepsis and antisepsis
3- Inicial local anesthetic infiltration
4- Incision
5- Introduction of the infiltration cannula
	• Tumescent Anesthesia (Figure 1A)
	• Back-and-forth movements for subdermal tunneling
6- Removal of glands by inverted curettage (Figure 1B)
7- Suction (dermal and subcutaneous cellular tissue) - optional
8- Sutures
9- Compressive bandage (Figure 1C and 1D)

Brasil

Brasil

Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands* * Study conducted at the Hospital Universitário Antônio Pedro - Universidade Federal Fluminense (HUAP-UFF) - Niterói (RJ), Brazil.

Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands^* * Study conducted at the Hospital Universitário Antônio Pedro - Universidade Federal Fluminense (HUAP-UFF) - Niterói (RJ), Brazil.