A new form of treatment for excessive sweating in the armpit area (hyperhidrosis axillaris) in the armpit area (hyperhidrosis axillaris) is suction curettage. It has only been performed for a few years at individual centres in Germany. in Germany.
As the name suggests, this surgical procedure is a combination of curettage and liposuction. procedure is a combination of curettage and liposuction. The target organs are the sweat glands located in the deeper part of the dermis. the sweat glands or the fibres of the autonomous nervous system that lead to them. nervous system. The tissue under the dermis with the above-mentioned structures of the adenoids is structures of the armpits contained therein. From our point of view, this would be achieved when the patient still still have underarm perspiration, if this were also the case in people without hyperhidrosis. would be the case. In extreme cases, after the treatment, the patients are patients are completely dry after the treatment, even under physical or mental stress. In our opinion, suction curettage is currently the best compromise between the the best compromise between the improvement of sweating, the improvement of sweating, size of the resulting scars, sustainability of the therapeutic success and the possibility of complications for the patient. the patient. Although the procedure of sweat gland removal as such is in the relatively unproblematic in the hands of an experienced surgeon, the experienced surgeon, the success of the therapy depends on the details of the surgical technique.
Suction curettage can be carried out using the "tumescent method" according to Klein. general anaesthetic or an inpatient stay is usually not necessary. is usually not necessary. Patients should shower the evening shower the evening before and morning of the operation. Furthermore, on the day shave under the armpits the day before the operation. Small wheals with local anaesthetic are placed in 3 - 4 places. anaesthetic. After a sparing incision of the skin in these areas, a liposuction is inserted into the subcutaneous fatty tissue and the appropriate solution is injected. and the appropriate solution is injected. After a reaction time of 30 minutes, the suction cannula is inserted and the liquid is sucked out accordingly. At treatment, a compressive, absorbent pressure bandage is applied. pressure bandage is applied. You will need to wear this for one to two days and change the absorbent material regularly. Wearing a tight garment and your normal clothing usually helps to a sufficient degree to counteract serum formation (e.g. breathable sportswear, aerobic or cycling shirts). cycling shirts). Sports activities should be avoided for 4 - 6 weeks. weeks.
Due to the small size of the incisions, wound healing problems are rare. are rare. Theoretically, all possible postoperative complications are conceivable. complications are conceivable. Experience shows, however, that only swelling, haematoma only swelling, haematoma, occasional reddening in the area of the skin incision skin incisions and a prolonged numbness of the skin in the armpit area. of the skin in the area of the armpits. Due to the radical approach to the underside of the dermis some skin damage may occur. If this occurs most cases it is only a crust formation that disappears after a few days. crust formation that falls off after a few days. For this reason patients about the occurrence of skin necrosis. The lidocaine contained in the tumescent solution can very rarely be diffuse through the soft tissues of the armpit to the brachial plexus. brachial plexus. Should this be the case, it can lead to temporary signs of paralysis in the area supplied by the brachial plexus. brachial plexus.
Suction curettage is currently the most sensible surgical procedure for the treatment of primary hyperhidrosis. treatment of primary hyperhidrosis. The impairment for the patient is considerably less for the patient compared to earlier surgical less. If the work is not too physically demanding, the patient can return to work return to work is possible after only a few days. The decisive factor for a successful therapy with this procedure of the procedure is the sufficient radicality of the suction and curettage on the and curettage of the lower surface of the dermis. In the area of tension between the success of the operation and the risk of skin necrosis. recommendation to perform these procedures at specialised centres. centres.
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