Jiao-Jiao Yang, MBBSa , Jie-Ling Bai, MBBSa , Shuai Qiang, PhDb, Yong Ma, MBBSc, *
Abstract
Axillary bromhidrosis is characterized by malodor stemming from hyperplastic and hypertrophic apocrine sweat glands. Although surgical excision remains the most definitive treatment, postoperative complications—particularly hematoma—can compromise outcomes and patient satisfaction. This study evaluated the effectiveness of a micropore drainage technique in reducing hematoma and improving overall results. This retrospective comparative study analyzed data from medical records of 73 patients diagnosed with axillary bromhidrosis who underwent surgical treatment at the 3201 Hospital in Hanzhong, China, from January 2020 to January 2024. Patients had initially been randomized into either the experimental group (group A, n = 38), which received micropore drainage combined with subdermal undermining via a miniature incision, or the control group (group B, n = 35), treated by subdermal undermining alone. Inclusion and exclusion criteria were strictly followed during retrospective selection. Outcomes, evaluated by blinded assessors, included malodor elimination, Dermatology Life Quality Index (DLQI) scores, hair growth reduction, scar formation, postoperative complications, and patient satisfaction. Both groups achieved significant improvements in malodor control and DLQI scores. Notably, the hematoma rate was 0% in Group A compared to 11.43% in Group B (P = .02). Group A also demonstrated higher patient satisfaction (81.58% vs 51.43%, P = .01). There were no significant differences between the groups in operative time, scar formation, DLQI improvement, or hair growth reduction. Incorporating micropore drainage into surgical management of axillary bromhidrosis effectively reduces postoperative hematoma and enhances patient satisfaction without increasing operative complexity or compromising apocrine gland removal. This technique shows promise as a safer, more reliable option for axillary bromhidrosis treatment, warranting further validation through larger multicenter studies and longer-term follow-up.
Abbreviations: AB = axillary bromhidrosis, DLQI = Dermatology Life Quality Index.
Keywords: apocrine glands, axillary bromhidrosis, Dermatology Life Quality Index, hematoma, micropore drainage, seroma, surgical treatment
Giorgia Fabrizio1 , Francesca Sivori2 , Ilaria Cavallo2 ,
Mauro Truglio2 , Luigi Toma3 , Francesca Sperati4 ,
Massimo Francalancia2 , Francisco Obregon2 , Luisa Pamparau2 ,
Daniela Kovacs5 , Fulvia Pimpinelli2 * and Enea Gino Di Domenico1 *
1Department of Biology and Biotechnology "C. Darwin", Sapienza University of Rome, Rome, Italy,
2Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy, 3Medical
Directorate, IRCCS Regina Elena National Cancer Institute, Rome, Italy, 4UOSD Clinical Trial Center,
Biostatistics and Bioinformatics, IRCCS San Gallicano Dermatological Institute, Rome, Italy,
5Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
Sodium hypochlorite (NaOCl) is widely recognized for its broad-spectrum antimicrobial efficacy in skin wound care. This study investigates the effectiveness of NaOCl against a range of bacterial and fungal isolates from pressure ulcer (PU) patients. We analyzed 20 bacterial isolates from PU patients, comprising carbapenem resistant Klebsiella pneumoniae (CRKP), multidrug-resistant Acinetobacter baumannii (MDRAB), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus aureus (MSSA), along with 5 Candida albicans isolates. Antibiotic resistance profiles were determined using standard susceptibility testing. Whole-genome sequencing (WGS) was employed to identify antimicrobial resistance genes (ARGs) and disinfectant resistance genes (DRGs). Genetic determinants of biofilm formation were also assessed. The antimicrobial activity of NaOCl was evaluated by determining the minimum inhibitory concentration (MIC) and the minimal biofilm eradication concentration (MBEC) for both planktonic and biofilm-associated cells. CRKP and MDRAB showed resistance to fluoroquinolones and carbapenems, while MRSA exhibited resistance to β-lactams and levofloxacin. MSSA displayed a comparatively lower resistance profile. WGS identified significant numbers of ARGs in CRKP and MDRAB, with fewer DRGs compared to MRSA and MSSA. All isolates possessed genes associated with fimbriae production and adhesion, correlating with pronounced biofilm biomass production. NaOCl demonstrated substantial antimicrobial activity against both planktonic cells and biofilms. The MIC90 for planktonic bacterial cells was 0.125 mg/mL, and the MBEC90 ranged from 0.225 to 0.5 mg/mL. For planktonic C. albicans, the MIC90 was 0.150 mg/ mL, and the MBEC90 was 0.250 mg/mL. These results highlight the challenge in treating biofilm-associated infections and underscore the potential of NaOCl as a robust antimicrobial agent against difficult-to-treat biofilm infections at concentrations lower than those typically found in commercial disinfectants.
KEYWORDS
NaOCl, biofilm, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Candida albicans, sodium hypochlorite solution, skin, ESKAPE
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伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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