Dermatosurgery

Laser Doppler Scanning Study of Axillary Skin before and after Liposuction Curettage in Patients with Focal Hyperhidrosis
F.G. Bechara^a, M. Sand^b, M. Stücker^a, D. Georgas^a, K. Hoffmann^a, P. Altmeyer<sup>a

a</sup>Department of Dermatology and Allergology, Ruhr University Bochum, and
^bDepartment of General and Visceral Surgery, Augusta Krankenanstalt, Academic Teaching Hospital of the Ruhr University Bochum, Bochum, Germany

Address of Corresponding Author

Dermatology 2008;216:173-179 (DOI: 10.1159/000111518)

  Key Words

• Laser Doppler perfusion imaging
• Skin blood flow
• Liposuction curettage
• Focal axillary hyperhidrosis

  Abstract

Background:Minimally invasive surgeries are frequently used in patients suffering from focal axillary hyperhidrosis (FAH). Sweat glands are removed surgically and the axillary skin is thinned out, with skin necrosis being a possible complication due to reduced microcirculation. Although of considerable interest, studies evaluating pre- and postoperative skin perfusion are unavailable. Objective: To evaluate the blood flow of axillary skin in patients with severe focal axillary hyperhidrosis before and after liposuction curettage (LC). Material and Methods: The blood flow in the axillary skin of 11 patients was measured by laser Doppler perfusion imaging before surgery and on days 1, 7 and 28 after LC with a rasping cannula. Skin perfusion was measured in arbitrary units (AU) with measuring points in the axillary center (AC), the operated skin 2 cm from the center (2C) and the surrounding healthy skin (HS). Results: No significant differences of preoperative skin perfusion were found (AC: 0.39 ± 0.08 AU/2C: 0.38 ± 0.07 AU/HS: 0.39 ± 0.07 AU; p > 0.05). On the first and seventh postoperative days, AC (0.2 ± 0.04 AU/0.27 ± 0.81 AU) and 2C (0.2 ± 0.03 AU/0.28 ± 0.06 AU) area were significantly less perfused, whereas the HS showed higher perfusion values (0.59 ± 0.1 AU/0.53 ± 0.09 AU). Twenty-eight days after LC the 2C (0.36 ± 0.07 AU) and HS (0.4 ± 0.06 AU) skin revealed no significant differences compared to preoperative skin perfusion (p > 0.05). The AC perfusion was still slightly reduced (0.37 ± 0.09 AU) without significant difference compared to preoperative findings. Conclusion: LC reduces the axillary skin blood flow with the axillary center being the least perfused area. However, in our collective, no correlation to possible side effects was observed.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Falk Georges Bechara, MD
Department of Dermatology and Allergology, Ruhr University Bochum
St. Josef Hospital, Gudrunstrasse 56
DE-44791 Bochum (Germany)
Tel. +49 234 5090, Fax +49 234 5093 445, E-Mail f.bechara@derma.de

  Article Information

Received: May 25, 2007
Accepted: August 29, 2007
Published online: January 23, 2008
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 0, Number of References : 32