Objective:To investigate the anatomical significance of four groups of small vascular arches, which distributed in the anterior, posterior, medial and lateral of axillary in radical bromhidrosis surgeries.Methods:One hundred and fifty patients treated for bromhidrosis at Qianjiang Central Hospital of Chongqing from February 2015 to August 2018 were included in the study , including 80 males and 70 females. Sixty patients were aged 10-16 years old, and 90 were aged 17-49 years old. There were 21 mild cases, 43 moderate cases and 86 severe cases. The area of axillary hair was marked before surgery, and then the surgical incision was selected between the anterior and posterior folds of the middle part of the axilla. The anterior, posterior, medial, and lateral axillary small vascular arches were identified, and the minimum distance between the vascular arch and the margin of axillary hair area was measured. The tissues with a diameter of about 1 cm were removed at the lateral, medial (close to the vascular arch), 1 cm medial, 2 cm medial to the vascular arch and the surface of the axillary fascia for pathological examination. The superficial fascia including the axillary hair follicles in the area enclosed by the four vascular arcs were then completely cut off with tissue scissors. The specimen was examined microscopically after HE staining to determine whether it was apocrine sweat gland. If there were apocrine sweat glands, it was counted as 1, and if there were no apocrine sweat glands, it was counted as 0. The proportion of specimens diagnosed as apocrine sweat glands was counted. The patients were followed up to evaluate the incision healing and the residual bromhidrosis.Results:All the 150 cases were successfully completed, and it was found that the position of the 4 groups small vascular arch was relatively consistent. The range defined by the axillary small vessel arch was all larger than the axillary hair area, and the minimum distance between the axillary small vessel arch and the margin of axillary hair in 90.00%(270/300) patients was more than 1.5 cm. The apocrine sweat glands were found in 0% (0/1 200) of the samples taken from at 1cm lateral to vascular arch, 1.33%(16/1 200) at medial vascular arch (close to vascular arch), 100.00% (1 200/1 200)at 1 cm and 2 cm media to vascular arch. And the apocrine sweat glands on the surface of the axillary fascia were 0% (0/1 200). All patients were cured postoperatively, without residual glands or recurrence. All patients had good postoperative wound healing without hematoma and skin necrosis. After 6 months to 3 years follow-up, all the patients were cured without residual or recurrence.Conclusions:The four groups of small vascular arches, anterior, posterior, internal and external of axilla, haveanatomical significance in standardizing radical bromhidrosis surgery.

Objective:To investigate the anatomical significance of four groups of small vascular arches, which distributed in the anterior, posterior, medial and lateral of axillary in radical bromhidrosis surgeries.Methods:One hundred and fifty patients treated for bromhidrosis at Qianjiang Central Hospital of Chongqing from February 2015 to August 2018 were included in the study , including 80 males and 70 females. Sixty patients were aged 10-16 years old, and 90 were aged 17-49 years old. There were 21 mild cases, 43 moderate cases and 86 severe cases. The area of axillary hair was marked before surgery, and then the surgical incision was selected between the anterior and posterior folds of the middle part of the axilla. The anterior, posterior, medial, and lateral axillary small vascular arches were identified, and the minimum distance between the vascular arch and the margin of axillary hair area was measured. The tissues with a diameter of about 1 cm were removed at the lateral, medial (close to the vascular arch), 1 cm medial, 2 cm medial to the vascular arch and the surface of the axillary fascia for pathological examination. The superficial fascia including the axillary hair follicles in the area enclosed by the four vascular arcs were then completely cut off with tissue scissors. The specimen was examined microscopically after HE staining to determine whether it was apocrine sweat gland. If there were apocrine sweat glands, it was counted as 1, and if there were no apocrine sweat glands, it was counted as 0. The proportion of specimens diagnosed as apocrine sweat glands was counted. The patients were followed up to evaluate the incision healing and the residual bromhidrosis.Results:All the 150 cases were successfully completed, and it was found that the position of the 4 groups small vascular arch was relatively consistent. The range defined by the axillary small vessel arch was all larger than the axillary hair area, and the minimum distance between the axillary small vessel arch and the margin of axillary hair in 90.00%(270/300) patients was more than 1.5 cm. The apocrine sweat glands were found in 0% (0/1 200) of the samples taken from at 1cm lateral to vascular arch, 1.33%(16/1 200) at medial vascular arch (close to vascular arch), 100.00% (1 200/1 200)at 1 cm and 2 cm media to vascular arch. And the apocrine sweat glands on the surface of the axillary fascia were 0% (0/1 200). All patients were cured postoperatively, without residual glands or recurrence. All patients had good postoperative wound healing without hematoma and skin necrosis. After 6 months to 3 years follow-up, all the patients were cured without residual or recurrence.Conclusions:The four groups of small vascular arches, anterior, posterior, internal and external of axilla, haveanatomical significance in standardizing radical bromhidrosis surgery.