A Retrospective Cohort Study Comparing the Clinical Outcomes of the Hydrosurgery System and Traditional Single-Incision Surgery for Axillary Osmidrosis.

Purpose: To compare the postoperative scarring, complication rates, and efficacy between the hydrosurgery system and traditional single-incision surgical techniques for treating axillary osmidrosis.

Methods: A retrospective collection was conducted of all patients who underwent radical surgery for axillary osmidrosis at the Day Surgery Unit of the Department of Plastic Surgery at the First Affiliated Hospital of the Army Medical University from January 2023 to January 2024. Patients were screened based on inclusion and exclusion criteria and divided into the hydrosurgery group and the traditional surgery group. The evaluation was done through medical records, follow-up records, electronic questionnaires, and photographs. Assessments included 6-month postoperative scarring conditions, comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality scores, and complication rates.

Results: A total of 73 patients completed this study: 34 in the hydrosurgery group and 39 in the traditional surgery group. 6 months postoperatively, the hydrosurgery group had significantly lower scores of the Vancouver Scar Scale (VSS), 0.5 (range 0.0-2.0) compared with 1.5 (range 0.5-3.0) in the traditional surgery group (p = 0.018). The incidence of complications such as subcutaneous hematoma, epidermal necrosis, and wound dissidence was also lower (26.5% vs. 51.3%, p = 0.031). Additionally, the surgical incision length in the hydrosurgery group was significantly smaller than in the traditional surgery group (1.200 cm (1.000, 1.275) vs. 2.500 cm (2.500, 3.000), p < 0.001). There were no significant differences between the two groups regarding comprehensive effectiveness scores, postoperative odor/hair/sweating scores, postoperative dermatological life quality index, and surgical duration.

Conclusion: Compared with traditional single-incision surgical techniques, patients in the hydrosurgery group exhibited lower scar scores 6 months postsurgery, required smaller surgical incisions, and had lower rates of surgical complications. Thus, the hydrosurgery is suitable for the minimally invasive surgical treatment of axillary osmidrosis, offering a safe, effective, and aesthetically superior treatment method.