遺傳影響 穿耳致蟹足腫

 

 【本報訊】愛美一族穿耳洞為要佩戴美型耳環，但耳垂穿孔之處突長出如螃蟹腳般的肉瘤實在嚇人。這種醫學界俗稱為「蟹足腫」的疤痕增生，原來與遺傳基因有關，難以預防。外科醫生指出，不少市民對蟹足腫有誤解，常見如誤以為與飲食有關，延遲求醫錯失最佳治療時機。
記者：梁麗兒

蟹足腫是一種疤痕組織增生引起的良性皮膚病變，由於增生組織變得又紅、又肥厚，似張牙舞爪的螃蟹腳，故又稱蟹足腫。外科專科醫生陳東飛表示，蟹足腫與遺傳 有關，如父母曾有蟹足腫，子女也有的機率比一般人高。蟹足腫常見於皮膚傷口，如暗瘡、蚊咬或燙傷，尤其張力大、容易牽扯的傷口位置。逾半出現在耳朵，包括 穿耳後，傷口出現疤痕增生，其餘在前胸或背部。注射疫苗的針口也容易有蟹足腫，在臨床治療上很常見。

穿耳人士中約3%會出現蟹足腫，部份人即使未有傷口發炎，也會在穿耳一段時間後出現蟹足腫。陳東飛表示，蟹足腫不會致命，但會影響外觀，部份人會有痕癢、 疼痛等不適，但事前難以預防，「穿耳之前最好睇嚇自己同家人係咪有過蟹足腫，如果自己身體已經有，穿耳之後有嘅機會就好大」。在手術傷口使用除疤膏或除疤 貼，也有助預防蟹足腫。

切除手術復發風險高

及早正確處理蟹足腫，也可避免對生活造成影響，惟不少人對蟹足腫存有誤解，他表示，常見誤解包括與處理傷口不當有關，或有傷口時無戒口，如常吃雞蛋、海鮮 致傷口不正常癒合等。他強調，消毒傷口可減少發炎風險，但非直接預防蟹足腫的方法。飲食會增加出現蟹足腫的風險，也無科學研究證實。

不少患者誤以為蟹足腫「無得醫」，又或會自行康復，最後令蟹足腫變得越來越大，影響外觀。他表示，於蟹足腫出現初期求診，可透過定期注射類固醇等方法，令 疤痕組織變小變軟，有機會根治。另外，有人誤以為用外科手術將蟹足腫切除就可以一了百了，但手術也會帶來傷口，或會令疤痕進一步增大，復發風險高達九成以 上。

現有較新治療蟹足腫的「合併療法」，先以冷凍治療用低溫破壞蟹足腫的增生組織及血管，再配合壓力治療，即佩戴壓力磁石耳環，壓迫耳部的相關微絲血管。每天 佩戴至少12小時，為期約半年至一年，以減少疤痕增生，預防復發。他表示，今年已為超過10名病人進行上述療法，暫無人復發。 














參考資料: hk.apple.nextmedia.com/news/
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

婦疑聯院漏割外痔 術後仍疼痛

 「返到屋企坐低都係咁痛，究竟係咪割漏咗？」陳女士於2011年因肛門位置出現腫痛，懷疑患上外痔，到衞生署轄下診所求診，苦候至去年7月獲安排到聯合醫院進行直腸鏡檢查，冀徹底根治病患，豈料事後卻換來一肚氣，「兩粒瘡用肉眼都睇到，點知檢查嗰陣醫生同我講：『你有內痔，不如清咗佢喇！』，仲以為內外痔都幫我清晒，做完先發現出面兩粒瘡根本仲喺度！」

陳因感疼痛持續且加劇，日常生活亦大受影響，「呢半年兩粒瘡成日都發炎流血，有時仲腫到成粒乒乓波咁大，去廁所要慢慢嚟，坐低都要加塊軟墊先舒服啲，如果唔係實痛到彈起！」

聯合醫院發言人表示，根據紀錄，該院醫生曾於去年7月首次為陳女士進行檢查，證實病人患有痔瘡，症狀主要為內痔，獲當事人同意即時進行痔瘡結紮術作治療，再配合處方藥物以紓緩病情。痔瘡結紮術是其中一種治療內痔的方法，非外痔瘡切除手術，如內痔於結紮術後仍然有持續症狀，或有外痔出現徵狀，則可以考慮進行痔瘡切除手術。

發言人續指，再次審視有關個案後，涉事醫生已按臨床情況作出合適的檢查及治療，強調處理過程恰當，當中亦不存在「漏割」情況。

外科專科醫生陳東飛表示，痔瘡屬人體肛門附近的血管組織，負責控制排便，生活壓力、年齡漸長或長期便秘皆可令血管澎漲，位置主要有內、外及混合3種，容易導致患處紅腫甚至流血。陳指治療痔瘡的方法眾多，向病人清楚解釋治療細節屬醫生的「基本功」，「治療後出現徵狀好普遍，醫生事前絕對要講清楚，例如結紮治療只係針對內痔，術後有可能發生咩事，簽埋同意書確認病人清楚晒細節！」

「病人接受治療前有外痔定內痔都搞唔清，醫生事前可以再解釋多啲！」立法會衞生事務委員會委員張國柱認為聯合醫院處理上有改善空間，要求醫院徹查並盡快跟進當事人的覆診事宜。張又建議，如有病人對病情或治療方法存疑，可主動向主診醫生了解，避免事件重演。

參考資料: http://hk.on.cc/hk/bkn/cnt/news/20160103/bkn-20160103200538413-0103_00822_001.html
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

離開狐臭 (多汗症) - 多汗症 / 狐臭手術,狐臭治療

 

多汗症 / 狐臭

輕度至中度的多汗症可以用止汗噴霧。將噴霧噴於乾的皮膚表面，便可逹到止汗的效果。由於藥物治療副作用多，而且成效低，一般都不會採用。

其次是注射肉毒杆菌，效果可維持六個月，需定期注射。雖然每次要注射多逹一百個 (很多)位置，但優點是，即使有副作用，半年後會隨藥效消失。

另一種治療，離子透式技術(Ionophoresis)，讓患者可安坐家中接受狐臭治療，所需儀器需於美國及歐洲購置。治療時將皮膚浸於生理盬水中，然後通電，初時每星期四次，每次三十分鐘，情況好轉後只需每月一次。不過，部份患者可能會感到麻煩而不選用此治療。

 

多汗症 / 狐臭手術

當所有治療都失效時，可考慮施手術，移除引致出汗的交感神經。交感神經是自主神經的一種，位於肺部後的脊椎。交感神經於大部份位置都與其他神經線重疊，只有在胸椎較分離。
由於每節的脊骨底部都有個結節，是神經線交接的地方，所以手術的目標是切除這個結節。是項手術同時適合手及腋下的多汗症。

即使是微創狐臭手術，不同醫生會有不同的切口。有醫生會以單一切口 (10-15 mm)，經切口放入鏡頭及手術刀。亦有醫生會有三個5mm的切口，其中一個放鏡頭，另外兩個切口放入手術儀器，相對單一切口，雖然多了兩個傷口，但相對較靈活。

 

手術分三種方法進行

• 電刀 - 用電流將結節電死，但由於結節仍留在體內，所以復發率較高
• 止血夾 - 用止血夾夾住供血的血管，令結節缺血死亡，但狐臭手術不可還原，而且傷口大
• 切除 - 手術較以上兩個複雜，但手術復發率最低，而且最有效

多汗症 / 狐臭手術一般需要一小時左右，需留院觀察一晚，手術後可能會有數日胸痛，少數會持續數星期。




參考資料: www.miradry.hk/hyperhidrosis-treatment.html
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

Hyperhidrosis/Body Odour Treatment – MiraDry Microwave Technology

Compared to traditional treatments for hyperhidrosis and body honour, the minimally invasive MiraDry microwave technology, approved by the USFDA, provides speedy treatment for patients of primary hyperhidrosis without the risks that come with the surgical removal of sweat glands. Treatment for this condition is no longer temporary, and MiraDry’s microwave technology can bring long lasting effects.

MiraDry treatment can be administered at a specialist’s clinic, and no hospitalization is required. Before the treatment, the surgeon will administer local anesthesia at the patient’s underarms, and then place the head of the MiraDry equipment on the skin at the underarms. Microwaves will then be released to remove the sweat glands at the underarms through minimally-invasive means.

As the microwaves released at the treatment will penetrate the dermis of the sweat glands, effectiveness of the treatment will not be affected by skin thickness. The cooling technology further prevents skin damage. As the removed sweat glands will not regrow, MiraDry treatment is an effective solution to hyperhidrosis and body odour. Not only is it non-toxic, the procedure is speedy and the effects are long lasting. Latest clinic research shows that patients who had undergone MiraDry treatment experience up to an 80% reduction in sweat secretion.

Will undergoing MiraDry treatment affect my daily life?

Recovery after undergoing MiraDry treatment takes less time than surgery. After the treatment, patients may return to work on the same day, and may perform exercise after several days. It is normal to experience soreness or swelling at the affected area. Applying an icepack can relieve any discomfort, and doctors may prescribe painkillers when necessary. Generally, soreness and swelling will cease after several weeks.




 Reference information:  http://www.miradry.hk/miradry-procedure.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Treatment for Hyperhidrosis, Sweaty Palms

MiraDry microwave technology has been approved by the United States Food and Drug Administration (FDA) as a non-invasive treatment for hyperhidrosis. This technology provides speedy treatment for patients of primary hyperhidrosis without the risks that come with the surgical removal of sweat glands. Treatment for this condition is no longer temporary, and MiraDry’s microwave technology can bring long lasting effects. Treatment can be administered at a specialist’s clinic, and no hospitalization is required.

 

 

MiraDry Treatment Procedures

MiraDry Microwave Technology: Safe, Speedy & Long-Lasting

1. Whole treatment is followed by our professional specialist, he will first carry out consultation and decide the energy needed for the treatment. He will also follow up on the patient’s situation after MiraDry treatment.
2. Long-lasting effect to remove underarm over-sweating problems, which the trouble of underarms perspiration no longer exist in the future.
3. Sweat glands in the underarms only occupy 3-5% of sweat glands of the whole body, thus treatment would not affect normal body sweating or increase sweating in other parts of the body.

 Reference information:  http://www.miradry.hk/miradry-procedure.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Three Types of Surgeries - Hyperhidrosis

 Three Types of Surgeries

• Electrosurgery – Using electric currents to destroy the nodule. However, chances of relapse is relatively higher as the nodule remains inside the body.
      
• Clamp - Using the clamp to clamp onto the blood supplying vessels, destroying the nodule with the lack of blood supply. However, this is an irreversible surgery, and the wound is relatively large.
      
• Removal – Surgical removal is more complex than the two methods above, but it is the most effective with a very low chance of relapse.

Surgeries for hyperhidrosis or body odour generally takes around one hour. Patients will then be hospitalized overnight for observation. Patients may experience chest pains for several days, and may last for several weeks for a minority.


Compensatory hyperhidrosis is one of the complications of surgery, meaning sweating may occur at other locations of the body.

Perspiration is caused by the constriction of blood vessels that force out water within the blood. Therefore, after surgical removal, without the stimulation of the nerves, sweating is reduced.

Surgery is not the first and foremost method of treatment. Doctors will provide appropriate treatments based on the severity of the patient’s condition. As opposed to other kinds of surgery, surgery for hyperhidrosis is not urgent. It is necessary for patients to balance the pros and cons of each method of treatment.






Reference information:  http://www.miradry.hk/miradry-treatment.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Surgery for Hyperhidrosis

When all methods of treatment fail, patients may consider surgery to remove the sympathicus that causes perspiration. The sympathicus are nerves within the autonomic nervous system that are located at the spine behind the lungs. The sympathicus overlap with other nerves in most parts of the body except at the thoracic vertebrae.


As there is a nodule at the bottom of each vertebrae that connects the nerves, the objective of the surgery is to remove this nodule. This surgery is suitable for patients with hyperhidrosis in the arms and underarms.


Even if this is a minimally invasive surgery, different surgeons will make different incisions. Some surgeons may make only one incision (10-15mm) and place the endoscope and scalpel through the incision. Some may also make three 4mm incisions, one for the endoscope and the other two for placing surgical equipments. Although this means having two more wounds, this method is more flexible.

Reference information:  http://www.miradry.hk/miradry-treatment.html

The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.