Optimizing hematoma management in axillary osmidrosis surgery: the role of timely drainage and prevention of flap necrosis

Hematoma formation is a rare complication following axillary osmidrosis surgery, and its delayed liquefaction can pose significant risks to flap viability, leading to complications such as necrosis. This study examines two cases of postoperative hematomas, highlighting the importance of appropriate drainage management. In both cases, the initial hematomas were evacuated and treated with Penrose drains, but complications arose due to delayed liquefaction. The first case experienced delayed flap necrosis after premature removal of the drain, while the second case benefited from a proactive approach by reintroducing the drain on the sixth postoperative day. This strategy allowed for the prevention of toxic hematoma buildup, improving flap survival. The findings emphasize the need for vigilant postoperative monitoring and drainage management to minimize risks associated with hematoma liquefaction and optimize flap healing. Further research is required to establish standardized protocols for managing postoperative hematomas in axillary osmidrosis surgery.