Sebaceous cyst excision

Complete Excision of A sebaceous cyst on the scalp by Halim Grace.
1. Local anesthesia infiltration surrounding the cyst and beneath the cyst but not in the cyst . Lidocaine 2% with adrenaline is preferred as the scalp is very vascular . Sedation was by a tiny dose Of fentanyl.
2. A linear incision near the punctum was done with a number 15 scalpel. Although an elliptical incision enclosing the punctum is the most popular method.
3. The skin edges were raised by allis forceps ( skin hooks are less traumatic , but they weren't available)
4. Sharp dissection was done by the scalpel , in a circumferential manner , to achieve an adequate plane for blunt dissection .
5. Blunt dissection was done using curved scissors. Keeping the convex side up , and dissecting the cyst from the skin and surrounding tissue.
6. Small bleeders are cauterized by diathermy .
7. Suturing was done with silk 2-0. Dead space is minimized by taking a deeper bite . Edges of the skin should be everted .
8. Patient is instructed not to get water on the wound , and a follow up visit to replace the dressing was done On the 4th day following the surgery .
Sutures are removed after 6 days , as the scalp is very vascular and heals very fast.
N.B . If the cyst was inflamed , then I wouldn't have suggested excision until the inflammation subsides. Also if the cyst has been inflamed previously then excision without rupturing the cyst wall is not easy due to adhesions to the surrounding tissues.
If an abcess forms then treatment is only incision and drainage , and if possible excising as much as the sac as possible , (anatomy would be distorted) This has an increase in recurrence rate .
I dont advocate the minimal Excision technique ; were a tiny incision is done , and the contents of the cyst are squeezed out , then the sac removed . Simply because how will you know that you've excised the whole wall of the cyst. Surgeons that like this technique say that the incision is smaller , and operative time is not as much and stitches aren't required .

Category:

Education

Tags:

• Sebaceous
• Cyst
• Excision
• Skin
• Daff
• Dafrawy
• Surgery
• Epidermal
• cyst
• epidermoid
• epithelial
• Scalp
• surgical
• excision
• how
• to
• remove
• sebaceous
• excise
• procedure
• technique

[drhalimgrace]

@invasiondomination

[drhalimgrace]

@dianelovesbsl Hey there , it's dr Halim . You've got it right . If it bursts then it really hard excising the whole cyst wall , meaning recurrence. However , if the cyst has been infected before the patient got it excised , chances are the cyst will burst. That's why you shouldn't wait once yu feel you've got a cyst . According to your case , and why they keep recurring , maybe it's familial ? Did ur parents gettem

[drhalimgrace]

@invasiondomination really thanks !!!

[drhalimgrace]

@TheBigLeeg Heyy sorry for late reply. Yes you're right if the cyst wall is still present then for sure that sebum will fill that potential cavity . Also it's cleaner .

[drhalimgrace]

@EliteBushido It's called local because only the area that's operated on , can't perceive pain . General anesthesia is when your totally knocked out .

[Bianca16161616]

How the hell did i get here from kittens vs apples!?

[invasiondomination]

More satisfying than porn.

[pastorvbl]

-.- oh thts nasty *clevland voice*

[MrGiovannisassano]

i was thinking he didnt get it al but then he burned the small stuff just in case, nice godd doc good work, that guy was lucky to have such good care

[jr55ful]

@invasiondomination it's pure porn for a microbiologist!

[GunnerBoyz514]

that had to be touching his fucking brain!

[sexijay101]

That Awkward Moment When You Have To Explain To People Why You Have A Huge Dent In Your Head.

[6happydude3]

Ord Ab Chao! Order out of chaos is the gameplan of the enemy!

[dianelovesbsl]

very impressed he got it out in one go, usually they burst easily! I had 2 removed from my head but they wasnt as big as urs, trouble is they can come back! sigh!