Dermatology Book

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Minimal Excision of Epidermal Cyst

Aka: Minimal Excision of Epidermal Cyst, Minimal Epidermal Cyst Excision
  1. Indications
    1. Epidermal Cyst
  2. Contraindications
    1. Avoid if lesion previously ruptured or scarred
    2. May be difficult for Pilar Cyst due to thick wall
    3. Avoid in cysts larger than 2 cm
  3. Procedure
    1. Preparation
      1. Knead surrounding skin to break adhesions
      2. Prepare skin with betadine and Local Anesthesia
    2. Insert 11 blade into center of cyst
      1. Creates 2-3 mm incision
    3. Remove cyst contents
      1. Cover lesion with gauze to protect from spraying
      2. Insert hemostat into cyst and spread opening
      3. Expell cyst contents from opening with firm pressure
      4. Break up contents further if needed
        1. Hemostat
        2. Curette #1
    4. Remove cyst wall
      1. Use hemostat to grasp capsule at wound base
      2. Pull sac out via opening (may break into pieces)
      3. Confirm all cyst wall removed prior to completion
    5. Completion
      1. Suture not necessary if incision in 3 mm or less
      2. Apply Bacitracin
      3. Apply pressure bandage and leave in place 1-2 hours
  4. References
    1. Habif (1996) Clinical Dermatology, p. 644
    2. Zuber (2002) Am Fam Physician 65(7):1409-12 [PubMed]

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