Minimal Incision Suction-Assisted Excision of a Large Epidermal Cyst

Abstract

Background In minimal incision methods for removing an epidermal cyst, the cyst contents and lining are generally manually squeezed out through a small opening using lateral pressure. However, lateral pressure can cause unintended rupture, such as intracavitary rupture, and fragmentation of the lining into small pieces that may cause infection and recurrence. Additionally, it is difficult to completely remove cysts that are larger than 2 cm. In this paper, we present a small-incision method using negative- pressure suction instead of lateral pressure for excision of large epidermal cysts ([2 cm in diameter). Methods Between 2006 and 2015, 19 patients with large epidermal cysts were included in this study. The most common locations of the cysts were the face and neck (8 cases), back (5 cases), buttocks (4 cases), and axilla (2 cases). The mean diameter of the cysts was 4.4 cm, and the largest cyst was 14 cm in diameter. Results The incision length ranged from 0.7–1.8 cm (mean, 1.0 cm). The mean operative time was 28 min. The mean follow-up period was 13.2 months. During this period there were no recurrences. One patient developed a hematoma, but there were no other complications. Conclusions We used negative-pressure suction instead of lateral pressure with a minimal surgical technique. We were able to completely remove the lining of a large epidermal cyst through a small incision.