Efficacy and safety of modified cystic wall peeling combined with Zhang′s tension-reduced suture in treatment of sebaceous cysts
10.3760/cma.j.cn114657-20241202-00206
- VernacularTitle:改良囊壁剥离法联合章氏超减张缝合治疗皮脂腺囊肿的疗效及安全性
- Author:
Baogang LI
1
;
Yang LUO
;
Chao ZHANG
;
Xiaoliang ZHANG
Author Information
1. 解放军联勤保障部队第九四〇医院皮肤科，兰州 730050
- Publication Type:Journal Article
- Keywords:
Sebaceous cyst;
Cystic wall;
Stripping method;
Tension-reduced suture;
Minimal invasive surgery
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2025;31(6):592-597
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy and safety of a modified cystic wall peeling method combined with Zhang′s tension-reduced suture in the treatment of sebaceous cysts.Methods:Twenty-eight patients with sebaceous cysts, 22 males and 6 females, aged 18-44 (27.3±5.7) years, who were treated with modified cystic wall peeling combined with Zhang′s tension-reduced suture at the 940 Hospital of the Joint Logistic Support Force from July 2022 to October 2023 were prospectively included. A simple cyst peeler was self-made using a sterile tear duct probe with a diameter of 0.5 mm and a length of 7.3 cm. The skin was incised directly when the cyst protruded <5 mm from the skin surface; a shuttle incision was used to remove excess skin when the cyst protruded ≥5 mm from the skin surface. After incision of the skin, the cavity between the cyst wall and the surrounding normal tissue at the incision site was peeled off with ophthalmic scissors, and the cyst peeler was inserted into the cavity up to the bottom of the cyst and rotated along the cystic wall for 1 week to achieve complete blunt peeling within the cyst from the surrounding normal tissue. After the peeling was completed, the sebaceous cyst was squeezed by hand to discharge the cystic wall and its contents; if it could not be discharged, the cyst contents were released first and then squeezed. Absorbable sutures were used to close the residual cavity with Zhang′s tension-reduced suture, and then the incision was closed intermittently with non-absorbable sutures, and the surgical site was bandaged with pressure. Postoperative follow-up was performed for 1 year by telephone or WeChat to assess the overall postoperative effective rate, overall satisfactory rate, modified sebaceous cyst score and incidence of incisional scarring hyperplasia, and to record the occurrence of adverse reactions.Results:The preoperative modified sebaceous cyst score of 28 patients was (5.39±1.34) scores, which decreased to (0.25±0.59) scores one year after surgery, and the difference was statistically significant ( P<0.001). The overall postoperative effective rate was 100% (28/28), and the overall satisfactory rate was 96.4% (27/28), and all patients had no scarring hyperplasia. One patient had localized epidermal necrosis at the skin edge of the chest incision, one patient had erythema and scattered ecchymosis in the surgical area of the buttocks, and one patient had pain at the surgical site of the left upper extremity, which were cured after symptomatic treatment. Conclusion:Modified cystic wall peeling combined with Zhang′s tension-reduced suture is effective in the treatment of sebaceous cysts, and the incidence of adverse effects is low.
