Procedure Recording Form
Minimal Excision Technique for Epidermoid (Sebaceous) Cyst Removal
Patient name: ______________________________ Date: __________ Age: ______
How long has the growth been noted? _________________________________________________________
Symptoms associated with the lesion:
| Pain | Yes | No | Bleeding | Yes | No |
| Drainage | Yes | No | Swelling | Yes | No |
| Tenderness | Yes | No | Irritation | Yes | No |
| Itching | Yes | No | Clothing rubs on lesion | Yes | No |
Side affected: Right Left
Procedure description:
The patient gave informed consent for the procedure. Other options were discussed, and the patient elected to undergo the minimal excision technique. The skin was washed with povidone-iodine solution, and the skin and subcutaneous tissues anesthetized with 2 percent lidocaine with epinephrine. The patient tolerated the anesthesia well. A no. 11 blade was used to create a small skin opening into the cyst cavity. The tips of a hemostat were placed in the cyst cavity, widening the opening and assisting with removal of the cyst contents. The tissues surrounding the cyst were squeezed, forcing the cyst contents out onto gauze. Once the entire cyst contents were emptied and the compression had loosened the cyst wall from the surrounding tissues, the hemostat was placed within the cyst cavity, and the cyst wall was grasped. The cyst wall was delivered through the incision. The wound was examined for any residual cyst wall. Once the entire wall was removed, pressure was applied over the wound.
| Entire cyst wall removed | Yes | No | Sent to pathology | Yes | No |
| Fusiform excision required for complete removal | Yes | No | Suture used to close the wound | Yes | No |
Suture material: ________________________________________
Complications: _________________________________________________________
Follow-up for wound check: ________________________________________
Follow-up for suture removal: ________________________________________
Impressions: _________________________________________________________
| Plan: | Postoperative instructions given. |
| Pressure to be applied for one to two hours following the procedure. | |
| Bandage to be changed in 24 hours. |
Physician: ____________________________ CC: ____________________________
Adapted with permission from Zuber TJ. Office procedures. Baltimore: Lippincott Williams & Wilkins, 1999.
Copyright © 2002 by the American Academy of
Family Physicians.
This content is owned by the AAFP. A person viewing it
online may make one printout of the material and may use that printout only for
his or her personal, non-commercial reference. This material may not otherwise
be downloaded, copied, printed, stored, transmitted or reproduced in any
medium, whether now known or later invented, except as authorized in writing by
the AAFP. Contact afpserv@aafp.org for
copyright questions and/or permission requests.
