Arch Craniofac Surg.  2019 Apr;20(2):84-88. 10.7181/acfs.2018.02152.

Comparison of complete surgical excision and minimally invasive excision using COâ‚‚ laser for removal of epidermal cysts on the face

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea. jeongyahn@gmail.com

Abstract

BACKGROUND
Epidermal cysts are benign, slow growing cysts that often develop on the head, neck, chest, and back of adults. The most common method of surgical excision involves the use of a scalpel and often leaves a scar proportional to the size of the cyst. Therefore, minimally invasive techniques are required. Among these techniques, the CO2 laser-based technique is minimally invasive and has lower complication rate, shorter recovery times, and lesser scarring. This paper aimed to compare the results and postoperative complications associated with a CO2 laser-based excision against conventional surgical excision for epidermal cysts.
METHODS
We surveyed 120 patients, aged 16 to 65 years, with epidermal cysts on the face measuring 0.5 to 2.2 cm in diameter. Twelve months later, we compared the scar length, recurrence rate, patient satisfaction, and complications between patients treated with CO2 laser excision versus surgical excision.
RESULTS
The mean scar length (12 months postoperative) after CO2 laser excision was 0.30± 0.15 cm, and that following surgical excision was 1.23± 0.43 cm (p= 0.001). The procedure time (time from incision after local anesthesia to the end of repair) was 16.15± 5.96 minutes for CO2 laser excision versus 22.38± 6.05 minutes for surgical excision (p= 0.001). The recurrence rates in the surgical excision group and CO2 laser excision group were 3.3% and 8.3%, respectively; this difference was not statistically significant (p= 0.648).
CONCLUSION
The cosmetic outcome of CO2 laser excision is excellent. For epidermal cysts measuring 2.2 cm or smaller, CO2 laser excision is recommended, especially when aesthetic outcome is considered important.

Keyword

Epidermal cyst; Laser; Surgery, plastic

MeSH Terms

Adult
Anesthesia, Local
Cicatrix
Epidermal Cyst*
Head
Humans
Lasers, Gas
Methods
Neck
Patient Satisfaction
Postoperative Complications
Recurrence
Surgery, Plastic
Thorax
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