synonyms:mucous cyst excision, ganglion cyst excision, resection, removal
Mucous Cyst Excision CPT
Indications
- pain
- recurrent infection
- chronic drainage
- cosmesis
Mucous Cyst Excision Contraindications
Mucous Cyst Excision Alternatives
Mucous Cyst Excision Pre-op Planning
- Consider if skin graft will be require and consent for graft if needed.
- Consider DIP arthrodesis if underlying arthritis is severe.
Mucous Cyst Excision Technique
- Preop antibiotics
- Sign operative site
- Digital block anesthesia
- H, T, U, or transverse curving incision shape, depending on skin integrity and cyst size and location
- Dissection carried down under 2.5x loop magnification
- Avoid injury to extensor tendon, nail matrix, articular surface, terminal NV bundle.
- Perform synovectomy, osteophyte resection, and debridement
- Repair terminal extensor tendon if disrupted repaired to prevent subsequent extensor lag
- Closure: skin graft, a rotational flap, or primary closure
Mucous Cyst Excision Complications
- Extensor tendon rupture / lag
- Recurrence
- Incomplete relief of pain
- Nonuion
- Infection
- Painful hardware
- Nail deformity
- Stiffness
Mucous Cyst Excision Follow-up care
- Post-op: place in extension splint, STAXX splint if extensor tendon repair required or skin graft used. Early motion otherwise
- 7-10 Days: wound check. Staxx splint if extensor tendon repair, early ROM otherwise.
Mucous Cyst Excision Outcomes
- 3-15% recurrence rate
- Continued nail defomity is not uncommon
Mucous Cyst Excision Review References
- Thornburg LE. Ganglions of the hand and wrist. JAAOS. 1999;7:231-8.
- Budoff JE. Mucous Cysts. J Hand Surg Am 2010;35:828
- Kasdan ML, Stallings SP, Leis VM. Outcome of surgically treated mucous cysts of the hand. J Hand Surg Am 1994;19:504.
- Shin EK, Jupiter JB. Flap advancement coverage after excision of large mucous cysts. Tech Hand Up Extrem Surg. 2007;11:159.
