[Use of a bilobed flap for the treatment of mucous cysts]

INTRODUCTION

In the case of mucous cysts with attenuated skin, the authors suggest radical excision of the cyst together with the overlying skin. The skin defect is repaired with a bilobed flap whose donor site is left to heal by secondary intention. This surgical procedure also allows exploration of other areas of mucoid degeneration and repair of the proximal nail fold when necessary.

METHOD

Twenty-six patients with an average age of 59 years (27 cysts), were operated with this procedure. Nail bed deformities were present in 55% of the cases. The cyst and the overlying skin were radically excised in conjunction with a dorsal capsulectomy; the use of the bilobed flap made the dissection easier, and flap translation allowed cover of the capsulectomy area and simultaneous repair of the nail fold in eight cases.

RESULTS

Patients were reviewed with an average follow-up of 13.7 months. Seventy percent of the patients had no pain, and in 85% of the cases there was no loss of motion. Cosmetic appearance was satisfactory, and nail bed deformities disappeared or clearly subsided in 86% of the cases. One patient developed recurrence.

DISCUSSION

Many surgical procedures have been described for mucous cysts treatment. This simple procedure allows radical excision of the cyst and the attenuated skin with low risk for the germinal matrix, precise location of cyst origin, repair of the nail fold and good skin cover in the capsulectomy area.