Removal Of Atheroma: Does It Hurt? Removal Types, Consequences

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Removal of atheroma: types of surgery and consequences

Atheroma is a sebaceous cyst that can form in almost any part of the body. The only place where it never occurs is the feet and palms, which do not have corresponding glands on their surface. The main reason for the appearance of atheroma is blockage of the sebaceous gland mouth. A specific property of this benign formation is the impossibility of curing it by means of conservative or alternative medicine, only surgical removal will help.

Indications for removal:

• Inflammation and suppuration of the cyst due to the penetration of pathogenic bacteria inside it, the formation of an abscess, phlegmon;
• Discomfort caused by a large atheroma formed in the groin, behind the ear, on the neck, in the armpit;
• Violation of blood circulation due to squeezing of arteries by the neoplasm;
• Cosmetic defect.

The procedure for removing atheroma is simple, almost always it is performed not in a hospital, but on an outpatient basis. In most cases, this is a low-traumatic and almost painless manipulation.

Content:

• Is it painful to remove atheroma?
• Features of removal of atheroma in children
• Enucleation of atheroma with a laser knife
• Radio wave method for removing atheroma
• Removal of atheroma by electrocoagulation
• Removal of atheroma in the traditional way
• Consequences of surgery
• Postoperative rehabilitation
• Possible problems after removal of atheroma
• Where are atheroma removal operations performed?
• What does the cost depend on?
• Patient reviews

Is it painful to remove atheroma?

Cyst enucleation is not painful because the procedure is performed under local anesthesia. General anesthesia is used in the case of such a surgical intervention in young children. Before starting the operation, the doctor injects anesthetic in several places at the base of the atheroma, to the depth of the location of the fiber. The effect of local anesthesia lasts at least 30 minutes, during which time the doctor manages to remove the formation. If it is large, an additional injection of anesthetic is given to prolong the pain relief time.

Preparations for local anesthesia:

• Lidocaine,
• Novocaine,
• Bupivacaine,
• Markain.

Their mechanism of action is based on blocking the formation and transmission of a pain impulse through the nervous system. Before the operation, the doctor should conduct a drug tolerance test in order to avoid an allergic reaction of the patient's body.

Contraindications to the use of certain drugs:

• Lactation, pregnancy;
• Malignant neoplasms;
• Blood diseases (anemia, hemophilia);
• Ascites;
• Meningitis;
• Hypotension.

Removal of atheroma using modern technologies (laser or radio wave surgery) is almost painless. A small cyst is removed very quickly even in the traditional way, but purulent inflammation of atheroma can complicate the process and cause minor pain.

Features of removal of atheroma in children

The main indication for cyst removal in childhood and adolescence is a cosmetic defect. Atheroma can be congenital or appear in children aged 5-16 years. Most often, its occurrence in a child is associated with hormonal changes, hereditary features of the skin, disorders of fat metabolism. The doctor conducts dynamic monitoring of the state of atheroma and decides on its removal, depending on the patient's age and the possible risk of complications.

Atheroma in children is not removed in the following cases:

• Its size is less than 1-1.5 cm;
• Localization of education - chest, shoulders, back, it does not affect vital functions;
• There is no inflammation and no increase in education;
• Atheroma is located away from large blood vessels and lymph nodes.

If there are good reasons for removing the cyst, it is advisable to carry out the operation no earlier than 3-4 years, and preferably no earlier than 7-10 years of age.

Indications for enucleation:

• The size of education is growing rapidly;
• Atheroma is located in the armpit, on the face of the child or in the groin, which brings tangible discomfort;
• The formation becomes inflamed, suppuration, abscess or phlegmon is formed;
• The cyst disrupts the functioning of important organs, it is located near the nose, eyes, ear;

• Atheroma interferes with blood flow, squeezing arteries, lymph nodes.

Before the operation, the doctor conducts differential diagnostics, separating the symptoms of atheroma from the manifestations of other tumors.

Laboratory and instrumental diagnostics before surgery:

• Ultrasound of atheroma and nearby organs;
• General blood analysis;
• X-ray examination;
• CT or MRI in case of localization of atheroma in the places where large blood vessels pass.

In children under 7 years of age, manipulation is carried out under general anesthesia, at an older age - under local anesthesia. In pediatric surgery, modern methods of atheroma removal are used - evaporation (vaporization) of the cyst with radio waves of a certain frequency, removal of the formation with a laser knife. These methods are used for enucleation of small atheromas.

In the case of removal of a large cyst or the addition of inflammation, the formation of pus, use the traditional method. The formation is opened, its contents are aspirated, a drainage is installed for the outflow of pus. After stopping the inflammatory process, the atheroma is exuded together with the membrane. If the removal was carried out incorrectly, parts of the capsule remain, a relapse may occur, and then the operation will have to be repeated.

The recovery of the child's body takes place quite quickly, since children have high reparative capabilities. After 2-3 months, the postoperative scar becomes hardly noticeable.

Enucleation of atheroma with a laser knife

Laser surgery is the most gentle method of treatment compared to the traditional method. It is used to remove small formations, has a short rehabilitation period, and does not leave scars.

Benefits of laser surgery:

• Can be used to remove formations on the face, on the head;
• The operation takes no more than 20-25 minutes;
• There is no pain syndrome;
• No postoperative scar remains;
• Simultaneously with the enucleation of the formation, coagulation of blood vessels occurs, so the operation is almost bloodless;
• Healthy tissues are preserved as much as possible;
• During the operation, a high level of antiseptic is maintained.

The traditional scalpel is being replaced by an erbium or carbon dioxide laser. The method was tested back in 1964 and still has no analogues.

During manipulation, the laser scalpel destroys the atheroma cavity and evaporates its contents. This circumstance fully protects against the recurrence of cysts, the appearance of relapses. After the operation, the wound is treated with antiseptics, an ointment with regenerating properties is applied. Before removing the cyst on the scalp, it is not required to shave the hair from the operating field, which is another advantage of the manipulation.

Radio wave method for removing atheroma

Radio wave removal of atheroma is carried out by the "Surgitron" apparatus, which converts electric current into a concentrated energy beam. This radio wave knife pushes the neoplasm tissue apart without causing significant damage.

Benefits:

• The operation lasts no more than 15-20 minutes;
• The manipulation is not accompanied by pain and bleeding;
• Tissues remain intact, no need to suture;
• The regeneration process takes 2-3 weeks, no scars remain.

Contraindications to using the method:

• The presence of dental implants, a pacemaker;
• Diabetes;
• Epilepsy;
• Oncological and infectious diseases;
• Somatic pathologies in the acute stage.

Removal of atheroma by electrocoagulation

The use of an electric knife is advisable for the destruction of a small cyst without signs of inflammation.

Stages of the manipulation:

• Local anesthesia is performed.
• The electrode is used to dissect skin tissue and capsules of the neoplasm.
• The contents of the atheroma are squeezed out of the capsule.
• The capsule is removed with a surgical instrument.
• An antiseptic is injected into the operating wound.
• A suture is applied to the incision.
• The wound is closed with a sterile tissue.

The method of electrocoagulation has recently given way to the position of laser surgeons, since, although it guarantees the absence of pain, it often leads to relapses.

Removal of atheroma in the traditional way

Before the operation to remove the cyst, preoperative preparation is carried out - the patient should not drink or eat. The doctor conducts a drug tolerance test for pain relief by the patient's body.

Stages of the operation:

• The skin at the site of the operation is treated with an antiseptic solution, the hair (if any) is shaved off.
• Anesthetic is injected around the atheroma.
• An incision is made along the apex of the cyst.
• Atheroma is excreted with detritus extraction or without opening the capsule. The incision does not exceed 4-5 mm in length.
• The removed tissues are sent for histological examination to exclude the presence of atypical cells.
• The surgical wound is sutured with a cosmetic suture using an absorbable ligature (polysorb, catgut, glycolide-lactide).

The postoperative scar heals completely within 1.5-3 months. With inflammation and the addition of purulent fusion of tissues, the operation is carried out in 2 stages. First, pus and dead tissue are removed, drainage is installed, and then the incision is made a second time to remove the capsule. Such manipulations leave a rough suture that does not heal for a long time.

Consequences of surgery

The main significant consequence of the operation is the formation of a postoperative scar during enucleation using the traditional method. The laser or radio wave method does not require suturing at the end of the manipulation, therefore, no scars are observed after such removal. Other types of complications after such a simple operation are extremely rare.

Possible consequences:

• Local increase in the temperature of the injured area, as a reaction to a violation of the integrity of the epidermis;
• General hyperthermia;
• Swelling of the tissues around the former cyst;
• Accumulation of exudate during enucleation of a cyst of impressive size, drainage or a pressure bandage is used;
• Infection of the operating wound due to non-compliance with sanitary requirements.

To prevent complications, hygienic dressings are performed using antiseptic and regenerating ointments. In 2-3 months, the scar completely disappears, and after the use of a laser or radio knife, it does not appear at all.

Postoperative rehabilitation

All postoperative wound care manipulations are performed on an outpatient basis.

Actions of the medical staff:

• Dressing the suture site, the wound on the scalp is especially carefully treated;
• With inflammation of the incision site, performed when removing a large cyst or festering atheroma, an antiseptic treatment of the scar is performed
• On the 5-7th day after the intervention, the stitches are removed;
• For complete healing of the wound, at least 2 weeks are required, during this period, drugs are used to dissolve the suture, regenerate the skin, and prevent inflammation.

To avoid complications, you need to treat the wound with an antiseptic solution, protect it with a sterile bandage to avoid infection. The wound on the scalp is covered with a clean headdress worn over the bandage. It is forbidden to wet the area of removal of atheroma for 2 days.

The smaller the distance education was and the higher the qualifications of the doctor, the faster the postoperative scar will heal. This process is also directly related to the individual characteristics of the patient, the state of his health.

Possible problems after removal of atheroma

Complete tissue regeneration takes place within 2-3 months after the operation. Atheroma is a benign formation that never turns into a malignant tumor. However, it is better to remove the sebaceous gland cyst, preventing its significant growth, inflammation and suppuration, so that a rough postoperative scar does not remain.

Possible complications:

• Swelling and inflammation of tissues in the area of the operating field due to a violation of the integrity of the epidermis;
• An increase in local body temperature when atheroma is located in places of increased blood supply (groin, scalp, armpits);
• Hematoma - most often occurs during operations on the face, in the eye area, because the vessels in this area are fragile and close to the skin surface, but the hematoma quickly resolves;
• Hyperemia - skin redness that lasts longer than 5-7 days is considered a sign of incipient inflammation;
• Slow healing - observed in case of impaired blood supply, infection;
• Relapse - occurs with incomplete removal of the cyst capsule or with purulent inflammation, when atheroma tissues lose their outlines due to purulent fusion.

If a relapse occurs, you need to do a second operation.

Where are atheroma removal operations performed?

To diagnose a sebaceous cyst, you need to contact a dermatologist or surgeon. Surgical removal of atheroma can be carried out on an outpatient basis, less often in a hospital.

Options for institutions for manipulation:

• Surgical office of the polyclinic;
• Treatment room of the dermatological dispensary;
• A large cosmetology center licensed to carry out such manipulations.

It is forbidden to remove atheroma in beauty salons, hairdressers, not by a doctor, but by a makeup specialist. It is strictly forbidden to squeeze out atheroma yourself at home, because the cyst can become inflamed, then an abscess or phlegmon will appear. Although this formation is always benign, its removal must be carried out under sterile conditions by a qualified specialist.

What does the cost depend on?

In different regions and medical institutions, the prices for atheroma removal differ significantly from each other.

What affects the pricing of the transaction:

• The region of residence of the patient;
• The size of the cyst - the larger the formation, the more expensive its removal, since the operation involves a careful approach and significant time costs;
• Place of localization of atheroma - the abundance of nearby blood vessels requires more meticulous preparation for the operation (face, groin, neck, armpit);
• The condition of the cyst - inflammation and suppuration of the formation complicate the manipulation, since in such conditions drainage, opening and repeated cleaning of the capsule is necessary, which increases the cost of the operation;
• Patient's age - children under 5-7 years old need more complex and expensive anesthesia;
• The patient's health condition - concomitant diseases require a special approach;
• The level and status of the medical institution - state clinics perform most of the procedures free of charge, while private medical centers provide these services on a commercial basis.

What the patient has to pay:

• Doctor's consultation, examination;
• Ultrasound of the cyst;
• Blood tests for HIV, syphilis, sugar levels, clotting indicators;
• Anesthetic tolerance testing;
• Manipulations of the surgeon to remove atheroma (choice of cyst enucleation method, anesthesia, self-procedure, suture);
• Dressings, removal of stitches;
• Consulting on the results of histology.

The operation lasts no longer than 30-40 minutes and belongs to the category of "one-day surgery".

Patient reviews

In most cases, patients leave positive feedback.

Possible claims can be made on the following grounds:

• Postoperative scar formation - the larger the formation, the longer the incision length. If you have to treat an inflamed atheroma, the seam will be even larger. Although the suture material dissolves spontaneously, the localization of atheroma and its size significantly affect the quality of the scar.
• Suture inflammation - in most cases, it occurs due to non-compliance with the rules of wound care, skipping dressings and a follow-up visit to the doctor.
• Relapse of the sebaceous cyst - usually occurs after treatment of an inflamed atheroma, when, due to suppuration, it is difficult to conduct a complete revision of the tissues.

The bulk of reviews are usually written in a positive way, patients reasonably confirm the need for timely treatment of atheroma.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.