Successful Excision of Infected Left Thigh Sebaceous Cyst with Concurrent Otitis Externa Care in 37-Y.O Female
PACE Hospitals’ expert Plastic and Reconstructive Surgery team successfully performed Incision and Drainage along with Excision of a Cyst on a 37-year-old female patient who presented with pain and swelling over the left upper lateral thigh for one week, along with a six-month history of gradually increasing swelling in the same area. There was no history of trauma, pus discharge, or fever. The procedure was performed to relieve pain, evacuate any underlying fluid collection, completely remove the cyst, and prevent recurrence, thereby restoring the normal structure and function of the affected area.
Chief Complaints
A 37-year-old female patient with a
body mass index (BMI) of 22 presented to the Plastic and Reconstructive Surgery Department at
PACE Hospitals, Hitech City, Hyderabad, with complaints of pain and swelling over the left upper lateral thigh for the past one week. She had a six-month history of gradually increasing swelling in the same area, with no history of trauma, pus discharge, or fever.
Past Medical History
The patient had no known history of hypertension or diabetes. The absence of comorbid conditions was considered clinically favorable, as it had minimized the risk of intraoperative and postoperative complications and had supported a smoother, more stable recovery in this case.
On Examination
On general examination, the patient was conscious, coherent, and cooperative. There were no signs of pallor, icterus, cyanosis, lymphadenopathy, clubbing, or pedal edema. Vital signs were stable, with normal pulse rate, blood pressure, temperature, and oxygen saturation on room air.
Diagnosis
Following the clinical examination, the Plastic and Reconstructive Surgery team conducted a thorough assessment, including a detailed review of the patient’s medical history and a focused evaluation of the left upper lateral thigh.
To confirm the diagnosis and assess the extent of the swelling on the left upper lateral thigh, a thorough clinical examination was performed. The findings were consistent with cystic swelling with signs of infection.
Based on the confirmed diagnosis, the patient was advised to undergo
Sebaceous Cyst Treatment in Hyderabad, India, under the care of the Plastic and Reconstructive Surgery team to restore the normal contour and function of the affected area and prevent recurrence.
Medical Decision Making
After a detailed consultation with Dr. Kantamneni Lakshmi, Senior Consultant Plastic, Reconstructive & Aesthetic Surgeon and cross-consultation with Dr. Shwetha Anand, ENT Surgeon & Allergy Specialist, in view of right ear pain, a comprehensive assessment was conducted to determine the most appropriate diagnostic and therapeutic approach for the patient. The surgical team performed a thorough review of the patient's medical history and a focused physical examination of the left upper lateral thigh swelling. Clinical evaluation confirmed the diagnosis of an infected sebaceous cyst requiring surgical intervention.
It was determined that the patient had an infected sebaceous cyst causing pain and swelling, with no systemic signs of infection. Incision and drainage combined with complete excision of the cyst was identified as the most effective intervention to evacuate pus, remove the cyst entirely, and prevent recurrence while promoting optimal healing.
The patient was thoroughly counselled regarding the severity of the condition, the surgical procedure planned under short general anaesthesia, potential risks, postoperative care, and the importance of adherence to follow-up for wound care and monitoring.
Surgical Procedure
Following the decision, the patient was scheduled to undergo Incision and Drainage and Excision of a Cyst in Hyderabad at PACE Hospitals under the supervision of the expert Plastic and Reconstructive Surgery Department.
The following steps were carried out during the procedure:
- Anesthesia and Preparation: The patient was administered short general anesthesia. Under strict aseptic conditions, the left upper lateral thigh area was painted with antiseptic solution (betadine) and draped to maintain a sterile field.
- Incision and Exposure: A careful incision was made directly over the swelling on the left thigh to access the cyst. The incision allowed drainage of pus accumulated within the cyst.
- Cyst Removal: The cyst cavity was fully opened, and the cyst was meticulously dissected and excised in toto, including the punctum (the cyst's opening or stalk), to prevent recurrence.
- Wound Cleaning and Hemostasis: The surgical site was thoroughly irrigated with betadine solution to cleanse the area and reduce infection risk. Hemostasis was achieved using appropriate measures to control any bleeding.
- Closure and Dressing: The wound was closed in layers using 4-0 Monocryl sutures for optimal healing and minimal scarring. Finally, an aseptic dressing was applied to protect the surgical site.
Postoperative Care
The postoperative period was stable and uneventful. The patient received intravenous antibiotics, analgesics, and gastric acid suppressants. An ENT consultation was obtained for right ear pain, and the patient was diagnosed with right otitis externa (inflammation of the ear canal). Treatment included local ear care with wick insertion, antibiotic ear drops, and oral anti-inflammatory medication. Wound hygiene was maintained with aseptic dressings, and the patient tolerated oral intake well. She was discharged in stable condition with appropriate follow-up instructions.
Discharge Medications
At the time of discharge, the patient was prescribed oral broad-spectrum antibiotics for infection control, oral analgesics and anti-inflammatory medications for pain relief and inflammation reduction, and gastric acid suppressants to protect the stomach lining during treatment. Additionally, topical antibiotic ear drops were prescribed for the management of right ear infection (otitis externa).
Advice on Discharge
The patient was advised to have the glycerine wick changed on alternate days and to maintain proper wound care. A normal diet was recommended.
Emergency Care
The patient was informed to contact the emergency ward at PACE Hospitals in the event of any emergency or the development of symptoms such as fever, ear pain, vomiting, swelling, pain at the surgical site, or signs of allergic reaction.
Review and Follow-up Notes
The patient was advised to return for a follow-up consultation with a Consultant Plastic, Reconstructive & Aesthetic Surgeon in Hyderabad at PACE Hospitals two days after discharge for wound evaluation and dressing change, with a prior appointment. Additionally, a follow-up consultation was scheduled with the ENT Surgeon, after two days, for further evaluation.
Conclusion
This case highlights the successful surgical management of an infected sebaceous cyst on the left upper lateral thigh through incision, drainage, and excision. Multidisciplinary care ensured comprehensive treatment, including management of concurrent ear infection. The patient recovered well and was discharged in stable condition with planned follow-up.
Comprehensive Infection Control in Cyst Excision Procedures
The presence of localized swelling, pain, and pus discharge in this case indicated an active soft tissue infection secondary to an underlying sebaceous cyst. Prompt surgical intervention with incision, drainage, and complete excision of the cyst, including the punctum, was essential to prevent further spread of infection and recurrence. The
Plastic surgeon / Plastic surgery doctor ensured effective infection control through complete cyst removal, aseptic surgical technique, and the use of perioperative antibiotics. Additionally, ENT evaluation addressed a concurrent ear infection, highlighting the importance of multidisciplinary care in managing coexisting infections. Close follow-up and wound care were emphasized to support optimal healing and minimize the risk of complications.
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