Abstract
Punch incision is an alternative to elliptical excision for treating epidermal inclusion cysts, but its efficacy has not been systematically reviewed. This study assessed the efficacy and safety of punch incision versus elliptical excision for epidermal inclusion cysts. Randomized controlled trials published through January 2021 that evaluated the performance of punch incision versus elliptical excision on epidermal inclusion cysts were identified through electronic databases and clinical registries. Version 2 of the Cochrane risk-of-bias tool for randomized trials tool was used. Review Manager software was used for the meta-analysis. Two trials (100 participants) were identified. The primary outcomes were recurrence rate (risk ratio, 2.40; 95% confidence interval [CI], 0.37–15.60 [favoring elliptical excision]), mean operative time (mean difference [MD], −5.28; 95% CI, −12.72 to 2.16 [favoring punch incision]), and mean postoperative wound length (MD, −11.67; 95% CI, −20.59 to −2.76 [favoring punch incision]). The evidence was low to moderate due to the small sample size and its considerable heterogeneity. The use of punch incision shortened the mean postoperative wound length and had comparable safety to that of elliptical excision.
Highlights
Epidermal inclusion cysts (EICs) are common cysts that are 0.3–9 cm in diameter, contain keratin, and are undercoated by the true epidermis [1]
The use of punch incision may make litt5le to no difference in outcomes as follows: relative risk (RR), 2.40; 95% confidence interval (CI), 0.37–15.60; I2 = 0%; low certainty of evidence (Figure 2)
The present study meta-analyzed the differences between punch incision and elliptical excision in EICs and showed that punch incision shortened the mean postoperative wound length and had comparable safety
Summary
Epidermal inclusion cysts (EICs) are common cysts that are 0.3–9 cm in diameter, contain keratin, and are undercoated by the true epidermis [1]. Patients with EICs often require cyst removal due to increasing size, poor appearance, foul-smelling discharge, or pain. Elliptical excision and manual blunt dissection of the cyst wall is most commonly used to achieve complete excision for cleaning up such lesions [3], the procedure often results in a longer scar than certain less invasive techniques [4]. Punch incision is an alternative to elliptical excision for the removal of EICs. Punch incision features a shorter scar and shorter healing time, but the efficacy of the two procedures has never been systematically reviewed and analyzed. Provide an explicit statement of the Objectives objective(s) or question(s) the review addresses. Registers, websites, organisations, reference lists and other. Information sources sources searched or consulted to identify studies. Specify the date when each source was last searched or consulted. Provide an explicit statement of the main objective(s) or question(s) the review addresses
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