Huge Infected Sebaceous Cyst Back Drainage .

This 74 year old man had a huge sebaceous cyst on his back which increased and become extremely tender for last one month. patient given a course of antibiotics but no benefit found.so incision and drainage of pus planned. i usually do these procedures under local anesthesia. 2 % lignocaine with adrenaline is used for field block before pus drain. with a no 11 blade stab incision given over the cyst. pus drained with gentle pressure from surroundings. proper drainage is essential . in inflammed cases the wall starts oozing with sudden decompression which is seen in this video , pus mixed with blood coming out. i put my little finger inside the cavity to ensure all loculi broken with no residual pus inside the cavity. as it is a inflammed cavity with inflammed wall ,complete removal of cyst wall not possible. so i use a scoop to scrape the wall to remove the cyst wall as much as possible. after the procedure i just pack the cavity with betadine soak gauge piece which i remove after 24 hours. then patient needs daily dressing, course of antibiotics . if patient is diabetic ,blood sugar control is essential.