> Yes, I was told that I would need to get it totally out once things
> settled down.
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> Does the seeping lesson while we are still packing it? Also, will the size
> decrease?
Most likely the size of it, now that it's drained, is due to inflammation
and induration of the surrounding tissue as a result of the infection. That
will decrease pretty rapidly now that the absess is drained and the
infection resolved. That inflamed tissue will seep serum, and it will seep
blood because that inflammed tissue is fragile, and it's painful. Likewise,
that will decrease over the next several days as the inflammation resolves.
The packing is placed for two reasons - 1) to minimize oozing of blood for
the first couple of days after it's drained and 2) to hold the absess cavity
open so that the skin doesn't heal before the cavity is closed. As the
induration and inflammation go down over the next several days there will be
less oozing of blood. The cavity will remain open as the cavity granulates
( http://en.wikipedia.org/wiki/Granulation_tissue ) . That granulation
tissue will be kind of fragile and will ooze serum in modest amounts. At the
point that that granulation tissue forms, there will be no need to pack the
wound. To get to that point will take about 10 days - 2 weeks from time it
was drained. Once that heals and the skin is closed, I would pretty much
ignore it for a long time, until the surrounding tissue is completely
normal.
Complete excision of the cyst can wait until it re-forms (if it does) and
it's margins are readily definable. That will make for a more accurate and
smaller excision. Excision of sebaceous cysts of the back, in the location
you describe, are more difficult because the skin of the upper back is so
thick compared to other parts of the body.
HMc
MZB - 27 May 2007 17:16 GMT
Howard:
Thanks for responding again; you are always so gracious with your time on
this BB.
Still a few questions: The doctor said I could take a shower, so I did. But
even coming out of the shower, it was quite bloody. I am wondering if I
shouldn't forego showering the next few days.
Also, things are still very swollen. I suspect there is still plenty of
cyst material that didn't get squeezed out as it was such a large cyst.
Should that be a concern or will it just eventually come out or get
reabsorbed?
I go tomorrow to have the packing changed. Is it typical to do more
"squeezing of contents" at that time? I suspect the removal and repacking
will be quite painful but won't take long. Am I correct?
You mentioned leaking serum/blood. The leakage seems to be about 75% blood
but surrounding yellowish fluid. I assume that is pus or is that serum?
The appearance is still worrisome. Before the surgery it was the size of a
snall lemon; it is now I would say a large walnut (loosely speaking; it is
diffuse).
I guess I have to keep in mind that the lancing was done just 24 hours ago!
Mel
>> Yes, I was told that I would need to get it totally out once things
>> settled down.
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>
> HMc
Howard McCollister - 27 May 2007 20:11 GMT
> Howard:
>
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>
> Mel
Showering won't hurt the recovery process at all. Cyst contents left behind
will make no difference. Your doctor may make more attempts at getting more
stuff out when he changes the packing, but squeezing would be unnecessarily
painful. Gentle irrigation is all that would be required. Re-packing might
be painful, but there's no point in really trying hard to stuff it in there.
At this point it's just there to keep the cavity open, so putting it in
gently and loosely is all that's necessary and will be far less painful for
you.
Your description sounds like a very typical course so far for this
situation.
HMc
MZB - 27 May 2007 23:03 GMT
Thanks. You are a patient man!!!
Mel
>> Howard:
>>
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>
> HMc
MZB - 28 May 2007 19:07 GMT
I went to see doctor today for the first changing of the wick. He took out
the old wick. He did emphasize that this was a huge cyst/cavity. But he
thinks it is doing well. He says there are now no signs of infection. Some
pink but no red areas.
After removing the wick he did a lot of squeezing trying to get more crap
out. He used forceps too-- it was painful but tolerable. He says he got more
stuff out. He irrigated also and repacked. He says it took six inches of
packing and that's why it looks so swollen to me. It is swollen, but
apparently not nearly as bad as I think (looked walnut-sized this morning).
Next changing of the packing will be Thursday.
I am supposed to leave in 2 weeks and he seems hopeful that by then I'll
only need to change smaller bandages and no wick will be needed.
Mel
>> Howard:
>>
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>
> HMc