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| |  Suture Treatment Provide Good Outcomes for Ganglion Cysts: Presented at AAP By Nora Steiner Mealy SAN FRANCISCO, CA -- October 29, 2007 -- A simple, outpatient treatment using a suture was found to be safe and effective for treating ganglion cysts, according to investigators who presented their study here at the American Academy of Pediatrics National Conference and Exhibition (AAP). Using sterile technique, the procedure involves passing a 2-0 vicryl suture on a small cutting needle through the ganglion. The needle is cut off and the suture pulled back and forth multiple times to release ganglion fluid onto the suture. The ganglion is then massaged to decompress the remaining contents. The suture is left in place as a drain and to cause a low-grade inflammatory reaction that may scar the cyst walls and minimise recurrence. A sterile compression dressing is placed over the suture followed by a plaster splint. The splint, dressing, and suture are removed after 1 week. The study findings were presented by Samantha Patil, premedical student, Department of Surgery, University of California at Berkeley, who participated in the study at Valley Children's Hospital in Madera, California, United States. Patil conducted the study with principal investigator William Hennrikus, MD, Orthopaedic Surgeon, Valley Children's Hospital. The study involved 16 children who were treated for ganglion cysts with the suture technique and were followed for 6 to 24 months. One patient (6%) had a ganglion cyst recurrence during the followup period. This patient subsequently underwent a second suture treatment, and the ganglion did not recur. Two patients had cyst recurrences following previous treatments -- one with surgical excision and one with simple aspiration. Patil noted that other treatments for ganglion cysts--including open surgical excision, arthroscopic excision, aspiration, aspiration and injection, herbal lotions, and crushing the ganglion with a bible -- tend to have higher recurrence rates. The suture technique requires no anaesthetic, although two of the patients were given oral midazolam to reduce the anxiety before the procedure. Patients varied in age from 6 months to 17 years, with the average age being 12 years. Ganglion size ranged from 1 cm to 2.5 cm. The two largest ganglions were treated with two sutures. Other than the single recurrence, no complications -- including infection, scarring, loss of motion, tendon or nerve injury, or keloid formation -- were noted. Dr. Hennrikus commented, "This procedure can be performed in the office, is inexpensive, involves minimal risk, and can be repeated if the ganglions recur. It is well accepted by patients and parents."
[Presentation title: Suture Treatment of Ganglion Cysts. Abstract Number 232]
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