Removal of hygrom

Hygroma is a benign cystic tumor. It consists of a dense wall, which is formed by connective tissue, and inside there is a viscous content that looks like a transparent jelly with a yellowish tint. It is actually a serous fluid that also contains fibrin and mucus.

Hygromas are always located next to the joints: wrist or ankle. Also, formations can occur on the fingers and on the feet. Depending on where exactly the hygroma is located, it can be either soft or bone-like to the touch. The diameter of the neoplasm can be from 5 millimeters to 6 centimeters.

Despite the fact that the hygroma is a benign tumor, it has a high recurrence.

Anatomy and causes of hygroma formation

To date, doctors have not come to an unambiguous opinion about the reason why hygromas appear. So, according to the most common theory, the root cause of the occurrence of such cysts is the process of metaplasia (rebirth) in the cells of the connective tissue. As a result, two types of cells are formed: spindle-shaped, from which the capsule is formed, and spherical. The latter are filled with fluid, which then pours into the intercellular space.

It is noteworthy that in women the disease is diagnosed three times more often than in the representatives of the stronger sex. In this case, most often hygromas develop in patients aged twenty to thirty years. Scientists have also been able to establish that there is a hereditary predisposition – in other words, blood relatives often suffer from this disease. Some researchers claim that the cause of hygroma may be a constant significant load on the tendon or joint, as well as a single injury.

Symptoms and manifestations

As a rule, in most cases, hygroma is an almost asymptomatic disease. It does not cause any special inconveniences, except for aesthetic ones, in patients.

The disease begins with a slight swelling over the joint area. Its distinguishing characteristic is a clear delimitation from the surrounding tissues. The skin over the neoplasm can move freely. As a rule, hygromas are single, but sometimes several formations can occur on the same joint.

Hygroma can grow both very slowly, almost imperceptibly, and rapidly. It should be noted that when the tumor begins to grow in size, it inevitably causes compression of the tendons and nerve-blood bundles. In addition, the functioning of the joint is disrupted.

Often patients are interested in whether the hygroma provokes pain. As a rule, patients feel pain of varying intensity if the tumor is located next to the nerves. Pain can be either constant, not too pronounced, or radiating. Sometimes discomfort can appear only after intense exercise. Also, sometimes the hygroma slightly increases after active movement and decreases in size at rest.

As for the skin over the formation, it can both remain unchanged and coarsen. In some cases, peeling is noted, the skin becomes reddish.

Indications for removal of hygroma

To date, the most effective way to get rid of hygroma is surgery. In the event that the procedure is performed by an experienced surgeon, the risk of recurrence is significantly reduced.

As a rule, physicians decide that the formation should be removed if it begins to rapidly increase in size. Also, an indication for removal is constant pain, which manifests itself both during movement and at rest. In addition, the neoplasm is removed if it compresses the nerves, as a result of which there is a violation of innervation.

Removal has to be resorted to if the hygroma disrupts the normal functioning of the joint or suppuration of the tumor occurs. The reason for surgical intervention is also the likelihood of spontaneous rupture of the formation and its unaesthetic appearance.

Preparatory period and contraindications

Before surgery, it is mandatory to conduct examinations that will help establish an accurate diagnosis. In other words, the surgeon must be XNUMX% sure that he is faced with a hygroma, and not with any other formation. To do this, the doctor conducts a thorough examination of the patient. Its first step is palpation. By probing the tumor, the doctor determines its approximate size and draws a conclusion as to whether there are any signs of an inflammatory process.

This is followed by an ultrasound. With its help, you can estimate the exact size of the neoplasm, draw a conclusion about its structure. The study also helps determine if blood vessels have grown into the cyst.

Magnetic resonance therapy is prescribed if the ultrasound was not informative enough and the doctor has any doubts.

To exclude the possibility of a malignant nature of the tumor, a puncture is performed. A biopsy is also done if an inflammatory process is present. In this case, a bacteriological culture of the biopsy specimen is carried out on a nutrient medium to determine which antibiotics to use in therapy.

In the event that the diagnosis of hygroma is finally confirmed, the patient is sent for preoperative examinations. As a rule, we are talking about the usual set of analyzes and examinations. These are general tests, blood biochemistry, blood for viral hepatitis, HIV and syphilis, ECG and fluorography.

As a rule, the patient does not need any special preparation before the operation. The only condition is that it is necessary to choose a period when the patient can reduce the workload without negative consequences – at least for several weeks after the operation, the joint will have to be protected.

Like any other surgical intervention, the removal of hygroma has its own contraindications. The operation is not performed on patients who have recently suffered acute infectious diseases. Also, surgical removal of the neoplasm is contraindicated in case of problems with blood clotting. In addition, hygromas are not removed for women in an “interesting” position.

How to remove hygroma

The question of how exactly the hygroma is removed worries many patients. At the moment, the operation to remove this neoplasm can be carried out in one of three ways. The first is excision, when the surgeon completely cuts out the formation along with the capsule.

The second way is to use a laser beam. In this case, only cells that have mutated are exposed to the laser. Healthy tissues are not affected by the laser.

Finally, the operation can be performed endoscopically, using special equipment that is inserted through small incisions.

Hygroma removal is an operation that requires high skill from the surgeon, since the neoplasm is located in close proximity to the joints, nerves and tendons. Moreover, the removal operation includes several stages, since a hygroma is a hernia, in other words, a protrusion on the synovial bag, which eventually develops into a cyst. Therefore, the surgeon is faced with the task of removing the cyst body itself, as well as the isthmus, after which the synovial bag must be sutured to its original size.

The most difficult is the removal of a hygroma located on the wrist joint. The wrist is a collection of blood vessels, ligaments, joints and nerves, and therefore only specialists in hand microsurgery, and not general surgeons, should remove the hygroma in this area. The second most difficult is the removal of foot hygroma.

Surgery is performed under local anesthesia. Sometimes general anesthesia is used – however, only in cases where the operation is long and complicated. As a rule, the procedure lasts no more than half an hour. Small lesions are removed on an outpatient basis.

The operation to remove the hygroma consists of the following steps:

1. A rubber tourniquet is applied to the limb and an anesthetic is infiltrated at the site of the future incision and along the contour of the formation.
2. The doctor makes an incision in the skin over the tumor and punctures to remove fluid.
3. The surgeon carefully separates the hygroma from the surrounding tissues. It is not enough to remove only the upper part of the formation, which is the easiest to reach. In this case, a significant part of its shell remains in the depths of the tissues, which will lead to the fact that a few months after the operation, fluid will again begin to collect in the hygroma. That is why it is so important to highlight the entire shell of the formation, to the places where its base connects to the joint.
4. The doctor performs excision of the protrusion and sutures the synovial bag.
5. The surgeon sutures the wound, applies a tight bandage and fixes the joint with an orthosis or splint.

If the patient is in pain, the doctor may prescribe pain medication. Dressings are carried out every day. If there is a threat of the development of the inflammatory process, antibiotics are prescribed.

As a rule, the stitches are removed one week after surgery, and the fixing bandage is removed after fourteen days.

Laser hygroma removal

Removing a hygroma with a laser resembles a conventional surgical intervention. The only difference is the method that is used to cut the tissues. A laser beam is used instead of a scalpel.

There is an erroneous opinion that a hygroma is removed with a laser without the help of an incision, and no scars remain. Actually it is not. However, with laser removal, the likelihood of bleeding is reduced, and infection of the wound does not occur.

During laser removal, the tissue above the hygroma is dissected, after which the hernia is separated as carefully as possible so that the fluid contained in it does not enter the surrounding tissues. After the operation, the wound is sutured and bandaged. The bandage is changed every day, and the suture is removed after about a week and a half.

Another method of laser surgery is also sometimes used. The tumor is punctured with two needles, after which a laser light guide is inserted through one of them, with the help of which the hygroma capsule is burned from the inside. The liquid is aspirated with the help of the second needle. The procedure ends with the application of a pressure bandage.

If we talk about the advantages of laser removal, then this is, first of all, a reduction in the duration of the surgical intervention, a decrease in pain, and the absence of bleeding due to the fact that small vessels are immediately coagulated by the laser beam itself. Also, the seam after the operation is very thin and less noticeable.

In this case, however, it must be taken into account that with traditional surgical excision of the hygroma, the number of relapses is much less than with the use of a laser. This is due to the fact that laser removal does not involve suturing the gate of the formation – in other words, the place where it connects to the joint.

Features of removal of hygroma depending on localization

Depending on where exactly the hygroma is located, its removal has a number of features.

Hygroma brush

A cyst on the arm, as a rule, forms on the back of the wrist joint. It can also appear on the side of the palm or in the area of ​​uXNUMXbuXNUMXbthe joints of the fingers. Such cysts are considered an occupational disease of people who constantly strain their hands – for example, secretaries and violinists. Also, the number of such hygromas has increased significantly in recent years due to the fact that people spend a lot of time at computers.

Removal of hygroma in the wrist joint is carried out very carefully due to the fact that there are two neurovascular bundles. That is why such an intervention should be carried out by a very highly qualified surgeon.

Hygroma of the finger

Features of the formation of this type depend on where exactly the cyst is located – on the back or on the palmar side of the finger. As a rule, on the back side, it usually occurs either at the base of the phalanges, or at the interphalangeal joints. The skin over such formations becomes thinner and stretched. In this case, pain is absent. If the cysts are on the palmar surface of the fingers, then they can spread to several phalanges. Also, since there are more nerve fibers in the tissues of the palmar surface of the fingers, the patient may experience severe pain.

Very rarely, hygromas form at the base of the fingers. They are much smaller in diameter, only up to 0,5 centimeters, however, when pressing on the formation, extremely unpleasant sensations arise.

Removal of hygroma of the wrist joint

Often, patients live with a hygroma of the wrist joint on the palmar side for several years, and the neoplasm does not bother the patient. However, if the tumor begins to grow in size, if it causes numbness of the fingers and tingling, it is necessary to resort to surgical intervention.

Since the hygroma is located next to the radial artery, the surgeon who will perform the surgery requires high accuracy and professionalism so as not to disrupt the blood circulation process.

Hygroma of the wrist joint is removed either under local or general anesthesia. Some physicians are supporters of general anesthesia, because during the intervention, deep tissues are touched in order to completely excise the capsule.

Removal of hygroma of the ankle and foot

Neoplasms on the lower extremity are usually located on the ankle joint or on the foot. As a rule, it is the formations on the foot that are the most painful and most traumatized due to the fact that shoes can rub the skin. In addition, the weight of the whole body presses on the hygroma. As a result, patients experience severe discomfort when walking. Due to constant injury, the capsule of the hygroma located on the foot can burst, which is fraught with an inflammatory process and suppuration.

After removing the hygroma on the leg, the patient will have to move on crutches for at least a week and a half.

Removal of hygroma in a child

As noted above, cysts are most often diagnosed in young people between the ages of twenty and thirty. However, sometimes hygromas are diagnosed in children. It should be noted that often the occurrence of neoplasms in the ankle joint is provoked by classes in sports sections and dance clubs, during which children are injured or experience serious stress.

If a hygroma is suspected, the child is referred to an orthopedic surgeon, x-rays and ultrasound are performed. Based on the results of the tests, the doctor decides whether a conservative or operative method will be used.

The direction for removal is issued if the formation is rapidly increasing in size, the child experiences pain not only when moving, but also at rest, complains of numbness of the limb and limitation of its mobility. Hygroma is also removed if conservative treatment does not bring a positive result.

Babies who have not yet reached the age of ten, the operation is performed under general anesthesia. If the child is already ten years old, the doctor focuses on individual indications and performs the intervention either under general or local anesthesia. The sequence of surgery to remove a cyst in a child is the same as in adults. When the neoplasm is removed, a tight bandage, orthosis, or elastic splint is applied to limit the mobility of the injured limb.

The most gentle option for a small patient is the removal of hygroma using an endoscope or laser.

Postoperative period

As a rule, after the operation, the patient leaves the medical facility on the first day. However, he will have to come in for dressings and removal of stitches.

Despite the fact that the operation to remove the hygroma is not considered too complicated, it will take a certain amount of time to recover. Immediately after the intervention, a splint is applied to the injured area – a removable plaster bandage. It does not interfere with dressings and wound treatment, but at the same time securely fixes the joint. The longet is removed after about a month, depending on where exactly the hygroma was located and how difficult the surgical intervention was. However, even after removing the plaster cast, the load on the joint should be limited as much as possible.

In some cases, after removing the cyst, doctors prescribe physiotherapy exercises and physiotherapy: warming up, electrophoresis, magnetic therapy. All this will help in restoring joint mobility. Full rehabilitation depends on how carefully the patient follows the recommendations of the attending physician and whether any complications arise after the operation.

Complications and relapses

Despite the fact that the removal of a hygroma is considered a relatively minor surgical intervention, complications can occur in some cases. So, an infection can get into the wound, which is the cause of the inflammatory process and suppuration. With insufficient qualifications, the doctor can damage the artery, which is fraught with the development of bleeding, or the nerve, which leads to a violation of innervation.

Separately, it is worth mentioning the possibility of relapse after removal of the hygroma. According to statistics, the disease develops again in thirty percent of cases. Doctors have identified the main causes that can provoke a relapse of the disease. This, for example, is a weakness of the connective tissue. In addition, the reappearance of a cyst can provoke non-compliance with the regimen after surgery or the patient’s return to the activity that led to the onset of hygroma.

Also, the cause of recurrence may be insufficiently performed surgical intervention. For example, the surgeon may leave particles of the hygroma capsule or not suture the so-called fistula – the place where the hygroma connects to the joint capsule. In most cases, relapse of the disease leads to repeated surgical intervention.

Hygroma removal without surgery

Many people are afraid of the prospect of surgery, so they seek to learn how to remove the hygroma without surgery. In some cases, removal of a cyst without surgical intervention is indeed possible, but one should not self-diagnose and start fighting the disease.

First of all, it is necessary to carry out diagnostics – X-ray and puncture. These studies will make it possible to exclude the possibility that another type of tumor, which may be malignant, is “disguised” as a hygroma. During the puncture, doctors pump out the contents of the cyst and send it to the laboratory for biochemical analysis. Based on the results of the study, the doctor determines the type of treatment that is suitable in each case.

If we talk about ways to remove hygroma without the use of surgical procedures, then there are at least five of them. These are physiotherapy, mechanical method, puncture, drug and / or homeopathic treatment, as well as the use of traditional medicine.

Physiotherapy

Physiotherapeutic procedures are indicated exclusively for the treatment of small hygromas. They are also used only in cases where there is no inflammatory process in the affected joint.

So, UHF can be used for deep heating. The procedure stimulates regeneration processes and has an anti-inflammatory effect, as well as improves blood flow. Ultrasound treatment has a relaxing effect on the muscles, stimulates microcirculation and enriches tissues with oxygen, and also stimulates regeneration processes. Magnetotherapy has an anti-inflammatory effect and stops similar processes in bone and cartilage tissue. Paraffin wraps relieve swelling and help stop the inflammatory process. Finally, salt and soda baths help restore joint mobility.

During the course of physiotherapy, a tight bandage should be applied to the affected joint, and one should also strive to limit the load on the affected joint.

Crushing (mechanical method)

Crushing the hygroma is the so-called “grandfather” method. Previously, it was used everywhere, but now only an elderly surgeon can recommend such a procedure.

The essence of this method is that the cyst is strongly pressed, as a result of which the shell bursts, and the liquid is poured into the surrounding tissues. Adherents of this method rest on the fact that the contents of the hygroma are sterile, and therefore the liquid is absorbed on its own. However, the problem is that sometimes such a method can provoke the development of inflammation, suppuration and abscess.

Carrying out a puncture

Puncture is a transitional link between conservative and surgical treatment of hygroma. It should be borne in mind that this method is not able to get rid of the cyst once and for all, however, it leads to the temporary disappearance of the tumor.

The essence of the puncture is that the neoplasm is pierced with a needle and the contents are sucked out of it. Drugs are introduced into the cavity that prevent the re-accumulation of the contents.

However, the fact is that the cyst shell remains in place, therefore, over time, a relapse will still occur.

The procedure is carried out very quickly and is not too painful. The doctor treats the skin over the hygroma with an antiseptic, after which he fixes the cyst with one hand, and pierces it with the other at an angle of thirty degrees. After that, the liquid is sucked off until the bulge under the skin completely disappears.

It should be noted that the puncture itself is an excellent diagnostic technique. If the fluid that the doctor pumped out of the cyst contains blood or pus, doctors make adjustments to the further course of treatment.

Medication

Treatment of hygroma with medication is indicated in cases where compression of the tissues around the cyst has led to the development of an inflammatory process. In this case, the doctor prescribes treatment based on the type of inflammation encountered.

So, medications are used to treat aseptic (non-purulent) inflammation. Doctors recommend using non-steroidal anti-inflammatory drugs, for example, Nimesil or Diclofenac. The use of antihistamines has also been shown.

It should be borne in mind that non-steroidal anti-inflammatory drugs should be taken with caution if the patient has been diagnosed with disorders in the liver and kidneys. Also, when using them, adverse reactions often develop, which should be the reason for stopping the intake and an immediate visit to the doctor.

Often used as homeopathic remedies – preparations of plant origin. This option for non-surgical removal of hygroma is suitable for those who suffer from allergies or individual intolerance to medications.

If the doctor diagnoses purulent inflammation, then only surgery can help. In this case, even taking antibiotics will not help, because they simply cannot cope with the rapid growth of bacteria.

Folk methods

The use of traditional medicine recipes to remove hygroma remains invariably popular and in demand. Some of these tools work really well. However, before starting such therapy, it should be borne in mind that treatment with these methods can last for years. In addition, you need to have considerable patience in order to keep compresses for several hours in a row.

It is also necessary to take into account the fact that even the seemingly safest means for removing hygroma without surgery should be used with the utmost care, monitoring the reaction of the body. Also, before starting such therapy, be sure to consult your doctor.

One of the most popular folk remedies for the treatment of hygroma is Dimexide, which is used for compresses. Despite the fact that this is a means of industrial production, this method of getting rid of a cyst can be considered folk, because it has not received the “official blessing” of doctors. It should be borne in mind that with the help of Dimexide, you can get rid of a hygroma of only a small size and very soft in structure. It will not help to remove formations of large diameter and dense ones.

If we talk about truly folk remedies, then we will give only a few of them that have proven themselves quite well.

So, a popular method of treating hygroma is a red clay compress. Dissolve two teaspoons of salt in 100 g of water, then add red clay powder purchased at the pharmacy. The finished product should have the consistency of a fairly thick slurry. Put it on the hygroma and cover with several layers of bandage. Moisten dried clay directly through the bandage. Keep this compress for a day, then take a break for two hours and repeat.

Another way is to treat with cabbage juice. Pass the cabbage leaves through a meat grinder, then squeeze the juice. It is necessary to drink it twice a day before meals, 100 ml each. At the same time, a cabbage leaf smeared with honey should be applied to the diseased area itself and wrapped with a warm scarf.

Also used are compresses from bitter wormwood juice, alcohol lotions, blue clay compresses.