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cybersharque's Comments

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  3 Weeks Ago cybersharque commented on TAKING THE ALIENS OUT OF MY BACK:

  Just outstanding technique. For a cyst to be this tethered and still come out intact testifies to the skill of the physician who performed the procedure. I only wonder whether the MD closed the incision (suturing) or marsupialised it. And the saying is that you should give it a name and a Christian burial, though there are a few cysts on here that the expression is more germane to. Not the biggest cyst, but the best open excision I have seen on this site.
  
  
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  3 Weeks Ago cybersharque commented on Cute Guy with Ugly Leg Abscess:

  We can hope the poor bloke knows to return to the doctor. It's not supposed to be this much of a mess, but then we who have seen lots of wounds unpacked know that already. It's a very pyogenic wound, so I'm going to guess it's probably not Strep A: the infection is survivable. However, if he's not on antibiotics, he needs to start immediately, or the infection will take the leg.
  
  
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  May 22, 2008 cybersharque commented on Supersize Me? Giant Chin zit!:

  Please see a dermatologist before that infection--and it is a glorious staph infection--turns into a septicemia. We can't amputate your head, so the treatment options if this one goes deepare limited. And this is one of the bad ones. If it was located in the fold between your nose and mouth (nasolabial), you'd likely be dead or at least blind by now; this one still has the potential to migrate, and gee, is there any zitociation between this infection and the piercing? Is it just COINCIDENCE that the infection is connected directly to the anatomical space that was punctured for the piercing? (No, there are no coincidences in medicine and this one is loculated and indurated and needs to be treated by a physician).
  
  
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  May 03, 2008 cybersharque commented on Surgical Cyst Removal:

  I was taught that when an intradermal cyst breaks during removal, it's better to irrigate aggressively and close by secondary intention (i.e., don't suture it, pack it and let it heal from the inside out). The patient's skin does not not look like it was preppred with betadine, either. It all adds up to a high probability of post-op infection.
  
  
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  April 25, 2008 cybersharque commented on OHHH WHAT THE HELL!!!! GIANT GIANT GIANT Absess:

  This condition, in which muscle tissue is attacked by bacteria, is not terribly uncommon in the third world. Here's a dose of reality: in most of the world, anesthesia is scarce and expensive, and used only when necessary for the procedure to succeed, such as if you're going to do something intra-abdominal or enter a major joint. For incision and drainage of an infection like this, it's not that unusual for there to be no anesthesia at all, or for anesthesia to be limited to an ice pack compress X 10 minutes before opening the lesion. And it's highly unlikely that this patient will die from this infection.
  
  
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  April 04, 2008 cybersharque commented on Stomach Cyst - Great pus action:

  but it requires breaking up the loculations. An infection this big can develop membranes or septa that stop parts of it from draining. You can squeeze as hard as you like for as long as you like, and these septa will stop the infection from draining. You need to take a small hemostat, close it, insert it into the infection through the hole you made. See the lines on the skin...those are the targets, only on the inside. Get the hemostat as close as you can manage and OPEN THE HEMOSTAT. Oh, this will hurt like a cousinlover. One way to help it to pick up a pack of toothache swabs, the kind that are 20% benzocaine. That's not a typo, this jazz is 20% benzocaine, and you get the swab wet and apply the medication to the infection from the outside going in. Get numb (but not stone numb, because pain is your final warning that you are going too deep) and break up the membranes. Then squeeze again. Recognize that yu will need to repeat the drainage at least once or twice, but this will help resolve it and if you have a scrip for an antibiotice for pity's sake refill it and take a course of it.
  
  
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  March 04, 2008 cybersharque commented on Lipoma Removal:

  It's excision of a lipoma, an abnormal fat tissue. Why is this dumb? Look, when you pop a zit, you're monkeying around with superficial parts of the body. Worst case, you get a skin infection, an MD debrides it, drains the sinuses, gives you antibiotics both topical and systemic, and you get better. Even if the "worst case" is a MRSA infection, because it's in the skin and I and my colleagues can readily incise and excise the mess. In this case, we have a full-thickness incision completely through the skin into deep hypodermic spaces. There was no attempt to establish a sterile field. The patient is not prepped (no betadine-povidone wash, no drapes) and there is no sign that he was closed in layers (if the patient is lucky, the incision and extraction followed the Langur Lines, but that would be just luck 'cos the surgeon certainly did not demarcate the surgical zone). No packing. No suture. No sterile field. Great gracious gehenna, that's a recipe for a mother of a post-op infection with likely septicemia. Yummm, that's a couple of zithts on a noisy surgical ward with an IV drip of Vancomycin or something equally sickening. Blood poisoning, with frank pus circulating in the bloodstream. Common result is that a chunk of pus sticks to a heart valve, a/k/a erosive endocarditis. Oh, goody, that's $100,000 in medical bills to help me pay off my loans. Please don't do this. Go to a cool dermatologist and make sure he lets you stay awake and watch. Popping zits is not smart. Home surgery on deep sub-Q spaces is stupid. Oh, and there's so little blood because, probably, the "surgeon" infiltrated the site using lidocaine with epi. (Obviously there was some anesthesia because the patient is not screaming and writhing in pain, and the lack of blood announces that the anesthetic was "with."
  
  
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  February 25, 2008 cybersharque commented on Giant Boil/Cyst on chicks face!:

  And yes, I'm a PGY2 at an urban medical center and I deal with cutaneous infections regularly. The worst are the ones that people haves messed with, not cleaned out correctly, allowed to turn into mzitive infections, and then they show up and I end up with an examining room that needs to be decontaminated. It would be really instuctive to see followup videos, but scanning the site, I see exactly one (a fellow who aspirated a mzitive cyst but did not excise the infection, leading, unsurprising, to a generalized cellulitis of the face, which CAN kill you.
  
  
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  February 24, 2008 cybersharque commented on Giant Boil/Cyst on chicks face!:

  That's not a boil. It's a pre-auricular cyst. This resulted from an embyonic anomaly in the way the branchial cleft developed. In her case, it did not produce a birth defect but it still was present, and growing and growing and growing. And since the cyst wall was not excised, it will re-fill and be back. Probably infected, too, since it's been opened up to the outside (and it's pretty obvious that the person did not use aseptic technique). Listen, people, zitpopping is a natural and healthy thing to do, really, but you've got to know that not ever poppable lesion in the skin is a wen or comedo that is (reasonably) safe to handle on a DIY basis. Mzitive swellings on the jaw, near the ears or eyes, are rarely suitable for home surgery. If the person who had this done reads this post, I sincerely hope she gets to a physician soon to have this tended to before it turns into the life-threatening intracranial infection that it has the potential to become!
  
  
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  December 26, 2007 cybersharque commented on Merry Christmas!:

  but it looks like a portion of the cyst wall was not delivered, which means the cyst will likely recur. But even more urgently, given the lack of aseptic preparation and closure, this removal probably resulted in a honkin great staph infection. Now when that breaks up, it may take the cyst wall with it, but in the meantime the staph infection is going to call for antibiotics, and let us pray in God's Name that it's not CA-MRSA, because a CA-MRSA infection this involved with the neck can be lethal.
  
  

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