Comparison of the Surgical Outcomes of Minimal Excision and Elliptical Excision Techniques in Treating Epidermal Inclusion Cysts: A Prospective Randomized Study

[Background]Epidermal cysts are mostly benign tumors with a dome-like appearance usually observed in the body, behind the ears, and in the cervical area.[Objectives]The study aimed to compare the surgical results of minimal excision and elliptical excision techniques in the surgical management of epidermal cysts.[Methods]In a 24-month period, from 2012 to 2015, 356 patients with benign, non-infected epidermal cysts were surgically managed with minimal excision (n = 178) or elliptical excision (n = 178) techniques. Patient information, volume and place of the lesion, the length of the wound, the time of surgical procedure, and recurrence rate were evaluated using SPSS software at a significance level of < 0.05.[Results]The mean length of the wounds in the minimal excision and elliptical excision groups was 2.3 ± 0.32 and 2.7 ± 0.11 cm, respectively (P = 0.001). The mean operative time was significantly shorter in the minimal excision technique (6.4 ± 2.09 minutes) than in the elliptical excision technique (11.3 ± 3.35 minutes) (P = 0.001). There was no significant difference in the recurrence rate in minimal excision technique (2.8 %) than in elliptical excision technique (3.3%) (P = 0.065).[Conclusions]Minimal excision produced a superior cosmetic result. Epidermal inclusion cysts measuring less than 3 cm that were observed on the head or cosmetically important zones were optimally managed with the minimal excision technique.