Surgical Treatment of Digital Mucous Cysts with Autografting of the Overlying Skin: A Retrospective Observational Study of 29 Cases.

Abstract

Introduction: Digital mucous cysts (DMCs) are benign lesions commonly involving the distal interphalangeal joint and proximal nail folds. Although recurrence is common, surgical excision remains the most effective treatment. This study assessed the recurrence rate of DMCs following surgical excision with autografting of the overlying skin.

Methods: This was a retrospective, observational, and descriptive study based on photographic and medical record review of 29 patients treated between 2008 and 2024, with a minimum follow-up of 6 months and a mean follow-up of 74.4 months. The surgical procedure involved excision of the DMC, autografting of the overlying skin, and application of Brown's dressing for 10 days to ensure sustained local pressure. Recurrence was defined as clinical reappearance of the cyst.

Results: The cohort had a mean age of 61 years, with 89.7% being female. The recurrence rate was 6.9% (2/29), with both recurrences occurring early (at 3 and 10 months). Notably, no recurrences were observed in toe lesions, despite their high proportion (12/29 cases).

Conclusion: Surgical excision followed by autografting of the overlying skin and application of Brown's dressing resulted in a low recurrence rate. Sustained local pressure appears to promote fibrosis, contributing to long-term cyst resolution.