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Post-operative outcomes following the excision of dorsal wrist ganglions with/without the use of Methylene Blue

Suleyman Tas, Rustu Kose, Ahmet Sen, Sabri Balik.




Abstract

Objective: To compare the success and recurrence rates of surgical excision of the dorsal wrist ganglions depending on methylene blue injection usage.
Methods: Dorsal wrist ganglions of a total of 64 patients were excised between the years 2009 and 2014. All procedures were open surgical excisions and were performed under regional intravenous anaesthesia and tourniquet. Patients were randomly allocated to the use of methylene blue during surgery. In group 1 (n=32), 0.2 mL of 1% methylene blue solution was injected into each cyst before excision. In group 2 (n=32), cysts were treated as in group 1, but methylene blue was not utilized. The Chi-square test was employed for statistical analysis.
Results: Patients were followed up for a mean of 2 years. All patients were satisfied with the aesthetic outcomes and status of the scars. In group 1, recurrence was not observed. In five patients of group 2, the cysts ruptured intraoperatively. In these patients, recurrence was observed postoperatively. The difference between the success rates of the two groups was statistically significant (P = 0.02). Methylene blue-related complications were not observed in patients.
Conclusions: The recurrence of cysts is rare after complete excision, particularly when rupture is prevented. Methylene blue injection is useful for ensuring complete excision and, therefore, to prevent recurrence.

Key words: Ganglion cyst, methylene blue, surgical excision, recurrence






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