SKIN, SOFT-TISSUE MASSES & WOUND CARE
Skin, Soft-Tissue Masses & Wound Care
A lump, cyst or non-healing wound deserves more than a quick guess.
When you discover a new lump or have a wound that simply won't heal, the primary goal is achieving an accurate diagnosis before initiating treatment. Dr. Delgado provides a thorough clinical evaluation of skin and soft-tissue conditions, ensuring that procedures—from minor cyst removals to complex wound debridement—are performed only when clinically appropriate and with a clear understanding of the underlying pathology. Expert care starts with professional assessment.
What brings patients in for evaluation?
I found a lump or bukol.
Most lumps are benign, but any new growth should be evaluated to confirm its nature and decide if removal is needed.
The lump is painful, swollen or draining.
Increasing pain or drainage may indicate an infected cyst or abscess that requires immediate surgical assessment.
My wound is not healing.
A wound that persists for weeks needs a professional review to identify underlying factors preventing recovery.
A new lump
Firm, fixed or deep lumps
When should a lump be checked?
While many soft-tissue lumps are harmless, certain characteristics warrant a professional surgical evaluation.
A lump that is growing
Recurrent lumps
Pain or tenderness
Uncertain diagnosis
Some soft-tissue masses need more careful investigation before removal.
It is important to remember that not all lumps just under the skin should be immediately cut out. Large masses, those located deep within the muscle, or those that are fixed to underlying structures may require imaging or a biopsy before a definitive excision is planned to ensure the safest surgical approach.
LUMPS, CYSTS & SUPERFICIAL LESIONS
Common conditions evaluated
Lipoma
Epidermoid Cyst
A slow-growing, usually painless fatty lump that forms under the skin. While benign, they can grow large enough to become bothersome, unsightly, or uncomfortable.
Often called sebaceous cysts, these are common non-cancerous growths filled with keratin. They can sometimes become inflamed or infected, causing significant pain.
Common reasons for consultation: Bothered by the appearance, growth of the lump, or discomfort from its size.
Common reasons for consultation: Redness, pain, foul-smelling drainage, or a visible lump that is bothersome.
Other Skin & Subcutaneous Lesions
This includes diverse conditions such as dermatofibromas, skin tags, symptomatic moles, or other lumps that require clinical identification.
Common reasons for consultation: Uncertainty of diagnosis or a lesion that is irritated by clothing or movement.
Recurrent Lumps or Masses
Evaluation of lumps that have returned after a previous removal, which may require a different surgical strategy or further investigation.
Common reasons for consultation: Return of a previously treated lump or persistence of symptoms after a prior procedure.
INFECTION
Painful, swollen or draining lumps
A simple cyst or lump can become infected, leading to an abscess—a collection of pus beneath the skin. These often require more than antibiotic treatment alone.
Inflamed lesion
The lump is red and tender but has not yet formed a pocket of pus. This may settle with medical management or lead to an abscess.
Abscess
A localized, painful infection containing pus. Most skin-level abscesses require incision and drainage to heal completely.
More extensive infection
Spreading redness (cellulitis) or systemic symptoms like fever. This needs urgent evaluation to prevent further complications.
Seek urgent medical assessment if an infection is rapidly worsening.
- Redness that is spreading quickly.
- Severe or rapidly increasing pain.
- High fever or chills.
- A feeling of being generally unwell.
Do not wait for a routine clinic schedule. Proceed to the nearest emergency department if these symptoms occur.
MINOR PROCEDURES
When a minor surgical procedure may be appropriate
Not every lump needs removal. However, a procedure may be recommended for diagnosis, to relieve symptoms, or to treat infection.
Excision of Selected Skin & Soft-Tissue Masses
Complete removal of a lump, such as a lipoma or cyst, usually performed under local anesthesia.
Incision & Drainage of Abscesses
Creating a controlled opening to drain pus and allow an infected area to heal.
Skin or Soft-Tissue Biopsy
Removing a small sample of tissue to be sent for pathology to confirm a diagnosis.
Wound Debridement
The removal of non-viable or infected tissue from a wound to promote healing.
Why removed tissue may be sent for pathology
The only way to be 100% certain of what a mass is—and that it has been completely removed—is through microscopic examination by a pathologist.
“Mukhang lipoma” is not the same as a confirmed diagnosis.
Your safety depends on an accurate diagnosis, especially for deeper or growing masses.
WOUND CARE
A wound that does not heal needs more than repeated dressing changes.
Chronic wounds are not just skin problems; they are often the result of underlying medical conditions like diabetes, poor circulation, or constant pressure.
Effective wound care starts by asking why the wound is not healing.
Diabetic Foot Wounds
Ulcers on the feet of patients with diabetes require multi-disciplinary care to prevent infection and amputation.
Common reasons for consultation: Poorly healing foot sores, new redness, or foul odor.
Infected or Non-Healing Wounds
Any wound (sugat) that has been present for more than 4 weeks or shows signs of infection.
Common reasons for consultation: Increasing pain, drainage, or stagnation in healing.
Pressure Injuries / Bedsores
Wounds caused by prolonged pressure on the skin, common in patients who have difficulty moving.
Common reasons for consultation: New skin breakdown, darkening, or deep tissue injury.
Postoperative Wound Concerns
Issues with surgical incisions, including dehiscence (opening) or suspected surgical site infection.
Common reasons for consultation: Redness, warmth, or fluid leaking from a surgical site.
WOUND CARE
A wound that does not heal needs more than repeated dressing changes.
Healing a chronic wound is complex. It requires addressing infection, managing tissue viability, ensuring adequate blood supply, and protecting the site from further pressure or trauma.
Effective wound care starts by asking why the wound is not healing.
Diabetic Foot Wounds
Specialized care for ulcers and non-healing wounds related to diabetes, focusing on infection control and offloading.
Common reasons for consultation: Poorly controlled blood sugar, numbness (neuropathy), or foot deformities.
Infected or Non-Healing Wounds
Evaluation of wounds that show signs of persistent infection, foul odor, or failure to close within the expected timeframe.
Common reasons for consultation: Chronic trauma, underlying vascular issues, or recurring abscesses.
Pressure Injuries / Bedsores
Management of wounds caused by prolonged pressure on bony areas, common in patients with limited mobility.
Common reasons for consultation: Stage 2 to Stage 4 pressure injuries requiring debridement or specialized care.
Postoperative Wound Concerns
Assessment of surgical incisions that have reopened (dehiscence), exhibit redness, or show signs of abnormal healing.
Common reasons for consultation: Fluid collection (seroma), infection, or impaired tissue circulation.
What are we looking for when assessing a wound?
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Is it due to pressure, diabetes, circulation, or trauma?
Cause
2
Does it involve muscle, tendon, or bone?
Depth
3
Is there dead (necrotic) tissue that prevents healing?
Tissue
4
Are there signs of local or spreading infection?
Infection
5
Is blood reaching the area? Is pressure being removed?
Blood supply & pressure
6
How are nutrition, blood sugar, and general health?
Patient factors
Treating the underlying cause is often just as important as choosing the dressing.
What is wound debridement?
Debridement is the removal of dead, damaged, or infected tissue from a wound. These materials often act as a barrier to healing and a breeding ground for bacteria. By carefully removing them, we create a clean wound bed where new, healthy tissue can grow.
Not every wound needs debridement. The decision depends on tissue viability, blood supply, infection, wound location and the patient’s overall condition.
What happens during your consultation?
Examine the problem
A careful inspection of the lump, cyst, or wound, assessing for size, tenderness, depth, and signs of infection.
Review relevant history
Understanding how long the problem has been present, how it has changed, and any related health conditions like diabetes or circulation issues.
Decide if additional tests are needed
Determining whether an ultrasound, biopsy, blood tests, or vascular studies are necessary to clarify the diagnosis.
Develop a treatment plan
Discussing whether to observe, change wound care protocols, perform a minor procedure, or schedule a formal operation.
The goal is appropriate treatment—not performing a procedure simply because one is available.
Preparing for your consultation
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Reports or actual copies (on disc/link) of prior ultrasounds, CT scans, or biopsies.
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A current list of your medications, including blood thinners.
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Knowledge of when your symptoms started and how they have changed.
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For wounds: information on what dressings or treatments are currently being used.
Important: Do not delay consultation for a rapidly worsening infection or painful wound simply to gather these documents.