Traditionally, it is believed that surgery is not advisable during the acute infection period of body surface masses, and anti-infection treatment is mostly advocated in the early stage of abscess formation, and then surgery is performed at a later stage after the inflammation subsides or abscess incision and drainage treatment is performed after abscess formation; however, for sebaceous cyst infection in the back, which is called “hitching back” in Chinese medicine, traditional anti-infection treatment is often ineffective. However, in sebaceous cyst infection of the back, also known as “hitchback” in Chinese medicine, traditional anti-infection treatment is often not effective, and it takes a long time to wait from the acute inflammation period to abscess formation, and because of the thick skin of the back of the shoulder, even a small amount of pus in the early stage is difficult to detect, and the patient shows obvious pain, and the extent of skin redness and swelling will gradually increase, followed by possible fever. Recently, against the conventional experience, we performed a case of “hitchback” excision in the acute infection stage with satisfactory results. After the inflammation and edema subsided, the original suture was loosened, the Prolene suture was tightened, and the Prolene suture was ligated with a fine thread. If a contaminated trauma incision can be considered for one-stage closure within 6 hours of debridement, why can’t an inflammatory mass be excised for one-stage closure? It is on the basis of this thinking that we venture to do so, and practice proves that one-stage suturing is feasible, which of course requires more clinical practice to increase the convincing power. Some people may say that it is not worthwhile to do so nowadays because of the tension between doctors and patients, but it does not increase the medical risk compared with abscess incision and drainage, because even if the incision is infected, the big deal is open drainage. Another thought from such cases is that early surgical excision of sebaceous cysts or epidermoid cysts on the body surface is highly recommended when they are relatively small in size in the early stages to avoid the difficult treatment and increased trauma during the acute inflammatory phase.