What is Skin Lesion Excision?
An excision of skin lesion involves the removal of a sore or
growth (a lesion) from your skin and stitching the skin back
together.
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Effects of Skin Lesion Excision
The
objective of skin lesion excision is sometimes to remove an
unsightly mole or other cosmetically unattractive skin
growth. Other times, a skin lesion will be removed to make
sure it is not cancerous, and, if it happens to be
cancerous, to stop its spread to other parts of the body.
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Candidates for Skin Lesion Excision
Candidates for this procedure are those who have lesions
that are too big, bothersome or unsightly; have precancerous
or cancerous lesions; or those who are irritated or
uncomfortable with the lesions that rub against their
clothing.
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Your
Consultation
Before the operation, the area to be treated is cleansed
with alcohol or another antibacterial preparation. The
procedure is done on an outpatient basis, with the use of a
local anesthetic. This is not a highly invasive procedure
and can often be well-tolerated by young and old patients,
as well as those with other medical conditions.
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The Skin Lesion Excision
Procedure
An
elliptical excision is the most common type of excision. The
ellipse is designed so that the resulting scar runs parallel
with present skin creases. This makes sure that the scar is
as narrow and short as possible.
The area
to be excised is underlined with a colored pen. Next, the
dermatologist will cut around and under the lesion with a
scalpel and sharp scissors so that it is entirely removed.
The lesion is placed in formalin ready to be sent to the
pathology laboratory.
Some
bleeding in the area from where the lesion has been removed
may be possible. The doctor may coagulate the blood vessels
with a diathermy and this can make a hissing sound and a
burning smell. After which, the edges of the ellipse will be
sewn together to make a thin suture line. There may be two
layers of sutures - a layer underneath that is absorbable
and a layer of sutures on the surface that will need to be
removed in 4 to 14 days. A special kind of skin glue is
often used to join the edges together, instead of sutures. A
dressing may be
administered and instructions should be provided on how to
nurse your wound and when to get the stitches out.
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Recovery
Your
wound may be tender for about 1 to 2 hours when the
local anesthetic
wears off. Leave the dressing in place for 24 hours or as
advised by your dermatologist. Keep the wound dry for 48
hours. After which, you can gently wash and dry the wound.
If the wound becomes red or very painful, consult your
dermatologist - it could be infected.
Abstain
from strenuous exertion and stretching of the area until the
stitches are taken out and for some time afterwards. If
there is any bleeding, put pressure on the wound with a
folded towel without looking at it for 20 minutes. If it is
still bleeding after this time, seek medical attention. The
scar will be red and appear raised at first but usually
diminishes in color and size over several months.
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Risks
Some
risks connected with this procedure are:
-
The
local anesthetic may not numb the area enough and you
may experience some minor discomfort. In rare cases, you
may have an allergic reaction to the drug used in this
type of anesthesia.
-
Infection or bleeding.
-
The lesion may grow back if it was a cancerous or
precancerous growth.
-
A lumpy scar may grow where the lesion once was.
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Frequently Asked
Questions
Q:
What is the purpose of a skin lesion excision?
A:
The main
purpose of this procedure is to fully remove the skin
cancers such as
basal cell carcinoma,
squamous cell carcinoma or
melanoma. If the cancer is not cut out, it may spread to
the surrounding skin and to other parts of the body
(metastasize). Other reasons that skin lesions are excised
include cosmetic appearance, to remove an inflamed
cyst, or recurrent infection.
Q:
What happens during the procedure?
A:
The doctor disinfects the area and then numbs the skin
around the lesion using a spray or shot of a local
anesthetic. The anesthetic should prevent any feeling of
pain during the operation. The doctor will then cut a
football-shaped patch around the lesion, remove the lesion
and stitch the skin back together.
Q:
Will I have a scar?
A:
You will
always have some sort of scar since it is impossible to cut
the skin without scarring in some way. Your dermatologist
will attempt to excise the lesion in a way that will keep
scarring to a minimum. Some people have an abnormal response
to skin healing and these people may get larger scars than
usual (keloid
or hypertrophic scarring).
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