What is Excision of Skin Lesions
Excision of a skin lesion refers to the removal of a section of skin by making small cuts (incisions) in the skin. This procedure may be done to remove a cancerous (malignant) or noncancerous (benign) growth on the skin.
It is typically done to treat or prevent cancer or infection. It may also be done to improve cosmetic appearance.
The procedure may be done to remove:
- Cancerous growths, such as basal cell carcinoma, squamous cell carcinoma, or melanoma.
- Noncancerous growths, such as a cyst or lipoma.
- Growths, such as moles or skin tags, which may be removed for cosmetic reasons.
Various excision or surgical techniques may be used depending on your condition, the location of the lesion, and your overall health.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Bleeding.
- Infection.
- Scarring.
- Recurrence of the cyst, lipoma, or cancer.
- Changes in skin sensation or appearance, such as discoloration or swelling.
- Reaction to the anesthetics.
- Allergic reaction to surgical materials or ointments.
- Damage to nerves, blood vessels, muscles, or other structures.
- Continued pain.
What happens before the procedure?
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- You may be asked to take certain medicines.
- You may be asked to stop smoking.
- You may have an exam or testing.
- Plan to have someone take you home after the procedure.
- Plan to have someone help you with activities during recovery.
What happens during the procedure?
- To
reduce your risk of infection:
- Your health care team will wash or sanitize their hands.
- Your skin will be washed with soap.
- You will be given a medicine to numb the area (local anesthetic).
- One of the following excision techniques will be performed.
- At the end of any of these procedures, antibiotic ointment will be applied as needed.
Each of the following techniques may vary among health care providers and hospitals.
Complete Surgical Excision
The area of skin that needs to be removed will be marked with a pen. Using a small scalpel or scissors, the surgeon will gently cut around and under the lesion until it is completely removed. The lesion will be placed in a fluid and sent to the lab for examination. If necessary, bleeding will be controlled with a device that delivers heat (electrocautery). The edges of the wound may be stitched (sutured) together, and a bandage (dressing) will be applied. This procedure may be performed to treat a cancerous growth or a noncancerous cyst or lesion.
Excision of a Cyst
The surgeon will make an incision on the cyst. The entire cyst will be removed through the incision. The incision may be closed with sutures.
Shave Excision
During shave excision, the surgeon will use a small blade or an electrically heated loop instrument to shave off the lesion. This may be done to remove a mole or a skin tag. The wound will usually be left to heal on its own without sutures.
Punch Excision
During punch excision, the surgeon will use a small tool that is like a cookie cutter or a hole punch to cut a circle shape out of the skin. The outer edges of the skin will be sutured together. This may be done to remove a mole or a scar or to perform a biopsy of the lesion.
Mohs Micrographic Surgery
During Mohs micrographic surgery, layers of the lesion will be removed with a scalpel or a loop instrument and will be examined right away under a microscope. Layers will be removed until all of the abnormal or cancerous tissue has been removed. This procedure is minimally invasive, and it ensures the best cosmetic outcome. It involves the removal of as little normal tissue as possible. Mohs is usually done to treat skin cancer, such as basal cell carcinoma or squamous cell carcinoma, particularly on the face and ears. Depending on the size of the surgical wound, it may be sutured closed.
What happens after the procedure?
- Return to your normal activities as told by your health care provider.
- Talk with your health care provider to discuss any test results, treatment options, and if necessary, the need for more tests.
Excision of Skin Lesions, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.
What can I expect after the procedure?
After your procedure, it is common to have pain or discomfort at the excision site.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Follow
instructions from your health care provider about:
- How to take care of your excision site. You should keep the site clean, dry, and protected for at least 48 hours.
- When and how you should change your bandage (dressing).
- When you should remove your dressing.
- Removing whatever was used to close your excision site.
- Check
the excision area every day for signs of infection. Watch for:
- Redness, swelling, or pain.
- Fluid, blood, or pus.
- For bleeding, apply gentle but firm pressure to the area using a folded towel for 20 minutes.
- Avoid high-impact exercise and activities until the stitches (sutures) are removed or the area heals.
- Follow instructions from your health care provider about how to minimize scarring. Avoid sun exposure until the area has healed. Scarring should lessen over time.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have a fever.
- You have redness, swelling, or pain at the excision site.
- You have fluid, blood, or pus coming from the excision site.
- You have ongoing bleeding at the excision site.
- You have pain that does not improve in 2–3 days after your procedure.
- You notice skin irregularities or changes in sensation.
