Introduction
If your doctor has found a skin lesion with some concerning features for skin cancer or a lump that needs to be removed, an excision +/- biopsy will be carried out. This is to make sure that the lesion (e.g. mole) is removed and the tissue analysed.
Excision is the term for carefully cutting the lesion out. Biopsy is where the material is sent to the laboratory to be analysed.
What is involved in the procedure?
The doctor will identify the lesion, record its location in the notes and draw a margin around the lesion. The area will be cleaned and draped. A small needle will be used to introduce local anaesthetic, usually Iignocaine 1% with or without adrenalin, under the skin to make the area numb.
Once numb, the doctor will use a scalpel or ‘punch’ to cut the lesion out, put it in a specimen jar (if appropriate) and use sutures to close the wound.
A bandage will be placed on the wound area that is waterproof. You will be given instructions on how to look after the wound. Please disclose any allergies to your doctor.
How long does the wound take to heal?
Most small wounds with clean edges will heal in 7-10 days. We recommend you to change the dressing every 2-3 days after your shower.
What can go wrong?
Similar to any surgical procedures that breaks the skin, there is a risk of
- bruising
- pain
- infection
- bleeding
- damage to nerves or nearby structure
- wound breakdown, wound infection
- scar
- allergy to either the local anaesthetic or the adhesive of the dressing
These will be considered by the doctor and managed promptly if they arise.
With the skin lesion removed, there is a risk that the lesion is not cut out entirely and that the procedure needs to be repeated, that the result is indeterminate and further testing is required or that the clinician needs to refer the case for further management.
Any lesion deemed at risk of being a melanoma skin cancer should be surgically removed. Other forms of therapy are appropriate for lesions that may not have this risk, such as a Solar Keratosis, or for indeterminate lesions with mild features of skin cancer observation may be offered.
For procedures where the skin or other tissue is being taken to get a diagnosis, other avenues may be explored such as referral, scraping, trial of treatment.
