11426 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm

Name of the Procedure:

Excision of a benign lesion, including margins, except skin tag (unless listed elsewhere), on the scalp, neck, hands, feet, or genitalia; excised diameter over 4.0 cm

Summary

This procedure involves the surgical removal of a non-cancerous growth, including a margin of healthy tissue around it, from sensitive areas such as the scalp, neck, hands, feet, or genitalia. It is typically performed when the lesion exceeds a diameter of 4.0 cm.

Purpose

This procedure is intended to remove benign lesions that may be causing discomfort, have the potential to become malignant, or affect the appearance of the patient. The aim is to completely excise the lesion while ensuring minimal impact on the surrounding healthy tissue.

Indications

• Presence of a non-cancerous growth larger than 4.0 cm.
• Lesions causing physical discomfort or pain.
• Lesions that are cosmetically concerning or located in sensitive areas.
• Suspicion of potential malignant transformation.

Preparation

• Follow fasting guidelines if general anesthesia will be used.
• Adjust or discontinue certain medications as advised by the doctor.
• Undergo any necessary diagnostic tests such as imaging or biopsy.
• Clean the area thoroughly before the procedure.

Procedure Description

1. Anesthesia: Local anesthesia is commonly used, but general anesthesia may be applied based on the lesion's location and size.
2. Marking: The surgeon will mark the lesion and the margins to be excised.
3. Incision: An incision is made to encompass the lesion along with some surrounding healthy tissue to ensure clear margins.
4. Excision: The lesion and margins are carefully cut out.
5. Closure: The wound is closed using sutures, and a sterile dressing is applied.

Duration

The procedure typically lasts between 30 minutes to 1 hour, depending on the complexity and size of the lesion.

Setting

This procedure is usually performed in an outpatient surgical clinic or a hospital's surgical unit.

Personnel

• Surgeon (typically a dermatologist or general surgeon)
• Nurses or surgical assistants
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring or keloid development
• Nerve damage or altered sensation in the area
• Recurrence of the lesion

Benefits

Removal of the benign lesion often results in relief from discomfort, improved cosmetic appearance, and reduced risk of malignant transformation. Benefits are typically realized immediately after recovery.

Recovery

• Keep the surgical site clean and dry.
• Follow wound care instructions provided by the healthcare provider.
• Avoid strenuous activities or stretching the affected area for several weeks.
• Attend any scheduled follow-up appointments for suture removal and wound evaluation.

Alternatives

• Observation: Monitoring the lesion over time without immediate removal.
• Cryotherapy: Freezing the lesion with liquid nitrogen.
• Laser therapy: Using laser energy to remove the lesion.
• Electrosurgery: Using electric currents to remove the lesion.

Each alternative has its own pros and cons, such as recovery time, effectiveness, and potential for scarring.

Patient Experience

Patients may feel some pressure or tugging during the procedure if local anesthesia is used. Post-procedure, there may be mild discomfort, swelling, or bruising around the surgical site. Pain is generally managed with over-the-counter pain medications, and any significant discomfort should be reported to the healthcare provider.

Concern for bleeding and infection should be minimal with proper care. Most patients are able to resume normal activities within a few days to a week, depending on the lesion's location and size.