Excision of lip; transverse wedge excision with primary closure
CPT4 code
Name of the Procedure:
Excision of lip; transverse wedge excision with primary closure
Common name(s): Transverse wedge lip excision, Lip wedge resection
Summary
In layman's terms, this procedure involves the surgical removal of a section of the lip in a wedge shape, followed by stitching the remaining tissue together to aid in healing and minimize scarring.
Purpose
This procedure addresses conditions such as lip cancer, benign tumors, or chronic infections affecting the lips. The goals are to completely remove the abnormal tissue, restore lip function, and maintain the aesthetic appearance of the lip.
Indications
- Presence of lip cancer or suspicious lesions
- Symptomatic benign tumors
- Chronic infections not responding to other treatments
- Structural abnormalities causing functional issues
Preparation
- Patients may be asked to fast for 6-8 hours before the procedure.
- Medications may need to be adjusted, particularly blood thinners.
- Pre-procedure assessments could include blood tests and imaging studies.
Procedure Description
- The patient receives local anesthesia to numb the area.
- A wedge-shaped section of lip tissue is carefully cut out.
- The edges of the excision are brought together and sutured (stitched) to promote proper healing and minimize scarring.
- The procedure may use surgical tools like scalpels and suturing needles.
- Special attention is given to maintain the structural and functional integrity of the lip.
Duration
The procedure typically takes 30-60 minutes.
Setting
The procedure is usually performed in an outpatient clinic or surgical center.
Personnel
- A surgeon, often a specialist in oral and maxillofacial surgery or dermatologic surgery
- Nursing staff to assist with preparation and aftercare
- An anesthesiologist or nurse anesthetist, if sedation beyond local anesthesia is required
Risks and Complications
- Common risks: bleeding, infection, temporary swelling, and bruising
- Rare risks: nerve damage, long-term numbness, severe scarring, and asymmetry of the lips
- Management: antibiotics for infections, follow-up for monitoring, and potential revision surgeries if necessary
Benefits
- Effective removal of problematic or suspicious tissue
- Minimal scarring with the primary closure technique
- Restoration of normal lip function and appearance
- Benefits may become apparent shortly after the healing process, typically within a few weeks.
Recovery
- Post-procedure care includes keeping the area clean and applying prescribed ointments.
- Pain can usually be managed with over-the-counter pain relievers.
- Patients should avoid strenuous activities and follow-up with appointments as scheduled.
- Most patients recover fully within 1-2 weeks, with sutures typically removed within 7-10 days if non-dissolvable ones are used.
Alternatives
- Cryotherapy: Freezing the lesion, less invasive but may be less precise.
- Laser surgery: Another less invasive option that uses focused light beams to remove tissue.
- Observation: In cases where the lesion is small and not growing.
Patient Experience
During the procedure, the patient will feel minimal to no pain due to the local anesthesia. Post-procedure, mild discomfort or pain, swelling, and bruising are common but temporary. Pain management includes over-the-counter medications and comforting measures like ice packs. Communication with healthcare providers about concerns is essential for a smooth recovery.