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Excision of single external papilla or tag, anus

CPT4 code

Name of the Procedure:

Excision of single external papilla or tag, anus
Common Names: Anal skin tag removal, Perianal papilla excision

Summary

This procedure involves the surgical removal of a single skin tag or papilla located on or around the anus. It is usually performed on an outpatient basis and aims to alleviate discomfort or hygiene issues associated with the skin tag.

Purpose

The procedure addresses discomfort, irritation, or hygiene challenges caused by skin tags around the anus. The goals are to improve the patient’s comfort, prevent infections, and enhance the overall cleanliness of the anal area.

Indications

  • Persistent discomfort or irritation in the anal area
  • Difficulty maintaining hygiene
  • Recurrent infections or inflammations around the anus
  • Aesthetic concerns
  • Pain or bleeding from the skin tag

Preparation

  • Patients may be advised to fast for a few hours prior to the procedure.
  • Adjustments to medications, such as blood thinners, may be necessary.
  • Pre-procedural assessments might include a physical examination and review of medical history.

Procedure Description

  1. The patient is placed in a comfortable position, usually lying on their side with knees drawn towards the chest.
  2. Local anesthesia is administered to numb the area around the anus.
  3. The surgeon cleans the area with an antiseptic solution.
  4. Using a scalpel or surgical scissors, the surgeon carefully excises the skin tag or papilla.
  5. The wound is typically closed with sutures if necessary.
  6. A sterile dressing is applied to the site.

Duration

The procedure typically takes between 15 to 30 minutes.

Setting

This procedure is commonly performed in an outpatient clinic or a surgical center.

Personnel

  • Surgeon or Proctologist
  • Nurse or Medical Assistant
  • Anesthesiologist (if general anesthesia is required, though usually not necessary)

Risks and Complications

  • Minor bleeding
  • Infection at the surgical site
  • Pain or discomfort during recovery
  • Scarring
  • Recurrence of the skin tag (rare)

Benefits

  • Alleviation of discomfort and irritation
  • Enhanced ability to maintain hygiene
  • Reduced risk of infection
  • Improved aesthetic appearance of the anal area
  • Immediate relief from symptoms

Recovery

  • Patients can usually go home the same day.
  • Pain and discomfort are managed with prescribed analgesics.
  • Instructions include keeping the area clean, avoiding heavy lifting, and monitoring for signs of infection.
  • Recovery typically spans 1 to 2 weeks.
  • Follow-up appointments are scheduled to ensure proper healing.

Alternatives

  • Conservative management with topical treatments for minor discomforts
  • Cryotherapy (freezing the skin tag)
  • Laser removal
  • The cons of alternatives may include less effectiveness or longer recovery times compared to surgical excision.

Patient Experience

During the procedure, the patient might feel minimal discomfort due to local anesthesia. Post-procedure, patients may experience mild pain or soreness, which can be managed with pain relievers. Patients will need to follow care instructions to ensure a smooth recovery and prevent complications.

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