Name of the Procedure:

Incisional Biopsy of Skin (e.g., wedge biopsy) - including simple closure, when performed; single lesion.

Summary

An incisional biopsy of the skin is a minor surgical procedure where a portion of a skin lesion is removed for diagnostic purposes. This type of biopsy involves cutting into the skin with a scalpel to extract a sample from a single lesion, followed by suturing to close the incision.

Purpose

The procedure is performed to diagnose various skin conditions or abnormalities, including infections, inflammatory conditions, and skin cancers. The goal is to obtain a tissue sample for microscopic examination to provide an accurate diagnosis and inform appropriate treatment plans.

Indications

• Presence of a suspicious skin lesion that cannot be diagnosed through less invasive methods.
• Persistent skin abnormalities such as lumps, ulcers, or lesions that do not respond to treatment.
• Lesions suspected to be malignant or pre-malignant.

Preparation

• No specific preparation like fasting is necessary, but patients are advised to avoid certain medications that may increase bleeding risk, such as aspirin or blood thinners.
• Diagnostic tests, such as blood work or imaging, might be required to assess overall health and plan the biopsy.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. The area around the lesion is cleaned and sterilized.
3. Local anesthesia is administered to numb the area.
4. Using a scalpel, the surgeon makes an incision to remove a wedge-shaped section of the lesion.
5. The excised tissue is collected and sent to a pathology lab for examination.
6. The incision is closed with sutures (stitches).
7. A sterile bandage is applied to protect the wound.

Duration

The procedure typically takes 15-30 minutes, depending on the size and location of the lesion.

Setting

The procedure is usually performed in an outpatient clinic, dermatology office, or minor surgery center.

Personnel

• Dermatologist or surgeon
• Nurses or medical assistants

Risks and Complications

• Infection at the biopsy site
• Bleeding or hematoma (collection of blood under the skin)
• Scarring
• Pain or discomfort during healing
• Rarely, allergic reactions to local anesthesia

Benefits

• Accurate diagnosis of skin conditions
• Early detection of skin cancers
• Informing appropriate treatment options
• Providing peace of mind by ruling out serious conditions

Recovery

• Keep the biopsy site clean and dry as instructed by the healthcare provider.
• Follow specific wound care instructions, including changing bandages and avoiding heavy lifting or strenuous activities.
• Most patients can resume normal activities within a day, but complete healing may take 1-2 weeks.
• Follow-up appointments may be necessary to remove sutures and discuss biopsy results.

Alternatives

• Shave biopsy (removes outer layers of skin)
• Punch biopsy (removes a cylindrical core of tissue)
• Fine needle aspiration (less invasive but may yield limited information)
• Non-invasive imaging techniques (e.g., dermatoscopy)

Patient Experience

• During the procedure, patients typically feel slight pressure but no pain due to local anesthesia.
• After the procedure, mild discomfort, and tenderness at the biopsy site are common and can be managed with over-the-counter pain relievers.
• It's normal to experience some bruising and minor swelling around the incision.
• Patients should monitor the biopsy site for any signs of infection or complications and report them to their healthcare provider.