Name of the Procedure:

Excision of Malignant Lesion, Including Margins, Trunk, Arms, or Legs; Excised Diameter 0.6 to 1.0 cm
Common name(s): Excision of Skin Cancer, Surgical Removal of Tumor

Summary

Excision of a malignant lesion is a surgical procedure performed to remove skin cancer or other malignant growths along with some normal tissue around it to ensure complete removal. The procedure targets lesions on the trunk, arms, or legs that are 0.6 to 1.0 cm in diameter.

Purpose

This procedure addresses the presence of cancerous or suspicious skin lesions. The goals are to completely remove the malignant tissue, minimize the risk of cancer spreading, and achieve clear margins to ensure all cancer cells have been excised.

Indications

• Diagnosis of skin cancer (e.g., melanoma, basal cell carcinoma, squamous cell carcinoma)
• Suspicious skin lesions that have changed in size, shape, or color
• Biopsy indicating malignant cells
• Patient-specific factors such as lesion location and size

Preparation

• Fasting may be required if general anesthesia is used.
• Adjustments to medications, particularly blood thinners.
• Pre-procedure assessment including medical history, physical exam, and possibly imaging or biopsy.

Procedure Description

1. The patient is prepared, and the procedure area is sterilized.
2. Local anesthesia is administered to numb the area.
3. The surgeon marks the lesion and planned incision lines, ensuring a margin of healthy tissue around the tumor.
4. Using a scalpel, the surgeon excises the lesion and surrounding margin.
5. The excised tissue is sent for pathological examination to confirm clear margins.
6. The surgical site is closed with sutures and bandaged.

Duration

Typically lasts between 15 to 45 minutes, depending on the complexity and size of the lesion.

Setting

This procedure is usually performed in an outpatient clinic, doctor's office, or surgical center.

Personnel

• Surgeon (Dermatologic surgeon or General surgeon)
• Nurse or medical assistant
• Anesthesiologist or nurse anesthetist (if necessary)

Risks and Complications

• Common: Bleeding, infection, scarring, pain at the incision site.
• Rare: Nerve damage, reoccurrence of malignancy, adverse reaction to anesthesia.

Benefits

• Complete removal of the malignant lesion.
• Reduction in the risk of cancer spreading or recurring.
• Improved prognosis with early and complete excision.

Recovery

• Keep the wound clean and dry; follow wound care instructions.
• Monitor for signs of infection.
• Stitches are typically removed after 1-2 weeks.
• Avoid strenuous activities until cleared by your doctor.
• Follow-up appointment to discuss pathology results and ensure proper healing.

Alternatives

• Mohs surgery: Detailed layer-by-layer removal of cancerous tissue.
• Cryotherapy: Freezing off the lesion.
• Topical medications: For superficial skin cancers.
• Radiation therapy: For non-surgical candidates.
• Each alternative has its own benefits and drawbacks based on the specific case.

Patient Experience

• Numbness at the site during the procedure due to local anesthesia.
• Mild discomfort or pain after the numbness wears off, manageable with over-the-counter pain relievers.
• Experience some swelling or bruising around the surgical site.
• Guidelines provided for pain management and care to ensure a comfortable recovery.