Name of the Procedure:

Excision of Malignant Lesion, including Margins, Trunk, Arms, or Legs; Excised Diameter 1.1 to 2.0 cm

Summary

This procedure involves the surgical removal of a cancerous skin lesion along with some surrounding healthy tissue to ensure all cancer cells are eliminated. It is commonly performed on parts of the body like the trunk, arms, or legs.

Purpose

The main goal is to treat and prevent the spread of skin cancer by completely excising the malignant lesion. This procedure aims to ensure clean margins, reducing the risk of cancer recurrence.

Indications

• Presence of a biopsy-confirmed malignant skin lesion.
• Signs of an aggressive or rapidly growing skin lesion.
• Lesions that have changed in size, color, or shape.

Preparation

• Patients may need to stop certain medications, such as blood thinners, before the procedure.
• Diagnostic tests, including a skin biopsy and imaging, may be completed to assess lesion size and spread.
• Fasting may not be necessary unless general anesthesia is anticipated.

Procedure Description

1. The area around the lesion is cleaned and marked.
2. Local anesthesia is administered to numb the area.
3. The surgeon makes an incision around the lesion, ensuring to include a margin of healthy tissue.
4. The lesion and surrounding tissue are excised.
5. The incision is then closed with sutures.
6. The excised tissue is sent for pathological examination to ensure clear margins.

Duration

The procedure typically lasts between 30 to 60 minutes, depending on the lesion's size and complexity.

Setting

This procedure is usually performed in an outpatient setting, such as a surgical center or a dermatologist's office.

Personnel

• Surgeon or dermatologist
• Surgical nurse or assistant
• Pathologist (for tissue examination)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Scarring
• Sensory changes or numbness around the excised area
• Recurrence of the malignant lesion

Benefits

• Removal of cancerous tissue, decreasing the risk of spread.
• Biopsy of excised tissue ensures complete removal.
• Potential reduction in cancer recurrence.

Recovery

• Keep the incision site clean and follow wound care instructions.
• Activity may be limited depending on the excision site.
• Sutures may be removed in 1 to 2 weeks.
• Follow-up appointments may be required to monitor healing and discuss pathology results.

Alternatives

• Mohs surgery: precise removal layer by layer, often used for facial lesions.
• Radiation therapy: may be considered for inoperable cases or patients unfit for surgery.
• Topical chemotherapy: for superficial lesions, though with varying efficacy.

Patient Experience

• Patients typically feel minimal discomfort due to local anesthesia.
• Post-procedure pain can usually be managed with over-the-counter pain relievers.
• Some discomfort or tightness at the excision site is expected during healing.