Name of the Procedure:

Excision of malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm

Summary

This procedure involves the surgical removal of a cancerous skin lesion along with some surrounding healthy tissue to ensure all malignant cells are excised. The target lesion has a diameter of 2.1 to 3.0 centimeters and is located on the trunk, arms, or legs.

Purpose

The excision aims to remove malignant lesions, such as skin cancer, to prevent the spread of cancer and to achieve clear margins, indicating no remaining cancerous cells. The primary goal is to treat and cure localized skin cancer.

Indications

• Presence of a malignant skin lesion (e.g., melanoma, squamous cell carcinoma).
• Lesion located on the trunk, arms, or legs with a diameter of 2.1 to 3.0 cm.
• Biopsy confirming malignancy.
• No evidence of metastasis or significant spread to other body parts.

Preparation

• Fasting may be required if general anesthesia is used.
• Adjustments to medications such as blood thinners to prevent excessive bleeding.
• Possible blood tests and imaging to examine overall health and lesion characteristics.
• Informed consent discussing the risks and benefits.

Procedure Description

1. The patient is positioned comfortably and the surgical site is sterilized.
2. Local anesthesia is administered to numb the area, or general anesthesia for larger or multiple lesions.
3. The surgeon uses a scalpel to excise the malignant lesion along with a margin of surrounding healthy tissue.
4. The excised tissue is sent to a lab for pathological examination to ensure clear margins.
5. The surgical site is closed with sutures or stitches and dressed with a sterile bandage.

Duration

Typically, the procedure takes about 30 to 60 minutes, depending on the lesion's size and complexity.

Setting

This can be performed in an outpatient clinic, surgical center, or hospital operating room, depending on specific medical requirements and patient health conditions.

Personnel

• Surgeon (Dermatologist or General Surgeon)
• Surgical Nurse
• Anesthesiologist (if general anesthesia is required)
• Pathologist (for examining excised tissue)

Risks and Complications

• Common: bleeding, infection, scarring.
• Rare: incomplete removal requiring additional surgery, allergic reaction to anesthesia, nerve damage.

Benefits

• Removal of the malignant lesion with a high likelihood of curing localized skin cancer.
• Reduced risk of cancer spread and recurrence.

Recovery

• Keep the surgical site clean and dry.
• Follow dressing change instructions provided by healthcare professionals.
• Avoid strenuous activities for a few weeks.
• Follow-up appointment to check healing and discuss pathology results.
• Pain management with prescribed medications.

Alternatives

• Mohs surgery for certain skin cancers.
• Radiation therapy, if surgery is not an option.
• Cryotherapy or laser therapy for smaller lesions.
• Noninvasive treatments (e.g., topical medications) though these are less effective for larger, malignant lesions.

Patient Experience

• During the procedure: Local anesthesia will numb the area, so minimal discomfort should be felt.
• After the procedure: Mild pain, swelling, and redness at the surgical site, manageable with pain relievers.
• Follow post-operative care instructions for rapid and smooth healing.

By understanding this procedure, patients can better prepare and engage in discussions with their healthcare providers, ensuring comprehensive care and optimal outcomes.