Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
CPT4 code
Name of the Procedure:
Excision of a Malignant Lesion including Margins, Scalp, Neck, Hands, Feet, Genitalia; excised diameter 0.5 cm or less
Summary
The procedure involves the surgical removal of a small malignant skin lesion, along with a margin of surrounding healthy tissue, from sensitive areas such as the scalp, neck, hands, feet, or genitalia. This minor surgery is typically done to prevent the spread of cancer.
Purpose
The procedure aims to:
- Remove malignant (cancerous) skin lesions.
- Ensure clear margins around the lesion to reduce the risk of cancer recurrence.
Indications
- Diagnosis of a malignant lesion (e.g., melanoma, squamous cell carcinoma) on the scalp, neck, hands, feet, or genitalia.
- The lesion is 0.5 cm or smaller in diameter.
- Patient is generally in good health and can tolerate minor surgery.
Preparation
- Instructions may include fasting for a few hours before the procedure.
- Avoid certain medications, like blood thinners, as directed by your doctor.
- Diagnostic tests (e.g., biopsy, imaging) may be necessary to confirm the malignancy and plan the excision.
Procedure Description
- Anesthesia: Local anesthesia is administered to numb the area around the lesion.
- Incision: The surgeon makes an incision around the malignant lesion, including a margin of healthy tissue to ensure complete removal.
- Excision: The lesion and surrounding tissue are carefully removed.
- Closure: The incision is closed with stitches or sutures, and a sterile dressing is applied.
Tools Used: Scalpels, surgical scissors, forceps, and possibly cautery tools for bleeding control.
Duration
Typically, the procedure takes about 30 minutes to an hour, depending on the lesion's size and location.
Setting
This procedure is usually performed in an outpatient clinic or a minor surgical center.
Personnel
- Surgeon: A dermatologic surgeon or a general surgeon with experience in skin cancer removal.
- Nurses: Assist with the procedure and provide patient care before and after.
- Anesthesiologist or Nurse Anesthetist: May be involved if deeper sedation is required.
Risks and Complications
- Common Risks: Bleeding, infection, scar formation.
- Rare Risks: Damage to surrounding tissues, incomplete lesion removal requiring further surgery.
- Management: Antibiotics for infections, follow-up appointments to monitor healing and recurrence.
Benefits
- Removal of the malignant lesion reduces the risk of cancer spreading.
- Early intervention can prevent more extensive surgery or treatment down the line.
- Expected benefits are usually realized within a few days to weeks, as the site heals.
Recovery
- Keep the wound clean and dry.
- Follow specific wound care instructions provided by your healthcare provider.
- Avoid strenuous activities that may strain the surgical site.
- Stitches are usually removed within 7-14 days.
- Follow-up appointments to ensure proper healing and no recurrence of the lesion.
Alternatives
- Other Treatments: Cryotherapy, laser surgery, topical chemotherapy.
- Pros and Cons:
- Cryotherapy and lasers are less invasive but may not achieve clear margins.
- Topical chemotherapy is a non-surgical option but can be less effective for deeply invasive lesions.
Patient Experience
- During the Procedure: Minimal discomfort is expected due to local anesthesia.
- After the Procedure: You may experience mild pain and swelling, manageable with over-the-counter pain medication.
- Pain Management: Follow prescribed pain relief methods, and contact your doctor if pain persists or becomes severe.
This provides all the necessary information a patient or caregiver might need to understand the procedure, preparation, and what to expect.