Name of the Procedure:

Excision of Malignant Lesion, Including Margins, Scalp, Neck, Hands, Feet, Genitalia; Excised Diameter 3.1 to 4.0 cm

Summary

This surgical procedure involves removing a cancerous lesion along with some surrounding healthy tissue (margins) from sensitive areas such as the scalp, neck, hands, feet, or genitalia. The excised area measures between 3.1 to 4.0 centimeters in diameter.

Purpose

The procedure aims to eliminate malignant (cancerous) skin lesions to prevent spread and recurrence. Removing the lesion and some of the surrounding tissue helps ensure that no cancer cells are left behind, which is crucial for effective cancer treatment and preventing metastasis.

Indications

This procedure is indicated in patients who have been diagnosed with a malignant skin lesion in sensitive or high-risk areas, such as the scalp, neck, hands, feet, or genitalia. It is suitable for lesions measuring between 3.1 to 4.0 cm in diameter that require definitive surgical removal.

Preparation

• Patients may be instructed to fast for several hours before the procedure if general anesthesia will be used.
• They should inform their doctor about any medications they are taking, especially blood thinners, which may need to be adjusted.
• Pre-operative tests, such as blood work and imaging studies, may be required.
• The surgical site will be cleaned and disinfected.

Procedure Description

1. Anesthesia: Local anesthesia is applied to numb the area; general anesthesia may be used in some cases.
2. Marking the Area: The surgeon will mark the area around the lesion to include a margin of healthy tissue.
3. Excision: Using a scalpel, the surgeon will carefully excise the lesion along with a margin of healthy tissue to ensure all cancerous cells are removed.
4. Histopathological Examination: The excised lesion and margins are sent to pathology to check for cancer cells at the edges.
5. Closure: The incision is closed with sutures, and a sterile bandage is applied.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the lesion's size and location.

Setting

The procedure is usually performed in an outpatient clinic, surgical center, or hospital.

Personnel

• Surgeon
• Surgical Nurse
• Anesthesiologist or Nurse Anesthetist (if general anesthesia is used)

Risks and Complications

• Infection at the surgical site
• Bleeding
• Scarring
• Pain or discomfort
• Recurrence of the malignant lesion
• Nerve damage (rare)

Benefits

• Effective removal of malignant tissue
• Reduced risk of cancer spreading or recurring
• Pathological examination ensures clear margins

Recovery

• Keep the surgical site clean and dry.
• Follow specific wound care instructions provided by your healthcare provider.
• Pain can usually be managed with over-the-counter pain relievers.
• Avoid strenuous activities until cleared by your surgeon.
• Follow-up appointments will be necessary to monitor healing and review pathology results.

Alternatives

• Mohs surgery: Offers a higher precision for certain types of skin cancer.
• Radiation therapy: Used for lesions that are difficult to remove surgically or for patients who cannot undergo surgery.
• Topical chemotherapy: Applicable for certain superficial skin cancers.

Patient Experience

Patients may feel some discomfort or pain during the recovery period, which can be managed with prescribed medication. Most patients return to regular activities within a couple of weeks. Scar formation is possible but can be minimized with proper wound care and follow-up treatments, if necessary.