Name of the Procedure:

Excision of Malignant Lesion, including margins, on the face, ears, eyelids, nose, or lips; excised diameter 0.6 to 1.0 cm

Summary

This procedure involves surgically removing a small cancerous skin lesion from sensitive areas such as the face, ears, eyelids, nose, or lips. The procedure includes taking out some surrounding healthy tissue margins to ensure complete removal of the cancer.

Purpose

The primary goal is to completely remove malignant (cancerous) skin lesions to prevent the spread of cancer. The procedure aims to minimize cancer recurrence and promote healing while preserving the appearance and functionality of the affected area.

Indications

• Presence of a small malignant skin lesion (0.6 to 1.0 cm in diameter) on the face, ears, eyelids, nose, or lips.
• Biopsy-confirmed skin cancer requiring surgical removal.
• Lesions that exhibit rapid growth, change in color or shape, bleeding, or ulceration.

Preparation

• Patients may need to undergo a skin biopsy or imaging.
• Instructions might include avoiding certain medications like blood thinners weeks before the procedure.
• Patients may need to fast for a few hours if sedation or general anesthesia is used.

Procedure Description

1. The patient is given local anesthesia to numb the area, or sedation/general anesthesia based on procedural and patient requirements.
2. The surgeon marks the lesion and plans the margins (0.6 to 1.0 cm in diameter).
3. A scalpel or surgical instrument is used to excise the lesion along with a margin of surrounding healthy tissue.
4. The excised tissue is sent to a pathology lab to ensure all cancer cells are removed.
5. The wound is closed with stitches or sutures, and a dressing is applied.

Duration

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

Setting

This procedure is typically performed in an outpatient clinic, a dermatologic surgery center, or a hospital setting.

Personnel

• Dermatologic or general surgeon
• Surgical nurse or nurse practitioner
• Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is required)

Risks and Complications

• Bleeding
• Infection
• Scarring
• Nerve damage leading to numbness or weakness in the area
• Incomplete removal requiring additional surgery

Benefits

• Complete removal of malignant skin lesions
• Reduced risk of cancer recurrence
• Preservation of healthy tissue and aesthetics

Recovery

• Keep the wound clean and dry, and follow specific care instructions provided by the healthcare provider.
• Over-the-counter pain medications may be recommended.
• Sutures may need to be removed in a follow-up visit.
• Recovery typically takes 1 to 2 weeks, with some restrictions on physical activities.

Alternatives

• Cryotherapy (freezing)
• Radiation therapy
• Mohs surgery (for larger or recurring lesions)
• Topical treatments or systemic therapy for small, superficial lesions

Each alternative has its advantages and disadvantages, such as varying levels of effectiveness, invasiveness, and recovery time.

Patient Experience

• Patients will feel numbing from the anesthesia application with minimal discomfort during the procedure.
• Following the procedure, there may be mild pain, swelling, or redness managed by pain relief methods.
• The patient will receive detailed instructions to care for the wound and facilitate healing.