Name of the Procedure:

Excision of Malignant Lesion Including Margins, Face, Ears, Eyelids, Nose, Lips; Excised Diameter 3.1 to 4.0 cm

Summary

This procedure involves surgically removing a cancerous skin lesion from areas such as the face, ears, eyelids, nose, or lips, along with some surrounding healthy tissue to ensure complete removal. The excised area is between 3.1 to 4.0 cm in diameter.

Purpose

The primary objective of this procedure is to treat skin cancer by completely removing the malignant lesion and a margin of surrounding healthy tissue to prevent recurrence. The goal is to eliminate the cancerous cells while preserving as much of the surrounding healthy tissue as possible.

Indications

• Presence of a confirmed malignant skin lesion (e.g., melanoma, squamous cell carcinoma, or basal cell carcinoma) on the face, ears, eyelids, nose, or lips.
• Biopsy results indicating malignancy with a lesion size of 3.1 to 4.0 cm.
• Lesions that have not responded to other treatments, such as topical medications or smaller excisions.

Preparation

• Patients may be advised to stop certain medications, such as blood thinners, a few days before surgery.
• Fasting might be necessary if general anesthesia is used.
• Pre-operative imaging or biopsy may be conducted for precise assessment.

Procedure Description

1. Anesthesia: Local anesthesia is typically used, but general anesthesia may be required depending on the lesion's size and location.
2. Incision: The surgeon makes an incision around the malignant lesion, including a margin of healthy tissue.
3. Excision: The lesion and surrounding tissue are carefully excised.
4. Closure: The wound is closed with sutures, and sometimes a skin graft may be necessary if a significant amount of tissue is removed.
5. Pathology: The excised tissue is sent to a pathologist for examination to ensure all cancerous cells have been removed.

Duration

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

Setting

This procedure is typically performed in an outpatient clinic, surgical center, or hospital operating room.

Personnel

• Surgeon
• Surgical Nurse
• Anesthesiologist (if general anesthesia is used)
• Pathologist (for tissue examination)

Risks and Complications

• Infection
• Bleeding
• Scarring
• Nerve damage, potentially leading to numbness or muscle weakness
• Recurrence of the malignancy
• Adverse reactions to anesthesia

Benefits

• Complete removal of the malignant lesion
• Reduced risk of cancer recurrence
• Improved prognosis and potential for a cure

Recovery

• Post-procedure care includes keeping the wound clean and dry, and following the surgeon's wound care instructions.
• Pain management with prescribed medications is often necessary.
• Stitches may be removed after 1-2 weeks.
• Full recovery and wound healing can take several weeks to months.
• Follow-up appointments are important to monitor healing and for further treatment if necessary.

Alternatives

• Cryotherapy (freezing the lesion)
• Mohs surgery (a more detailed method of removing skin cancer)
• Radiation therapy
• Topical chemotherapy Each alternative has its pros and cons regarding efficacy, recovery time, and potential complications.

Patient Experience

Patients might feel a pinch during local anesthesia injection, followed by pressure or tugging sensations during the procedure. Post-operatively, pain and discomfort can be managed with medications. The patient should expect some swelling and bruising in the treated area, which will subside over time. Comfort measures such as cold compresses and elevation may help with swelling.