Name of the Procedure:

Excision of a Tumor or Vascular Malformation, Soft Tissue of Hand or Finger, Subcutaneous; Less than 1.5 cm

Summary

This procedure involves the surgical removal of a small tumor or vascular malformation located just beneath the skin of the hand or finger. The target mass is typically smaller than 1.5 cm in diameter and is situated within the soft tissue.

Purpose

This procedure addresses abnormal growths in the soft tissues of the hand or finger. The primary goals are to remove the growth to alleviate symptoms, confirm a diagnosis through pathological examination, and prevent potential complications such as pain, infection, or interference with hand function.

Indications

• Presence of a palpable mass or nodule in the hand or finger.
• Pain or discomfort in the affected area.
• Suspicion of a benign or malignant tumor, or vascular malformation based on imaging or clinical assessment.
• Functional impairment or cosmetic concerns related to the growth.
• Lack of improvement with non-surgical treatments.

Preparation

• Patients may need to fast for several hours before the procedure if general anesthesia is planned.
• Current medications should be discussed with the healthcare provider; adjustments may be necessary.
• Preoperative imaging studies like ultrasound or MRI might be performed.
• Routine blood tests and a medical evaluation may be required to assess overall health.

Procedure Description

1. The patient is positioned appropriately, and the hand or finger is cleaned and sterilized.
2. Local anesthesia is administered to numb the specific area. In some cases, regional or general anesthesia may be used.
3. A small incision is made over the lesion.
4. The subcutaneous tumor or vascular malformation is carefully dissected and removed.
5. The excised tissue sample is sent to pathology for analysis.
6. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the complexity and size of the lesion.

Setting

This procedure is generally performed in an outpatient clinic, surgical center, or hospital outpatient department.

Personnel

• A surgical team typically includes the primary surgeon (often an orthopedic or plastic surgeon) and one or more assisting nurses.
• An anesthesiologist or nurse anesthetist may be involved if regional or general anesthesia is required.

Risks and Complications

• Common risks: Infection, bleeding, and swelling.
• Rare risks: Nerve damage, recurrence of the tumor or malformation, allergic reactions to anesthesia, and scarring.
• Management of complications: Antibiotics for infection, compression or drainage for excessive bleeding or swelling, and possibly additional surgery for recurrence or nerve issues.

Benefits

• Alleviation of symptoms such as pain and discomfort in the hand or finger.
• Restoration of hand function and improved cosmetic appearance.
• Definitive diagnosis from pathological examination.
• Prevention of future complications related to the growth.

Recovery

• Patients may experience mild pain and swelling, managed with prescribed pain relievers and cold compresses.
• Instructions on keeping the surgical site clean and dry will be provided.
• Stitches are usually removed within 1 to 2 weeks.
• Full recovery and return to normal activities typically occur within a few weeks, but patients should follow specific guidelines provided by their healthcare provider.

Alternatives

• Observation and monitoring if the lesion is not causing significant symptoms.
• Non-surgical treatments such as corticosteroid injections for certain types of growths.
• Minimally invasive techniques like laser therapy or cryotherapy, but these are less commonly used for small subcutaneous tumors in the hand.

Patient Experience

During the procedure, patients will feel minimal pain due to anesthesia. Post-procedure, they may experience mild pain, swelling, and temporary limited use of the hand or finger. Pain management includes prescribed analgesics and comfort measures like cold compresses.