Name of the Procedure:

Excision of Tumor, Soft Tissue, or Vascular Malformation of Hand or Finger, Subfascial (Intramuscular) Less than 1.5 cm

Summary

This procedure involves the surgical removal of a small tumor, soft tissue growth, or vascular malformation located beneath the fascia and within the muscles of the hand or fingers. The excised area is typically less than 1.5 centimeters in size.

Purpose

The procedure aims to remove abnormal growths or malformations that may cause pain, discomfort, limited movement, or other functional issues in the hand or fingers.

Indications

• Presence of a palpable mass or growth in the hand or fingers.
• Pain or discomfort in the hand or affected digit.
• Limited range of motion or functional impairment.
• Diagnostic confirmation of a benign or malignant tumor, soft tissue growth, or vascular malformation through imaging or biopsy.

Preparation

• Patients may be required to fast for several hours prior to the procedure.
• Medication adjustments might be necessary, especially for blood thinners and anticoagulants.
• Pre-procedure imaging studies, such as MRI or ultrasound, to precisely locate the growth.
• Routine blood tests and health assessments.

Procedure Description

1. The patient is positioned and the surgical area is sterilized.
2. Local or regional anesthesia is administered to numb the hand or affected finger.
3. A small incision is made over the site of the tumor or malformation.
4. The surgeon carefully dissects through the superficial layers to reach the subfascial and intramuscular level where the growth is located.
5. The tumor or malformation is excised, ensuring clear margins.
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 location of the growth.

Setting

This surgery is generally performed in an outpatient surgical center or hospital.

Personnel

• Orthopedic or hand surgeon.
• Surgical nurse.
• Anesthesiologist or anesthesia nurse.

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Scarring
• Incomplete removal of the tumor, necessitating further surgery

Benefits

• Relief from pain and discomfort.
• Improved hand or finger function.
• Removal of potentially malignant tumors, reducing the risk of cancer spread.
• Improved cosmetic appearance of the hand or finger.

Recovery

• Keep the surgical area clean and dry.
• Follow the surgeon's instructions on wound care and suture removal.
• Pain management may include prescribed medications or over-the-counter pain relievers.
• Avoid strenuous activities and heavy lifting for several days to weeks.
• Follow-up appointments for wound check and to monitor healing.

Alternatives

• Observation and regular monitoring for small, asymptomatic growths.
• Non-surgical treatments like steroid injections to reduce inflammation.
• Physical therapy to maintain hand function without surgery.
• Radiotherapy or chemotherapy in cases of malignant tumors.

Patient Experience

During the procedure, patients will be under local or regional anesthesia, so they should not feel pain but may experience some pressure or movement. Post-procedure, mild to moderate discomfort is common, which can be managed through prescribed painkillers. Swelling and stiffness may occur but usually resolve with time and proper aftercare.