Surgical Excisions

Surgical excisions are performed to remove a wide variety of skin lesions ranging from benign growths such as cysts and lipomas to malignant lesions including basal cell carcinoma, squamous cell carcinoma, and melanoma.

Surgical excisions are performed under local anesthesia. Typically an elliptical (football) shape of skin is removed that encompasses the primary skin lesion in addition to a margin of uninvolved skin. Any bleeding is controlled with electrocautery. The resulting wound is then repaired by loosening the surrounding skin and then suturing layers of tissue together – first the deep layer with sutures that dissolve, then the superficial layer with sutures you will see and that need to be removed. The incision line will be straight and is often longer than the patient expects because the final length of the incision is usually three times as long as the diameter of the wound. All excisions will result in a scar which can take a few months to a year to heal completely. The scar can be minimized by the proper care of your wound and adhering to activity restrictions.

Prior to your excision appointment, please bathe and wash your hair to minimize your risk of a surgical site infection. The day of your excision, please eat breakfast or lunch as you normally would – there is no need to fast. It is important that you do not take any anti-anxiety medicines, over the counter or prescription pain medicines the day of the excision.

After a surgical excision, pain is typically minimal and can usually be controlled with Tylenol, extra strength Tylenol, and/or icing the area. Bruising and swelling are common following an excision and can last for several days. Using ice in the first 24 hours helps reduce these symptoms. The risk of post-operative infection is very low. If you are concerned about worsening symptoms of redness along the incision line, pain, drainage, swelling, or you have fevers, please call our office immediately: 360-254-5267.

Once the excision is complete, a pressure dressing will be placed on the wound and should be left in place for 2 days. Rarely, post-operative bleeding occurs and can usually can be stopped with direct, firm pressure to the surgical site for 20 minutes. For any bleeding that is not controlled with pressure, please call our office immediately: 360-254-5267.

Following surgery, you should plan on decreased activity – no exercise or heavy lifting – and restrict travel for 2 weeks, possibly longer depending on the location of the surgical site. This will minimize the scar from spreading and reduce the chance of bleeding after surgery. Sutures will need to be removed 7-14 days following the excision – the timing depends on the site of the surgery. You will schedule this appointment after the excision appointment is finished.

The excision specimen will be examined under the microscope to generate the pathology report and diagnosis. It can take 1-2 weeks to obtain the pathology report. There is always a chance that the excision margins did not completely remove the lesion, in which case an additional excision may need to be performed at a later date, particularly if the lesion is malignant.

Please click here for post-surgical wound care instructions.

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Surgical Excisions