Excisions

During the excision of a skin lesion, Dr. Tina will explain to you why the skin lesion needs to be excised and walk you through the procedure. You may be asked to sign a consent form indicating your understanding and agreement with the surgical intervention. Inform Dr. Tina about any medications you are taking, allergies, medical conditions, or if you have a pacemaker or implanted defibrillator. Additionally, disclose any over-the-counter supplements or herbal remedies that could affect bleeding.

The most common type of excision is an elliptical excision, where Dr. Tina will design an incision in the shape of an ellipse. This helps minimise tension on the wound and orient the resulting scar along existing skin creases, making it less noticeable.

Dr. Tina will mark the area to be excised and administer a local anaesthetic injection to numb the skin. Using a scalpel and sharp scissors, she will carefully cut around and under the lesion, including a margin of healthy tissue. The excised lesion will be sent to the pathology laboratory for examination by a pathologist who will provide a report to Dr. Tina in a few days.

During the procedure, there may be some bleeding, which Dr. Tina can control by cauterising the blood vessels. The edges of the incision will then be stitched together using sutures, typically in two layers. Dr. Tina will provide instructions on wound care and inform you when to have the stitches removed.

Excisional Biopsy

Primarily diagnostic, this procedure entails the complete removal of a skin lesion to obtain a comprehensive tissue sample for histopathological analysis. It's especially critical when the nature of the lesion is ambiguous or there's a suspicion of skin cancer, including when a melanoma is suspected. In such cases, an excisional biopsy ensures that the entire lesion, along with a margin of normal surrounding tissue, is examined to provide a precise diagnosis.

The biopsy is aimed at confirming the presence, type, and extent of the disease, offering crucial insights for planning further treatment.

Excision

The main goal here is therapeutic, focusing on the complete removal of a lesion, typically one that has already been diagnosed as malignant or is problematic in some way.

Excision serves as a form of treatment for skin cancers like basal cell carcinoma, squamous cell carcinoma, or melanoma. The procedure involves removing the lesion along with an appropriate margin of healthy tissue to ensure all cancerous cells are eradicated.

This method is intended to cure or significantly manage the condition, unlike an excisional biopsy, which may necessitate additional treatment based on the findings.

In summary, while an excisional biopsy is conducted to diagnose the nature of a lesion, including suspicions of melanoma, an excision is performed to remove a known or assumed problematic lesion, such as skin cancer, with the intention of treatment and cure.

1. The procedure starts with marking the area around the lesion.
2. A local anaesthetic is then injected to numb the area.
3. The lesion, along with a margin of surrounding tissue, is removed and sent to a pathology lab.
4. There may be some bleeding, which is managed by the doctor.
5. The wound is then closed, often with sutures.
6. Dressing is applied.
7. Post-operative care instructions are provided, including when to remove the stitches.

It is impossible to excise a skin lesion without leaving some form of scarring. Surgical techniques aim to minimise scarring, taking into account factors such as the skin's tension lines to make scars less noticeable. Some individuals might experience keloid or hypertrophic scarring, where scars are larger and thicker than normal.