Surgical Excision
Surgical Excision for Skin Conditions: Overview and Considerations
Surgical excision is a common procedure used in dermatology to remove skin lesions, growths, or abnormalities. It involves cutting out the affected area along with a margin of healthy tissue to ensure complete removal and minimize recurrence. Below is a detailed synthesis of its key aspects, supported by current evidence.
Indications
Surgical excision is indicated for:
- Suspicious moles or skin cancers (e.g., melanoma, basal cell carcinoma).
- Pre-malignant lesions (e.g., actinic keratoses, Bowen disease).
- Cosmetic or diagnostic purposes (e.g., benign growths causing discomfort).
- Chronic irritation or discomfort from skin lesions.
Procedure
Preparation:
- Local anesthesia: Administered to numb the area, ensuring a painless procedure[1][2].
- Surgical marking: The excision site is outlined with a marker to guide the incision[5].
Excision:
- Elliptical incision: Typically used to ensure tension-free closure and minimize scarring[3][5].
- Lesion removal: The lesion is cut out along with a margin of healthy tissue[6].
Closure:
- Suturing: The wound is closed with stitches to promote healing[4][7].
- Dressing: Applied to protect the wound site[6].
Benefits and Risks
Benefits:
- Diagnostic clarity: Tissue is sent for histopathological examination to confirm diagnosis[4][7].
- Therapeutic effectiveness: Reduces recurrence risk by removing the entire lesion[2][7].
- Aesthetic outcomes: Minimizes scarring by aligning incisions with skin tension lines (Langer’s lines)[3].
Risks:
- Scarring: Inevitable but can be minimized with proper technique[5].
- Infection, bleeding, or pain: Common post-operative complications[3][8].
- Keloid formation: More likely in individuals prone to keloids[6].
Post-Operative Care
- Wound care: Follow specific guidelines to prevent infection and promote healing[1][2].
- Activity restrictions: Avoid strenuous activities until the wound heals[2].
- Follow-up appointments: Scheduled to monitor healing and remove sutures[1][2].
Conclusion
Surgical excision is a reliable method for managing skin conditions, offering both diagnostic and therapeutic benefits. While it carries risks like scarring and infection, proper technique and post-operative care can minimize these complications.
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References
- Wilmington Skinsurgery Center: Surgical Excision
- Skin Surgery Center: Surgical Excision
- TeachMeSurgery: Elliptical Incision
- Skin Surgery Center: Standard Excision
- Pymbledermatology: Skin Cancer Excision
- Perfect Derm: Surgical Excision
- Mid TN Skin: Standard Excision
- HWE Clinical Guidance: Benign Skin Lesions
