What Is Excisional Surgery?

Reviewed on 11/10/2020

What is excisional surgery?

Excisional surgery is used to remove skin growths and cancers.
Excisional surgery is used to remove skin growths and cancers.

Excisional surgery or shave excision is a surgical procedure that involves the removal of growths, such as moles, masses and tumors, from the skin along with the healthy tissues around the tumor. The doctor uses this technique to treat skin cancers, where they use a scalpel or razor to remove the tumor. After removing the tumors, the doctor may send the specimen to the laboratory for examination.

When is a surgical excision of skin cancer recommended?

Surgical excision is recommended in the treatment of various types of skin cancers, which include

What can I expect during a surgical excision?

Before the procedure

  • Let your doctor know your medical and medication history.
  • Mention any conditions that may interfere with wound healing, such as diabetes, smoking and heart disease.
  • Mention any drug allergies or substance allergies to the doctor.
  • You may have to undergo a physical examination before the surgery.
  • Blood thinning agents such as Coumadin (warfarin) should be stopped with a doctor’s permission.
  • Exceptionally sick patients should be operated on where specialized emergency services are available.
  • The physician may recommend antibiotics before the surgery.

During the procedure

  • The doctor may clean the surgery site with an antiseptic solution, such as povidone-iodine.
  • The doctor may inject a numbing solution or local anesthetics to numb the surgical site. 
  • Next, the physician uses a sharp razor or scalpel to make an elliptical incision covering the tumor and several millimeters of surrounding healthy tissue.
  • After making an elliptical incision, the physician removes the tumor with the help of a scalpel and forceps.
  • The physician may perform cauterization to close the blood vessels. It is a heated probe that burns and seals the blood vessels to stop bleeding.
  • Finally, the physician closes the wound with sutures.
  • They may also perform some electrosurgical feathering using an electrode to shape the edges of the wound. Feathering helps to remove the remnants of tumors and minimizes scars.

After the procedure

  • After closing the wound, the physician will apply a chemical such as aluminum chloride hexahydrate to stop bleeding.
  • After cleaning the surgical site, the physician applies antibiotics.
  • The physician covers the site with a sterile bandage to prevent the risk of infection.
  • Keep the excision site dry for 24 hours.
  • Protect the wound site from bright sunlight to prevent conspicuous scar formation.
  • You may have a burning sensation around the wound.
  • Apply antibiotics ointment on the wound to promote healing.
  • You should remove the dressing in 24 to 48 hours.
  • You should avoid laborious activity for at least two weeks after the surgery.
  • You should refrain from smoking for at least a week as it impairs wound healing.
  • Painkillers such as Tylenol may be given, if necessary.
  • You may need to follow-up with the doctor for one to two weeks. 
  • You may notice the following complications
    • Excessive scarring
    • Signs of infection such as fever and chills
    • Drainage from the wound site
    • Nerve damage
    • Bleeding
    • Swelling
    • Pain and discomfort
    • Incision reopening

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References
Medscape Medical Reference

SkinCancer.net


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