Overview

Excision Surgery is a surgical procedure to completely remove skin lesions with adequate margins for both treatment and diagnosis.

Excision surgery is crucial for treating skin cancers, suspicious lesions, and benign growths that require complete removal.

Learn more in our comprehensive RxDx Dermatology Course

Indications

✓
Skin Cancer

Basal cell, squamous cell carcinoma

✓
Suspicious Lesions

Melanoma, atypical lesions

✓
Benign Growths

Large seborrheic keratoses

✓
Cysts

Epidermal cysts

✓
Lipomas

Fatty tumors

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Uncontrolled bleeding

Relative Contraindications

✗ Anticoagulation
✗ Active infection

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient assessment, lesion evaluation, informed consent, and understanding surgical techniques.

Step-by-Step Procedure

Step 1: Lesion Assessment

Evaluate lesion and plan excision.

⚠️ Common Mistakes to Avoid:

  • Inadequate margins
  • Poor planning

💡 Pro Tip:

Plan adequate margins.

Step 2: Anesthesia

Administer local anesthesia.

⚠️ Common Mistakes to Avoid:

  • Inadequate anesthesia
  • Wrong technique

💡 Pro Tip:

Ensure complete numbness.

Step 3: Incision

Make surgical incision.

⚠️ Common Mistakes to Avoid:

  • Wrong orientation
  • Inadequate margins

💡 Pro Tip:

Use proper technique.

Step 4: Dissection

Dissect and remove lesion.

⚠️ Common Mistakes to Avoid:

  • Incomplete removal
  • Tissue damage

💡 Pro Tip:

Use careful technique.

Step 5: Hemostasis

Control bleeding.

⚠️ Common Mistakes to Avoid:

  • Excessive bleeding
  • Poor hemostasis

💡 Pro Tip:

Use electrocautery if needed.

Step 6: Closure

Close wound appropriately.

⚠️ Common Mistakes to Avoid:

  • Poor closure
  • Tension

💡 Pro Tip:

Use tension-free closure.

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Post-procedure Care

Post-procedure care involves wound care, monitoring for complications, and follow-up for pathology results.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 5-10% Excessive bleeding Pressure, sutures Proper technique
Infection 2-5% Redness, pain, discharge Antibiotics Sterile technique
Scarring 15-25% Visible scar Time, scar care Proper technique
Recurrence 5-15% Lesion returns Repeat excision Adequate margins

Clinical Pearls

💡

Always plan adequate margins for malignant lesions.

🎯

Use proper surgical technique.

⚡

Ensure complete lesion removal.

🔍

Document excision margins.

📊

Send specimen for pathology.

🎨

Consider cosmetic outcome.

⚠️

Monitor for complications.