The procedure
Removal of skin cancers can generally be done under local anaesthetic with or without light sedation. Larger skin cancers may require a general anaesthetic. It involves removing the lesion with a cuff of normal tissue around it. This has been shown to dramatically reduce the rate of recurrence. When the cancer is removed, the defect can then be closed by a variety of techniques including local flaps (rotation of tissue into the area) or direct closure.
The procedure can take anywhere from 20 minutes to several hours to perform depending on the size and complexity of the surgery. Occasionally even local flaps won’t suffice and complex reconstructions using transplanted tissue from elsewhere in the body is required.
Recovery is again dependent on the nature of the operation. For simple excisions you can return to most activities, including work, the following day. More complex procedures require lengthier recoveries which can be both as in inpatient in hospital as well as recovering at home.
Before the procedure
Before the procedure, you will be seen and given a complete skin examination. The lesion to be removed will be identified and our surgeons will discuss with you the most likely diagnosis and ideal surgical treatment. We will inform you of the type of anaesthetic we recommend and any risks with the operation. We will endeavour to answer any questions you have in regards to its removal as well as the reconstructive plan. All measures will be taken to ensure you are as informed as possible prior to your operation and that the post-operative recovery plan is clarified.
There are usually no further tests required for removal of small lesions. In cases of larger lesions further investigations prior to surgical management are sometimes required. These can include special scans as well as tissue sampling of either the primary lesion or any abnormal changes in regional lymph nodes or tissues elsewhere within the body.
During the procedure
If your operation is performed under local anaesthesia, you will be awake throughout the procedure. In most of these instances sedation is also given to make you more comfortable. In cases requiring general anaesthesia the length of the procedure can vary depending on the complexity of the surgical resection and the reconstruction requirements. Even in cases of general anaesthesia a local anaesthetic is used to decrease the amount of general sedation required in an effort to hasten recovery. Antibiotics may also be used during the procedure and potentially continued post-operatively.
Occasionally a pathologist will also be present during the operation to perform an initial evaluation of the adequacy of the surgical resection. This is called frozen section analysis and can be an effective in ensuring complete removal of the cancer and negating the need for either a second operation of non-surgical treatment such as radiation treatment.
Post-procedure recovery
For smaller lesions, you will normally be able to go home that day. All dressing information and suture removal times, will be explained to you prior to departure and these post-operative appointments with your surgeon will be arranged.
The formal results and diagnosis of the lesion removed will take several days to be processed but you will be notified as soon as they are available. Your GP will also be sent a copy of all relevant tests.
What’s next?
At your follow-up appointment, usually 1 week post op, the wound will be reviewed and any remaining sutures removed. The results will be explained in detail and any further treatment or surgery outlined.