Medical Questions » Skin Cancer Questions » Question No. 901
Question:I have been told that I must have a suspicious mole cut out, but I am frightened of any surgery. Can you please explain what will happen?
Answer:An area is excised (cut out) to remove a skin cancer, a mole that is annoying or cosmetically unacceptable, to improve the appearance of a scar, or part of a gtowth may be removed to see if it is malignant. After you lie down on a couch in the doctor' s surgery in a position that makes the area to be excised easily accessible, the area will be cleaned with a solution that destroys most of the germs on the skin. The doctor will then inject an anaesthetic around the area to be excised, or sometimes into the base of a finget ot toe, to anaesthetise the area. The injection stings for about 15 seconds, and with larger areas, two or more injections may be necessary. The atea injected will become numb within a few seconds, and no further pain or discomfort should be experienced. If any discomfort is felt, tell the doctor immediately, and further anaesthetic can be injected. A tray with instruments, solutions, drapes, swabs, sutures etc. will have been placed near you, and the doctor will wear sterile gloves, and possibly a mask and gown. The doctor will thoroughly clean the skin again, and then take a drape from the tray, and arrange it near or around the area to be excised. Using a scalpel, which has an edge sharper than a razor, the doctor will cut around the lesion being excised. You may feel pressure, but no pain. It is not possible to cut out closely around the lesion, as a round hole cannot be closed without using plastic surgery techniques to extend the size of the wound, so in most cases, a diamond shaped excision is made, and the scar is usually about three times longer than the lesion is wide. Over the next few minutes, the doctor will cut out the area of concern, and in most cases put the tissue removed into a bottle of preservative for further analysis by a pathologist. The repair of the wound then commences with stitches (or sometimes staples) being inserted to close the wound. This often takes longer than the excision of the lesion, and once again, you should feel no pain. Once the wound is closed, a dressing will be applied (unless the wound is on a sensitive area where it is inappropriate) and you can go home. The anaesthetic will last for one to three hours (depending on which type has been used), but after it has worn off there should be nothing more than a slight ache and paracetamol is normally the only medication necessary. There may be some slight ooze of blood onto the dressing in the first hour or rwo, but for no longer, and the dressing may need to be changed at this time. The wound should be kept clean, dry and, if possible, covered until the stitches are removed. You can normally have a shower, but not a bath or a swim. After a shower, remove the damp dressing, pat the wound dry and apply a clean dry dressing. Antiseptics, powders and other medications are not normally necessary If the wound becomes red, painful, discharges pus or you develop a fever, return to see the doctor immediately. Otherwise the stitches will be removed in a few days or weeks, depending on the area affected and the size of the wound. Sometimes only some of the stitches are removed, and a further visit is necessary for removal of the remainder. The scar will continue to heal after the stitches are removed. It will form a red line initially, but this usually fades to a white line after a few months. The scar will not reach its final form until a year after the excision. Some parts of the body heal better than others. The face and hands heal very well, while the back, chest and lower leg heal poorly and will scar more. Scars on areas of tension often spread, and will not appear as neat as scars that are not under tension. Your procedure may not exactly follow the outline above for multiple reasons. Please ask your doctor if you have any other queries.

       
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