Excision refers to the removal of a skin lesion by completely cutting it out of the skin. Close refers to the edges of the excision being sewn together resulting in a thin suture line. Excision is often used to diagnose and fully remove cancer growths that are result of such conditions as: basal cell carcinoma, squamous cell carcinoma, or melanoma. If the cancer is not excised, there is a high likelihood that it may metastasize (spread) inflicting other areas of the body. Excise & close is also utilized as a cosmetic procedure, particularly for removing an inflamed or frequently infected cyst.
Before the procedure takes place, be sure to let us know if you are taking any over-the-counter medications, herbal supplements, and especially “blood thinners”, such as Plavix, Eliquis, Warfarin, or aspirin; due to these drugs increasing the risk of bleeding during excision.
Excision begins by first marking the area with a surgical marker. Then a local anesthetic is injected into the area where it will rapidly numb the skin throughout the duration of the procedure. Next, a scalpel and sharp scissors are used to cut around and under the lesion, leaving an appropriate margin of normal surrounding tissue. For diagnosis circumstances, the removed growth may be placed in a formalin solution and sent to a laboratory for examination. To finish the excision, the blood vessels may be cauterized using a cautery. Next, the edges of the cut will be sewn together with stitches forming a thin suture line. The sutures on the surface will be removed usually within 4-14 days. Occasionally, special skin glue may be used to join the edges together rather than using sutures.
After the local anesthetic wears off, the area may be tender for up to 1-2 hours after the excision. Leave the dressing in place for 48 hours making sure that it remains dry. The scar will initially be red and raised but will heal over the next couple of weeks.