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What is surgical excision?

Excision is skin cancer treatment after a diagnosis has been made. Excision is surgery to remove the entire skin cancer and a margin of healthy tissue to remove any cancer cells that may have spread to the surrounding tissue. Surgical excision is generally an office procedure or can be performed as an outpatient with local anesthetic.

Surgical excision is surgery for all kinds of skin cancer, melanoma and nonmelanoma. With a skilled and experienced surgeon such as Dr. Sedrak, you can expect good medical and cosmetic results.

However, a tumor that is large (0.8 mm) or ulcerated is indicative of potential metastasis (spreading) to the nearby lymph nodes. In that case, a sentinel node biopsy will be performed to and determine if that is the cancer has spread. Many times, the entire tumor will be removed along with the lymph node biopsy in one procedure, but when the tumor is small and not ulcerated no lymph node biopsy is usually necessary.

Types of excision surgery

A simple excision removes a skin growth and a small border of healthy tissue. A shave excision literally shaves the growth off of the skin with a razor like device. In a wide excision of a melanoma, the margins are established based on thickness or depth of the tumor. Excision removes the entire tumor and a wide margin of healthy tissue.

Dr. Sedrak adheres to the margin guidelines recommended by the National Institutes of Health and the American Academy of Dermatology. These new guidelines remove less normal skin and reduce the need for cosmetic reconstructive surgery, while still providing a cure in most cases.

The Procedure

Dr. Sedrak will outline the tumor and margin of safety with a Sharpe and guide the incision. A local anesthetic will be administered, and he will use a scalpel to cut along the lines draw in an elliptical or football shape. This shape results in a more cosmetically acceptable scar. The scar itself will be a thin, straight line.

When a tumor is on a difficult to area of the body such as the sole of the foot, special repairs will likely be necessary. Stitches will be used to close the wound and will be removed within a week or two.

The entire procedure takes about 30 minutes. You will be advised on how to care for your wound, activities to avoid including anything that require heavy lifting or exercise, and what to watch for and when to call the Doctor. Once healed the scar will usually be small and will improve with time.

The removed tissue is sent to a pathologist to confirm that the entire tumor has been removed and that there are no cancer cells left at the site. When cancer cells remain, additional treatment will be necessary. That may include another excision, Mohs surgery, radiation and drug therapy.

Dr. Joseph Sedrak is a board-certified, fellowship trained dermatologist and Mohs surgeon. He founded the Texas Cancer Center to bring expert medical and cosmetic dermatology to residents of Houston, Kingwood and Sugarland, Texas and surrounding communities.

At the Texas Skin Cancer Center, you will always receive private, respectful and compassionate care in a state-of-the-art facility. Contact the Texas Skin Cancer Center to schedule a consultation today.

(281) 886-3600


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