Skin cancer removal

Introduction

You need an operation to remove a lesion from your skin in the head and neck region. In some cases, there may be a suspicion that this is a small cancer. Most of these lesions are associated with sun exposure, often in early life. Most of them grow locally and do not spread throughout the body. Because of this, accurate removal with some surrounding normal tissue is the best treatment. The gap formed after surgery will then need to be repaired.

What does the operation involve?

The day of the operation:
You will attend the hospital on the day of operation; local anaesthetic procedures are usually undertaken towards the end of the operating list.

The anaesthetic:
This operation is usually performed under a local anaesthetic. In some cases a general anaesthetic is more appropriate and your surgeon will discuss this with you.

The operation itself:
The most painful bit of the procedure is usually injecting the local anaesthetic. After this, the area is numb; if any pain is felt during the procedure, further local anaesthetic is inserted.

The nature of the surgery will depend on the site of the skin lump and your surgeon will discuss this with you. Additionally, in some areas of the face, and particularly if the lesion is large, it may be necessary to move some skin from elsewhere to cover the defect. This may leave a separate wound (donor site), which will need stitches, or this may make the wound look larger than the lesion removed. All lumps removed from the skin are sent to the laboratory.

After the operation:
In some cases the stitches used to close the wound will need removing and you will be informed of this after your operation. Where necessary, this should be arranged with your Practice Nurse. There may also be some antibiotic ointment to apply to the wound for the week prior to stitch removal and for the week afterwards.

You will normally be seen in clinic at around one month after surgery, to ensure that the wound is healed and to check the results of the laboratory tests.

Your discharge from hospital:
If a local anaesthetic was used, full mobility can be resumed 1-2 hours following surgery. Following general anaesthesia, you will need to arrange for a responsible adult to pick you up from hospital, take you home and stay with you for 24 hours after discharge. Depending on how fit and active you are before your operation, you may need to arrange for someone to stay with you for a few days.

 

 

POST OPERATIVE CARE

What should I do when I leave hospital?

Activity:
As long as the area operated on is protected, you should be able to resume normal activity within 2-3 days.

Driving:
If the procedure is performed under local anaesthetic, you should be able to drive immediately following surgery. If general anaesthetic is used you should not drive for 24 hours.

Wound care:
The wound should be kept dry for one week – any other specific instructions will be given to you on the day of surgery.

Work:
You should be able to return to work after one day, unless it is extremely physical.

 

Are there any risks involved in this operation?

Although modern surgery and anaesthetics are considered to be safe, all medical procedures carry some risks. The surgeon will discuss all these risks with you.

Risks associated with the operation are:

• Recurrence of the skin lesion
• Inadequate removal requiring further surgery
• A cosmetic deformity resulting from removal
• Bleeding through the stitches
• Pain in the area when the local anaesthetic wears off
• Infection of the wound- increasing pain, redness and discharge are key signs.
• Bruising
• Numbness

 

Are there any alternatives to this operation?
This will depend very much on the site and suspected nature of the lump – please discuss with your surgeon.

 

Further information and advice
If you experience pain not relieved by painkillers or heavy bleeding after your operation please contact your Surgeon, GP or go to the Accident & Emergency Department.