Skin Cancer Surgery
I perform most skin cancer surgery in the dedicated minor surgical theatre at Eastmed Doctors. These are done under local anaethesia.
This may involve a small match head portion of the spot taken out (punch biopsy) or taken out fully with about a 3 mm buffer of normal skin to give the mole clearance (Excision). After this then this is stitched up. If there is enough skin then it is a matter of pulling them together like a zip. This involves internal stitches and some on the outside. I try to put internal stitches that do not need to be taken out most times. But sometime due to a variety of reasons you need to have stitches that need taken out.
This stitching up if simple is called direct closure. If the skin is tight, then I need to do a flap which is just moving skin around like a jig saw puzzle, moving skin from a lax area to the hole created by taking the cancer out. If this is not possible then you will need a skin graft. This is taking skin from some other part of the body and patch it up like quilt work. This heals beautifully. If you scroll down you will see some examples. I will try and add more images as time allows.
Simple Excision and Direct Closure
You can click on the image to open a big image. This is just marking the cancer under dermoscopic control with a 3mm buffer of normal skin. Local anaesthetic is infiltrated. The cancer is cut out and the skin is stitched.
Flaps
You can click on the image to open a big image. This technique is used when I cannot bring the skin together like in direct closure. A small adjacent island if skin is either pushed or rotated to fill the gap caused by cutting the cancer out.
Skin Grafts
You can click on the image to open a big image. This technique is used when I cannot bring the skin together like in direct closure or use flaps. Either a full thickness or partial thickness of skin is cut elsewhere in the body. This is then trimmed to shape and attached to the defect with stitches.
