How is melanoma removed?

Melanoma is surgically removed excision, which means cut it. The goal is to remove all of the melanoma. Cancer cells. This is often done as two procedures.

• The first procedure is a diagnostic excision.
• The second procedure is re-excision, also called wide local excision.

Diagnostic excision removes the cancer.

If your doctor suspects that a spot on the skin is melanoma, it is cut with a small margin (usually about 2 mm) of normal skin surrounding it. This can be done by your family doctor or you may be referred to another doctor for the procedure. This is called diagnostic excision. The cut fabric is sent to a pathology laboratory for testing.

The new split ensures that no one is left behind

If the pathology report is positive for melanoma, a second procedure is usually performed a few weeks later. This is to ensure that the melanoma has been completely removed and includes removing a larger margin of normal tissue.

The size of the re-excision margin depends on Breslow thickness measured by the pathologist and the site of melanoma. Sometimes it is difficult to achieve the recommended margins in places such as the middle of the face.

Your family doctor may do a new excision if the melanoma is in the place (Stage 0) or thin and less than 1 mm thick (Stage IA). Otherwise, you will be referred to a dermatologist or a surgical specialist for further management.

How much skin will be removed when you have the new excision?

The new excision will remove the wound or scar from diagnostic excision, with a normal skin margin measured at the time of surgery, as shown in the table below.

Tell me more about the surgery.

Simple excision and repair

In most cases, melanoma is cut by simple excision.

• A local anesthetic An injection is given to numb the skin to be removed.
• The doctor will cut around and under the melanoma with a scalpel. As described above, a margin of normal skin tissue surrounding the melanoma will also be cut.
• There may be some bleeding in the area, and the doctor may use a tool to burn and seal the wound (electrocautery).
• The edges of the wound are sewn together to form a thin line of stitches (sutures).
• A dressing will be applied.
• You will be told how to care for your wound and when to remove the stitches.

Excision with complex repair.

Some large wounds cannot be repaired simply by gathering the edges and stitching them. In these cases, the defect may require a skin flap or skin graft. Your doctor will explain the procedure to you.

Mohs micrographic surgery

Mohs surgery is a surgical technique used by specially trained dermatologists for some facial skin cancers, including a type of melanoma called lentigo evil

• A Local anesthesia An injection is given to numb the skin around the melanoma.
• Visible melanoma is removed in the normal manner and sent to the pathology laboratory for standard processing.
• The dermatologist then takes horizontal sections (layers of skin tissue) surrounding the wound and examines them under a microscope. If cancer cells are found, another layer of tissue is cut and checked. This continues layer by layer until there is no sign of cancer cells remaining in the skin.
• Depending on the size of the wound, it may be closed with stitches or reconstructed with a skin graft or flap.
• Mohs surgery usually takes about 3 hours, but in some cases, if the tumor It's big, it can take a whole day or more.