Skin Cancer Surgery

There are 3 common types of skin cancers. 

Basal cell carcinomas (BCCs) are a form of skin cancer that if not treated will continue to grow in size and cause problems in the area of the body that they are growing in.

Squamous cell carcinomas (SCCs) are a form of skin cancer that if not treated will continue to grow in size, but also have a small risk of spreading to other parts of the body.

Melanoma is the type of skin cancer that has the greatest potential to spread to other parts of the body.  After your melanoma is removed the report from the pathologist will help determine the chance of it spreading.  You may also need a sentinel node biopsy (lymph node biopsy) to help determine this risk.

The size, location and type of skin cancer you have will determine the surgery you need.

You may be able to have your skin lesion excised in Dr Hamer's rooms.  If this is the case a separate appointment time will be made for this. 

Some lesions will require excision in a hospital.  This may be because they need a skin graft or a flap, a larger excision area or a sentinel node biopsy.

A split skin graft is a procedure where the top layer of skin from another part of your body such as your thigh, is shaved off and used to cover the area where the lesion was removed from.  It will be held in place with a combination of glue, foam and staples.  This dressing will need to be removed 5-10 days after your operation.  Depending on how much of the graft has 'taken' - grown into place, you may need no further dressings, or a series of dressings until the wound has healed. 

You will have a second dressing on your thigh where the graft was taken from. This should be left in place for 2 weeks.

In a full thickness skin is taken from either your groin or lower neck region and sutured to the area where the lesion was excised from.  The area where it is taken from will be closed with a dissolving stitch.

With a skin flap, the area of skin next to the area that was excised can be rotated or advanced into the excision area.  This technique can often avoid the need for a graft and provide better cosmesis.

To help determine risk of melanoma spread you may require a sentinel node biopsy.  For a sentinel lymph node biopsy you will undergo a lymphoscintigram on the day of your surgery.  This is a nuclear medicine test which will show which lymph node your melanoma would spread to first (if it were to spread).  At surgery this will help direct Dr Hamer to remove this lymph node and send it for testing.  A sentinel node biopsy requires a general anaesthetic.  It can be done as a day case surgery.  Further treatment may be recommended depending on the results of your node biopsy.