Skin surgery is usually performed for the removal of skin tumors. Many skin tumors are entirely benign (non-cancerous) but some are malignant (cancerous). The commonest cancerous skin tumor removed is the Basal Cell Carcinoma. Most skin surgery is performed under local anesthetic (an injection into the skin under the tumor to turn the area numb). Therefore most patients can eat and drink in the normal way and are fit to return home immediately after surgery. Taking drugs which thin the blood and therefore promote easy bleeding can complicate surgery - these drugs include warfarin (coumarin) and aspirin. You need to discuss your drug medications with your doctor before attending for surgery.
Sometime stitches are put into the skin but on other occasions the skin is left to heal naturally - it depends on what type of skin surgery you are having. Either way, it is usually advised to keep the treatment area completely dry for 3 - 5 days after surgery and protected with a dressing.
Skin Surgery can involve a stitching or a non-stitching type of approach. Most Skin Cancer surgery requires stitches - the resulting scar is located along the lines of natural skin creases, eg eye wrinkles, giving the best cosmetic outcome.
Dressings are especially important overnight in bed where accidental scratching or rubbing can cause bleeding , irritation, etc. After this first few days it is possible to wet the area for only a couple of minutes (e.g. a very very quick shower) but the treatment site should then immediately be dried with a hair dryer and an antiseptic spray or cream applied. The antiseptic should be repeated twice per day until healing has occurred. Stitches are typically removed 7 - 14 days after surgery. Scalp wounds can usually be rapidly shampooed and then dried in the same way.
Surgery scars heal according to the body site and the tension on the skin. The worst areas for healing are the skin sites stretched over any prominent bone such as the shin bone, the breast bone and the tip of the shoulder. In general a skin scar will remain red for about 2 - 3 months before gradually turning white and becoming much less visible.
There are several more specialised branches of skin surgery which we aim to provide further details about soon - these include laser surgery, plastic surgery, Moh's surgery, liposuction, etc.
We shall shortly be providing a comprehensive medical register of doctors involved in skin surgery. If you would like to be included in this new service and you are medically qualified please contact us with details.
by Dr John Ashworth