Procedure
- Mark the site of the incision on the skin [Figure 75].
- Apply iodine to the surgical area.
- Cover with a sterile fenestrated drape.
- Administer local anaesthesia by field block or guided anaesthesia according to the Oberst method.
Figure 75
- Holding the scalpel perpendicular to the skin, make an elliptical incision parallel to the skin lines [Figure 75]. Make the incision close to the tumour in unaffected tissue.
- Place your thumb and forefinger on either side of the area to be excised and apply tension to the skin.
- Set the tip of the scalpel at the beginning of the incision and, holding it perpendicular to the skin, cut in a fluid motion using the rounded portion of the scalpel.
- Avoid having the incision paths cross in the corner (“fish tail”) [Figure 76].
Figure 76
- Make the incision pass through the entire skin layer.
- Using the surgical tweezers, grip the skin flat containing the tumour and excise it, taking along some subcutaneous fat [Figure 77].
Figure 77
- Mark the specimen with a suture for the benefit of the pathologist.
- Deposit the resected material in a formalin-filled container.
- Dab the wound with sterile gauze until it is dry.
- Suture the wound margins with non-reabsorbable material.