FAQ About Skin Surgery

What happens in a skin biopsy or skin excision?

Skin biopsy involves taking a small sample of the skin lesion surgically so that it can be examined under a microscope.

Local anaesthetic is used to numb the skin and surgical antiseptic to clean the skin. Skin biopsy may be performed using a skin shave device (shave biopsy), skin scrape device (curette biopsy) or a skin ‘hole punch’ device (punch biopsy) depending on which approach is best suited for the skin lesion and skin location.

A sterile dressing is applied for 2 days to allow time for the skin to reform a water-tight seal. Thereafter you can leave the punch biopsy sites open to the air or cover with a Band-Aid. Curette and shave biopsy sites are best kept covered with a Band-Aid until they are completely healed which may take 2-3 weeks. Take the previous days Band-Aid off during your daily shower, gently wash the wound with fresh water and apply a fresh Band-Aid after your shower.

The skin biopsy is sent away for microscope examination by a pathology specialist.

Your doctor will see you a week later to discuss the skin biopsy results with you and to plan any further treatment if needed.

Skin excision involves surgically removing the entire skin lesion.

Skin excisions are performed under strict sterile surgery conditions in our minor operations theatre. The lines of the surgical excision, including an appropriate ‘safety’ margin of normal skin, and the lines of the surgical repair are planned on the skin using a surgical marker pen. Local anaesthetic is used to numb the skin and surgical antiseptic to clean the skin. Skin lesion and its ‘safety margin’ are excised and the resultant surgical defect is closed using simple suturing or ‘plastic surgery-style’ skin flaps or skin grafts. The skin excision is sent away for microscope examination by a pathology specialist.

How do I care for a surgical wound?

A sterile surgical dressing is applied at the end of the procedure and your post-operative wound care instructions will be discussed with you and give to you in written form.

It is important to keep surgical wounds dry to allow time for the skin to reform a ‘water-tight’ seal. A dressing that has become accidentally wet creates conditions favourable for bacteria growth leading to wound infections.

Where possible, a water-resistant layer will be added to your surgical dressing to enable exposure to water during showering in the first two days after your procedure. In some body locations it is not possible to get the water-resistant layer to adhere securely (for instance, the face, neck and fingers), so you will be asked to keep the wound and its dressing totally dry during this time.

We do not recommend using water-tight dressing materials beyond two days after surgery in our sub-tropical climate. ‘Water-proof’ dressings create a ‘greenhouse-like’ effect (closed, warm and humid) which promotes the growth of bacteria leading to increased wound infections.

Two days after simple excision or skin flap surgery you will be asked to remove the ‘water-resistant’ surgical dressing whilst showering and allow the fresh water to gently cleanse the wound of any dried blood. You will be supplied with a piece of dressing material to apply directly over the stitches to protect the wound until your sutures are removed. This dressing material is ‘wash’n’wear’ so that fresh water can pass through the dressing to cleanse the wound and you can pat the dressing to dry it after your shower. In body locations where a dressing will not securely adhere (for instance, the face, neck and fingers) you will be given a prescription for a tube of antibiotic ointment to apply to your wound three times a day as an alternative wound dressing.

You will be asked to keep full-thickness or partial thickness skin graft wounds dry from the time of the procedure. It takes much longer periods of time for grafted skin to heal to the point of achieving a ‘water-tight’ seal. This may require the use of plastic bags with rubber bands and tape to keep the wound and its dressing dry during the entire time it takes for the graft to fully heal. You will be given clear instructions on how to best manage your wound before you leave.

When you attend for the removal of your sutures you will be given a printed copy of the histology results. A copy can be forwarded directly to your GP if you wish.