Skin cancer management


Skin cancers are the most common cancers of the western world.  A significant proportion of the elderly develop skin cancers and they can be managed surgically with excellent aesthetic and functional long-term outcomes with over ninety five percent cure rate.

Mr. Komath has vast experience in the surgical management of skin cancers with excellent audited outcomes. He is part of the dermatology MDT at Royal Free Hospital London. The procedures are painless, carried out under sedation or general anaesthetic as a day procedure.

       

Complications of skin cancer surgery:

  • Less than five percent recurrence requiring re- operation
  • Bruising
  • Bleeding
  • Scars
  • Facial asymmetry
  • Altered sensation of the skin

 

Advice for patients having undergone Skin surgery  / Wound Care

Surgical excision is an operation to cut out the disease along with a cuff of surrounding healthy tissue to ensure the cancer is completely removed. It may be carried out out in combination with a  reconstructive procedure of a local skin flap (plastic surgery to move or rotate surrounding healthy skin into the surgical defect or skin graft which involves removing a patch of healthy skin , usually from a part of the body where any scaring can’t be seen , such as your neck, abdomen or upper thigh. Its then laid in ( Grafted) to the surgical defect. 

 

Immediate Wound Care

Your surgeon will provide you with instruction on how to care for your wound immediately after surgery. The wound will usually be covered with a pressurised dressing for about 24 hours to promote clotting and lower the risk of excess blood loss. Keeping the surgical site dry for at least one day after surgery is important in order to reduce the risk of infection.

Your surgeon will let you know when it is safe for you to shower the area, which is typically 48 hours after the procedure . You should also avoid lifting heavy objects and doing physical activities for about one to two days after surgery to minimise the risk of excess bleeding or wound opening up and allow the wound to begin the wound healing process. If you do notice blood or other slight wound drainage, apply firm pressure to the pressurised dressing for 10 -15 minutes until it stops.

Occasionally antibiotic ointment may be prescribed to you. Please use it only over the wound as instructed.

Sutures would normally be removed 7 to 9 days following surgery.

 

Cleaning  your Wound

Keeping your skin surgery wound clean is an important  part of the healing process.  

Your doctor may also prescribe some advanced surgical wound care supplies that can help promote healing and reduce scarring .

Please do not use the skin cleansers , antibacterial soaps, alcohol, Iodine, or peroxide during the early healing period. They can damage the skin in the wound and delay healing . Also don’t put on any lotion , cream or herbal product unless you’ve checked with your doctor first.

 

Signs  of  Infection

Keeping the wound clean and covered with the right dressing lowers your risk of infection , but it is still important to know what to watch for and inform  your surgeon as soon as possible if you notice any of the following signs of wound infection.

Drainage or discharge that is a greenish or yellowish colour or drainage that is cloudy rather than clear. Pale straw coloured discharge after bleeding has stopped following surgery is a normal part of wound healing.

Redness that spreads beyond the wound area and forms thread – like patterns or splotches.

Enlarged lymph nodes near the surgical site 

Fever

Pain that gets worse in the days following surgery

 

Minimising  Scars

As the wound heals, you can expect some scarring to occur . You can lower your risk of having permanently visible scars by following certain practices.

Avoiding sun expose of the scar in the first year.

Cover the wound with a silicone dressing to keep it moist and prevent thicker scars from forming. Your surgeon will prescribe it for you.

The scar maturing process lasts over a year. Gentle massage of the healed scar will soften it and improve the aesthetic appearance of it.