The treatment which affords the best chance of cure from any skin cancer is surgical excision. This can be performed under local anaesthetic, local anaesthetic with sedation or a general anaesthetic. The skin cancer will be surgically removed using a scalpel and sent to the laboratory for assessment which is important to confirm the diagnosis and also to ensure that the cancer has been completely removed.
After removal the skin will need to be closed and in many instances the skin edges can be pulled together and simply stitched. However, sometimes when the skin cancer is large or in areas where there is no surrounding skin laxity it is impossible to achieve what is called ‘direct closure.’ In this situation the wound will need to be closed with either a skin graft or skin flap.
A skin flap is tissue adjacent to the wound that can be moved to fill in the defect and a skin graft is a piece of skin taken from elsewhere on the body and stitched onto the wound somewhat like a patch. Skin grafts are categorised as either split or full thickness.
Split-thickness skin grafts are shavings of skin typically from the thighs or buttocks that can be used to resurface large skin defects. Unfortunately, the cosmetic result is not ideal as they leave a contour deformity and are usually a slightly different colour to the surrounding skin.
Full-thickness skin grafts are harvested from in front of or behind the ear, neck or groin. This skin is slightly thicker than a split-thickness skin graft so the contour and colour match are slightly better. However, they don’t completely correct the contour deformity and there is usually some degree of colour mismatch to the area of surrounding skin.
Skin flaps have the benefit of restoring contour and having a very good colour match. This is at the cost of a slightly longer scar but the overall result is generally more cosmetically acceptable than a skin graft.
The treatment which affords the best chance of cure from any skin cancer is surgical excision. This can be performed under local anaesthetic, local anaesthetic with sedation or a general anaesthetic. The skin cancer will be surgically removed using a scalpel and sent to the laboratory for assessment which is important to confirm the diagnosis and also to ensure that the cancer has been completely removed.
After removal the skin will need to be closed and in many instances the skin edges can be pulled together and simply stitched. However, sometimes when the skin cancer is large or in areas where there is no surrounding skin laxity it is impossible to achieve what is called ‘direct closure.’ In this situation the wound will need to be closed with either a skin graft or skin flap.
A skin flap is tissue adjacent to the wound that can be moved to fill in the defect and a skin graft is a piece of skin taken from elsewhere on the body and stitched onto the wound somewhat like a patch. Skin grafts are categorised as either split or full thickness.
Split-thickness skin grafts are shavings of skin typically from the thighs or buttocks that can be used to resurface large skin defects. Unfortunately, the cosmetic result is not ideal as they leave a contour deformity and are usually a slightly different colour to the surrounding skin.
Full-thickness skin grafts are harvested from in front of or behind the ear, neck or groin. This skin is slightly thicker than a split-thickness skin graft so the contour and colour match are slightly better. However, they don’t completely correct the contour deformity and there is usually some degree of colour mismatch to the area of surrounding skin.
Skin flaps have the benefit of restoring contour and having a very good colour match. This is at the cost of a slightly longer scar but the overall result is generally more cosmetically acceptable than a skin graft.