• Slide 1 of 11

    This is almost certainly a nodular melanoma clinically.It is situated below the knee.It was decided that definitive excision rather than a narrow excisional biopsy could be carried out.

    It was itchy,had been enlarging ,becoming darker and had an ulcerated appearance.

  • Slide 2 of 11

    A 2 cm margin was deemed appropriate. This was marked.

  • Slide 3 of 11

    The skin was tested to ensure closure could be obtained without tension.

  • Slide 4 of 11

    Local anaesthesia was injected around, but not into the lesion. 2% lignocaine with adrenaline was used.

  • Slide 5 of 11

    Ex ion carried out.Note there is little bleeding. The incision is vertical to skin – not shelving and carried down to the deep fascia.

  • Slide 6 of 11

    Note the deep fascia shining.The wound is gaping.

  • Slide 7 of 11

    The deep layer has been closed to reduce dead space, prevent bleeding and reduce tension on wound edges.

  • Slide 8 of 11

    The wound is closed with 3/0 interrupted nylon on a cutting edge needle

  • Slide 9 of 11

    Suturing completed – note the area had been shaved.

  • Slide 10 of 11

    Bandaging is firm.

  • Slide 11 of 11

    Diagnoses was confirmed.
    The lesion was 1.2 mm thick.
    Sutures were left in for 10 days

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  • This is almost certainly a nodular melanoma clinically. It is situated below the knee. It was decided that definitive excision rather than a narrow excisional biopsy could be carried out. It was itchy, had been enlarging, becoming darker and had an ulcerated appearance.

  • Slide 2 of 2

    A 2 cm margin was deemed appropriate. This was marked.

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