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
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.
