Minor Surgical Patient Information Leaflet Before Procedure

You have been referred by your GP to undergo a minor surgical procedure. This may involve the removal of a skin or deeper lesion
or cyst. Occasionally a nail procedure is undertaken or abscess drained. The GP Surgeon will discuss the nature of the procedure,
options and associated risks and benefits beforehand. To remove a skin lesion requires a cut to the skin and subsequent wound, which
then has to heal, leaving a faint scar.

You will also be informed of postoperative wound care and, if required, stitch and dressing care. If stitches are used, you will be
asked to make an appointment with your Practice Nurse or Health Care Assistant at the appropriate time to have them removed.
Please be aware that sometimes we use dissolvable stitches that do not require removal, but we cannot use them all the time. Where
deeper stitches are used, they are usually dissolvable but they lie under the wound and so are not visible.

Occasionally a skin lesion cannot be treated here and you will then be referred onward to see either a Surgeon or skin specialist
(Dermatologist) at the hospital. You will be fully counselled if this applies to you.

Occasionally other techniques are used to remove a skin lesion:

  • Curettage
    The removal of a lesion by scraping with a sharp surgical instrument
  • Shave excision
    The removal of a lesion so that it lies flat to the surrounding skin
  • Cautery
    The destruction of tissue by heat

Most skin lesions that are removed are then sent to the hospital for analysis (histology). Your GP will be informed of the histology result
and if any further treatment is necessary after 2 weeks.

If you are having an operation on your hand, please could you remove any rings or other jewellery from that hand and wrist.

  • Are taking any medication especially those to thin your blood e.g. Aspirin, Clopidogrel, Dipyridamole (you should stop these medication for 10 days prior to the operation) or Warfarin. If you have any questions about stopping your regular medication please speak to your referring Doctor.
  • Have any known allergies especially to anaesthetics, plasters and/or latex
  • Have a pacemaker or similar implanted device
  • Have any metalwork or joint replacements
  • Have problems with lying flat for up to thirty minutes
  • Have problems with wound healing (smoking can impair wound healing) or suffer with any medical conditions that may affect the wound e.g. Diabetes or Rheumatoid Arthritis
You will be asked to sign a consent form after a discussion with the GP surgeon (unless you are under 16 when a parent or guardian must sign). This form indicates to us that you are aware of the procedure that we are going to carry out. Most minor operations need local anaesthetic to numb the area. This will be injected under and around the area to be treated. General anaesthetic, the type that puts you to sleep, is not used.
You will be asked to remove enough clothing so that we can clearly see the part of the body involved. The area of skin may be marked with ink. Please wear loose clothing or layers as you may get warm during the procedure. Although every care is taken to not get any of your clothing soiled, it may be best to not wear your finest underwear or clothing (dependent upon the area being treated).
Apart from the exceptional circumstances such as immobility or breathlessness, all patients will be treated lying down on the couch. This makes the operation easier.
The anaesthetic is injected under the skin. An injection causes a sharp sting which lasts about 10 seconds. The area that has been injected will go numb. You may be able to feel a pulling sensation at times but you should not feel any pain. This can leave a numbness to the area injected for approximately ½-2 hours.
Palpitations can occur very occasionally. If they do occur a few minutes rest is all that is usually needed before they settle down. Allergy to local anaesthetic is very rare, if you have had a problem with local anaesthetic please let us know. You may have been given it most commonly during a dental procedure.
Procedures will normally last 20-30 minutes. The doctor will be accompanied by a Practice Nurse or HCA (healthcare assistant) to help assist with the procedure. Please arrive on time for your appointment, we regret to inform you if you are more than 10MINUTES late we may have to cancel and rearrange only where possible.
Any cut to the skin will cause bleeding and potential risk of infection. Bleeding is usually stopped with pressure, a silver nitrate pen or a cautery machine (diathermy). The cautery machine can make a hissing sound and release a burning smell.
Many minor operations require stitches; these are to hold the skin together. They are not dissolvable and will require removal although in a few cases deeper dissolvable sutures will be needed. The GP surgeon will inform you when the stitches need to be removed and you can book an appointment with the HCA after your surgery.
It is impossible to remove anything without leaving a scar. As a general rule the length of the scar is 2-3times the width of the lesion to be removed. Please alert the GP practice before your appointment if you have a history of poor healing of scars or of a hypertrophic or keloid scar (more common in Afro-Caribbean skin types) as the GP surgeon may want to discuss if having minor surgery is the best option with the risk of scarring being higher.
We do advise patients to find another method of safe transport to return home by, as in some cases after a procedure you may feel a bit woozy. We suggest do not drive immediately after the surgery if you only have means of driving to return home.
Most wounds will have a dressing put onto them, a newly healed wound takes several weeks to gain strength and care during this time will improve the appearance of the scar. We advise you to wear at least SPF30 sun cream on and around the scar to prevent the scar darkening (hyperpigmentation)