Am Fam Physician. 2002;65(9):1899-1902
What is dermal electrosurgery shave excision?
Dermal electrosurgery shave excision is a procedure used to remove skin tumors and other skin growths. The technique involves shaving the growth off the skin, without penetrating the skin. Electrosurgery is used to remove any remaining tumor cells from the base of the wound, while smoothing the wound edges. Electrosurgery attempts to improve the final scar appearance without damaging the healthy tissue below the surgery site.
What are the benefits of a shave excision?
Shave excision is a simpler and less expensive procedure to perform than a full-thickness skin excision that requires sutures (stitches). The skin wound from a shave excision procedure does not need stitches. All surgical skin procedures produce a scar, but the shave excision, with electrosurgical smoothing of the wound edges, can produce a less noticeable scar that blends well into the surrounding skin. Infections are infrequent after a shave excision procedure, and it provides a specimen for analysis.
What type of anesthesia is used for this procedure?
Most shave excisions are performed with local anesthesia (numbing medicine) that is injected beneath the skin growth using a tiny needle. This causes the lesion to raise upward. The numbing medicine actually makes the shave excision procedure easier to perform.
What happens to the skin growth once it is removed?
Once a skin tumor or skin growth is removed, it is sent to a laboratory where it is examined under the microscope by a doctor known as a pathologist. The pathologic evaluation can determine whether the skin growth is cancerous.
Will the scar go away after this procedure?
All skin surgeries produce some scarring. At first, the scar will be red. You should not worry, though, because most scars will eventually get lighter during the next year. Avoid getting the wound sunburned for several months after the surgery to prevent the scar from getting darker.
Following Dermal Electrosurgery Shave Excision
Your doctor applied a solution to stop bleeding from the base of the wound. The solution may make the wound look dark or brown, but the color should fade as the wound heals.
After washing the surgical site, the nurse will apply antibiotic ointment to cover the wound. The ointment is soothing and promotes faster healing. You should apply antibiotic ointment 2 times a day until the wound site is completely healed. The over-the-counter (nonprescription) antibiotic ointment Mycitracin Plus has numbing medicine added to the antibiotic.
You will have a bandage applied over the wound site. The bandage protects the wound from rubbing against clothing and absorbs any drainage that may occur. You can remove the bandage when your doctor says to. For several months after the procedure, you should reapply a bandage to cover the wound site whenever you are in sunlight, to prevent it from being sunburned. Sunburn can lead to darkening of the wound site.
Some people have a burning sensation at the wound site. If you have discomfort, you can take acetaminophen (brand name: Tylenol), two 325-mg tablets every 4 hours, or ibuprofen (brand names: Advil, Motrin, Nuprin), three 200-mg tablets 3 times a day with food, for the first few days after the surgery.
Infection rarely follows the electrosurgery shave excision. If your wound develops signs of infection such as pus, marked tenderness, swelling, or increasing redness, call your doctor.
Skin tumors can sometimes grow back. If your skin growth was removed and then seems to be coming back, return to your doctor for a follow-up exam.
Excessive scarring sometimes follows a shave excision procedure. If you notice that the scar is growing, becoming hard, nodular, raised, or dome-shaped, see your doctor.
Most shave excision scars look red during the first few weeks after the procedure and may be unsightly. Be patient with your scar; scars that appear unsightly at the beginning often become acceptable during the next year.