Advice after your nerve block for surgery
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Introduction
Skin lesions are areas of abnormal cells grouped together somewhere on the surface of the skin. There are many different types of lesions: simple, benign growths which may be unsightly, infected, or get in the way of your clothes or spectacles etc. and other growths may be types of skin cancers.
Why do I need the lesion removed?
Not all lesions need to be removed. Sometimes you will be given another appointment so that it can be kept under review. If the growth is causing a problem for you or your specialist thinks that the lesion might be cancerous, then it is better to have it removed. Once the lesion is removed it can be analysed under a microscope and an accurate diagnosis made.
Your specialist will discuss the choices with you and agree the best treatment plan with you when you are seen in the clinic. It is very important that you let your specialist know if you are taking Aspirin, Warfarin, Clopidogrel or any other blood thinning medicine.
About the procedure
Skin lesions can be removed very successfully under a local anaesthetic - you stay awake throughout the procedure. The area around the lesion is made numb with an injection. Where possible the surgeon will plan to keep scarring to a minimum by following the natural crease lines of the skin.
It is usually necessary to remove a small amount of normal skin surrounding the lesion in order to get a neat scar and ensure complete removal of the lesion. The scar may seem quite large compared with the size of the lesion; this is because the lesion might be larger underneath the skin and it is important to remove it all.
There are four ways to repair the wound; your surgeon will decide which method is best for you and will agree it with you before you sign the consent form for the operation:
Primary closure
The skin is gently pulled together and stitched over the operation site. The wound will consist of a line of stitches. The stitches may be covered with small dressings called steristrips. Most skin lesions can be removed and repaired simply in this way.
Local flap
If there is not enough loose skin in the area to close the edges together, then skin can be partly lifted from a nearby area and moved round to fill in the gap. The flap is then stitched into place. The scar will not be straight but will be in such a way as to blend in to the natural skin folds when it is fully healed. These stitches may also be covered with a steristrip dressing.
Full thickness skin graft
If the lesion is on an area which is already pulled quite tight, such as the forehead or scalp, or a larger area needs to be removed, then it may be necessary to repair the wound with a piece of skin (a graft) taken from elsewhere. The area just in front or behind the ear is often used, or just above the collar bone.
Once the piece of skin has been removed for the graft, the edges of that wound are stitched together. The skin for the graft is then put on the area where the lesion was removed, and sewn into place. A dressing will be placed over the graft and held in position with stitches so that the graft will not become dislodged. This dressing will stay in position for up to ten days.
Split skin graft
Some large skin lesions, particularly if they occur on the scalp, require larger skin grafts. If the donor site cannot be closed with stitches, a very thin superficial segment of skin is removed. This may be from the thigh or arm. The donor area is covered with dressings for up to two weeks and allowed to heal naturally.
Risks:
- Pain: There will be some pain and discomfort once the local anaesthetic has worn off. You may need to take some painkilling tablets such as paracetamol.
- Swelling/Bruising: There may be some swelling and bruising, especially if the lesion was near the eye. This is quite normal and will settle down after a few days.
- Bleeding: may occur and usually responds to pressure over the wound.
- Infection: Antibiotics are not given routinely, but if a post-operative infection occurs, your GP or specialist will prescribe a suitable antibiotic.
- Graft problems: The skin grafts need to integrate and develop a blood supply to survive. Occasionally this does not occur and the graft does not survive. Bleeding or infection makes this more likely. If a skin graft does not survive, the area will eventually heal naturally.
- Donor site problems: The site that a skin graft was taken from may also give problems such as delayed healing, bleeding or infection.
Post operative advice
If you have a local anaesthetic you can drive yourself home after the procedure but we recommend you take the day off work. If you do too much then the wound may start bleeding.
If the lesion is near your eye it is advisable to get someone else to drive you home in case your vision is altered by any swelling.
We will tell you how to look after your wound when you attend for your procedure. You will be advised when and where to have the stitches removed.
Follow up and results
Lesions are always sent for examination under the microscope as a matter of routine. The specialist can then tell you at your follow-up appointment what the skin lesion was and whether it has been completely removed. In some cases you may not need to be seen again in clinic. If so, the results of your biopsy will be sent to you and your GP instead.
Occasionally, if a skin lesion such as a skin cancer is not completely removed, it may be necessary to perform a wider excision of the scar. Your specialist will discuss this with you.
If any of these problems arise after you have gone home please contact the wards:
Frimley Park Hospital: Short Stay Surgery ward Direct No: 0300 613 3216
F1 (children’s ward) 0300 613 4252
Sources of Additional Information:
British Association of Otorhinolaryngologists: www.
National Institute for Health and Clinical Excellence (NICE) www.
Contact us
If you have any queries relating to this information, please contact the Ear or nose and throat (ENT) service.
About this information
Service:
Ear, nose and throat (ENT)
Reference:
G/035
Approval date:
23 February 2026
Review date:
1 February 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.