All wounds should be biopsied cancer, which should remove all or part of the wound to be examined. It is advisable to do a biopsy if the diagnosis is not clear.
For diagnosis using a biopsy punch:
Punch biopsy was performed using a small circular blade to cut the tissue cylinder. But the size is usually 3mm to 1cm in diameter, and cylinder provide the representative specimen of the lesion. Typical indications for biopsy punch rash or blisters, or pigmented skin lesions persist for more than two weeks or who have not responded to other treatments. It may malignancies such as skin cancer, skin involvement with cancer or blood, or, more commonly, skin infections, or auto-immune diseases, such as psoriasis.
For diagnosis and treatment with excisional biopsy:
A biopsy is the removal of skin lesions either formal representation of all or part thereof. Along with the typical indication of pigmented lesions such as moles, boils constantly, skin tags and warts.
Contraindications and other considerations
All biopsy scar. Wounds involving the eyelids and nose, as well as the palms and soles of the feet, should be biopsied dermatologist or plastic surgeon.
Patients on warfarin, or known bleeding disorders, clotting you check their profile before excision biopsy.
Patients with aspirin should be given the attention to hemorrhage, and pressure bandages.
Skin antiseptic like isopropyl, povidone iodine or chlorhexidine-alcohol is used to prepare the site.
In general, local anesthetics such as lignocaine used. Lignocaine is a vasodilator, and to counteract the effects, including the preparation of adrenaline may be used.
Giving a local anesthetic injected in and around the wound, and the depth of the wound.
To punch biopsy, skin slightly stretched vertically in normal skin tension lines. This will lead to an oval rather than circular wounds, which helps in wound closure. Punch is placed perpendicular to the skin, and constant pressure is applied in a circular motion. Having reached a depth of about 5mm, the blow will be removed and the specimen was taken.
For excisional biopsy, the incision will be placed along the natural folds or, in extremity, along the longitudinal axia strict requirements. This ensures that specific therapies in cancer cases diagnosed, uninterrupted.
To close the wound, stitches dissolve should be used so that the patient does not need to return to the stitches are removed.
Wounds are usually covered with a dressing or occlusion semiocclusive, maybe a bath with dressing patients, but should not swim or shower for at least 24 hours.
Usually perform date of the follow-up of patients to discuss the results.
Pigmented lesions, we should consider the possibility of malignant melanoma.
Small lesion removed by biopsy punch, considering the lesions completely removed. Need a larger wound excision biopsy. Wounds should be taken at the level of subcutaneous fat to allow for a proper assessment of how advanced wound.
When melanoma is diagnosed, the tumor-free margin is determined by the depth of intrusion of inflammation, which may indicate a re-excision scars have a wider margin, as well as the depth of the muscle fascia.
Bleeding, infection and allergic reactions all the possibilities.
Bleeding can usually be operated by applying pressure, adding stitches or by opening the bleeder that identify lesions, and tie it off.
Infection is usually the result of staphylococcus or streptococcus. If the infection is localized to the wound, treated with local wound cleaning and – if you do not get a response within 12 hours – had to open the wound and left to heal itself with the day-to-day dressing. Antibiotics are needed only if there is a fever or other signs of systemic infection.
Allergic reactions are usually due to dressing.