Delayed Closure Excisions are used primarily to take care of superficial melanomas (Melanoma In-Situ or Lentigo Maligna). We usually do not use this procedure to take care of melanomas that have depth to them because this technique does not give us much more information on the depth of the cancer. And, depth is a very important factor to consider with melanoma since depth can predict how serious a melanoma is. However, we think we already know the depth of the melanoma from the biopsy and what we are looking for now is being able to address how wide the cancer is on the surface of the skin. A Delayed Closure Excision, with a special method used at the lab to process the tissue called “en face processing,” does give us a lot more information of how wide the cancer has spread on the skin. So, we use the biopsy to determine depth and a Delayed Closure Excision to get around the surface portion of a superficial melanoma.
“Please make sure you ask any and all questions. We are here to help!”
In order to accomplish this you will need multiple visits to your Dermatologist’s office over a number of days. On day one we locally numb the area where the biopsy was taken and we remove the amount of tissue that we think is enough to get clear margins. Then, we bandage you and you go home with plans to return to the clinic the next day. The piece of tissue is sent to the lab where they process it.
When you return the next day we will either have news that it looks like we have removed the cancer or we have more to take. If we have removed the cancer then we will close you up with sutures. If we have not removed all the cancer we will take another piece of tissue, bandage you, and have you return to the clinic the next day. This process continues until we receive news from the lab that it looks like we have removed all of the cancer.
Since this is a more involved procedure that takes a number of days to complete, please make sure you ask any and all questions. We are here to help!