Shave Excision or Curettage with Cautery or Driclor

Shave Excision or Curettage with Cautery or Driclor

Patient information

Prosser White Dermatology Centre

Shave Excision and Curettage

These two procedures are used to remove lesions that are confined to the upper layer or surface of the skin.

Both procedures involve using a sharp instrument, either a ring or a flat blade, to scrape off the skin lesion. 

Important Information

IF YOU HAVE A PACEMAKER ANYWHERE IN THE BODY OR A COCHLEAR IMPLANT, IT IS VERY IMPORTANT THAT YOU INFORM THE DOCTOR OR NURSE, AS CAUTERY CAN INTERFERE WITH ITS PERFORMANCE.

IT IS IMPORTANT TO LET STAFF KNOW IF YOU HAVE HOLIDAYS BOOKED, TO AVOID WHERE POSSIBLE BEING AWAY FROM HOME, ESPECIALLY ABROAD, WITH A NEW SURGICAL WOUND.   

Driving

Legally, it is your responsibility to remain in control of your vehicle at all times. Depending on the size and the area of your surgery, it may be advisable not to drive yourself home afterwards. The decision to drive can be affected by:

•           Swelling – especially if the surgery is on the face, as this might affect your vision

•           Any distracting effect of pain or numbness in the area of surgery

•           Feeling faint or unwell after the procedure, especially if you are aware of any similar

          problems you may have had in the past

What Does it Involve

The doctor or nurse will explain to you the reason why your skin lesion needs treatment, the procedure involved and any associated risks. They will then ask you to sign a consent form to give them permission to continue with the procedure.

The person performing the procedure will inject local anaesthetic into the area surrounding the lesion to be treated. This can cause minor discomfort and a stinging sensation which normally lasts less than 30 seconds. This will make the skin go numb, so no pain should be felt during the procedure. You may feel a pushing sensation, but this should not be painful.

The skin lesion is then scraped off with either a ring blade (curette) or a flat blade (shave).

As with any surgery, you cannot cut the skin without it bleeding; this is usually a minor problem and can be stopped using two methods:

1. The use of a hot pointed instrument (cautery) to seal the blood vessels and stop bleeding.

IF YOU HAVE A PACEMAKER ANYWHERE IN THE BODY OR COCHLEAR IMPLANT, IT IS VERY IMPORTANT THAT YOU INFORM THE DOCTOR OR NURSE, AS CAUTERY CAN INTERFERE WITH ITS PERFORMANCE.

1. The use of a chemical called Driclor (Aluminium Chloride Hexahydrate), which stops bleeding by clotting the blood and sealing the small vessels.

Depending on the wound and where it is, it may be covered with a dressing.

Aftercare Following Surgery

Your wound may be tender one to two hours after surgery when the local anaesthetic wears off. Paracetamol (two tablets) can be taken every four to six hours as required (a maximum of eight tablets in 24 hours).

• If you have a dressing in place, you will be told when to take this off, although it is usually after 24 hours; you will notice that a scab will form
• Once the dressing has been removed, you may apply petroleum jelly twice daily over the wound area until it heals
• If there is any bleeding, this usually occurs as the anaesthetic wears off (one to two hours after surgery). If this does happen, press firmly on top of the wound using folded swabs (which will have been given to you by the nurse), for 10 to 15 minutes.  If there is a dressing in place, this need not be removed; press on top of it.  If there is no dressing, press directly on to the wound. If it is still bleeding after this time, seek medical attention from your local Walk in Centre or Emergency Department.
• Try to keep the wound dry for 24 hours, after which it may be gently washed and dried, taking care not to knock off the scab
• If the wound becomes red or very painful, consult your General Practitioner (GP) or Walk-in Centre for advice
• There are no stitches to be removed after curettage or shave excision
• The wound will take approximately three to four weeks to heal over. It may initially be red or pink in colour but gradually reduces in colour and size over several months

Benefits

Benefits are to enable diagnosis and removal of skin lesion, with minimal scarring.

Alternatives

If the skin lesion is not cancerous or causing any physical problems, you might wish to discuss with the Doctor or Nurse the benefits of not having surgery.

Risks

• Scarring – it is impossible to cut or curette the skin without scarring in some way. Your doctor or nurse will treat the lesion to keep scarring to a minimum. However, certain individuals sometimes have an abnormal response to the skin healing and as a result, they may get larger and more raised scars than usual. This is known as keloid or hypertrophic scarring. The risk is higher on the shoulders, upper back and chest, or if you have a family history of such scars. This can be treated, but the thickening may be permanent.  Scars from curettage or shave excision are usually flat and / or slightly depressed and white; they are a similar size and shape to that of the original skin lesion.
• Infection - as with any procedure, there is a small risk of infection, the risks of which will be explained to you before and after surgery, and what to do if the wound becomes infected.
• Bleeding - this is usually minimal and will be stopped using one of the two methods mentioned previously, cautery or Driclor.

Contact information

If you have any concerns about this medicine or your condition, please contact us at the Dermatology Department by telephoning 01942 264748 or speak to your GP.