If the pathohistology shows malignant melanoma there is an indication for re-excision. The distance starts from the suture punctures and not the scar.
If the tumor depth is under 1 mm, the re-excision is 5 mm to muscle fascia. (Total distance 10 mm).
If the tumor depth is over 1 mm or if it is not possible to measure tumor depth, re-excision is 15 mm to muscle fascia. (Total distance 20 mm)
|Final distance of excision |
is always defined by tumour depth
|MM in situ: total excision distance 5 mm|
MM ≤ 1 mm: total excision distance 10 mm
MM ≥ 1 mm: total excision distance 20 mm
If the melanoma was removed by a doctor outside the specialty of plastic surgery, the primary excision distance is unknown. Therefore the primary excision is 0 mm.
E.g: primary excision of SSMM 0.5 mm at general practitioner: 0 mm + 10 mm = Total distance 10 mm.
Step 1: Incision
The skin is incised 5 mm from the previous sutures and in a total of 10 mm from the original cancer.
Step 2: Dissection
Incision is continued to the deep fascial plane. This can be carried out by scalpel or dissection scissors.
Step 3: Dissection
The skin and subcutaneous fat is dissected along the deep fascial plane
Step 4: Removal
Complete removal of the area along the deep fascial plane.
- NOTE: The clamp is placed on an artery