Part 1 - Incision
As per WHO guidelines the correct lesion must be marked prior to the patient going to the theatre/treatment room. Once in theatre, time should be taken to mark the skin correctly, which should be done before the local anaesthetic is administered.
Part 2 - early haemostasis
It is important to always have a good field of view with good lighting, and haemostasis when needed.
Part 3 - tissue dissection
Some lipomas can be deeper than expected. This is especially so on the forehead when many sit underneath the frontalis muscle.
Part 4 - tissue dissection, lipoma now visible
An appropriate length of appointment is needed for lipomas as a considerable amount of dissection may be required for larger lesions.
Part 5 - tissue dissection nearly complete
Good lighting, appropriate instruements, and an experienced assistant all help.
Part 6 - lipoma almost out
Once out, further haemostasis may be required. Before closure, washing the wound with the same antiseptic used to clean the skin surface is encouraged.
Part 7 - lipoma out
Although close inspection confirms the diagnosis, the sample must be sent for histology.
Part 8 - interrupted subcutaneous sutures
These provide a strong wound and a more cosmetically pleasing scar.
Part 9 - interrupted surface sutures
For detailed information on skin surgery refer to the PCDS surgical guidelines.
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