Monday Medical: Streamlined surgery for skin cancer
For Steamboat Pilot & Today
Editor’s Note: This article is part two of a two-part series. Part 1 focused on skin cancer.
STEAMBOAT SPRINGS — Skin cancer removal and reconstructive surgery just got a little easier: using a multi-disciplinary approach, local surgeons are now able to remove complex skin cancer and reconstruct the remaining defect in one procedure.
Dr. Jason Sigmon, an otolaryngologist at UCHealth Ear, Nose and Throat Clinic in Steamboat Springs, and Dr. Aaron Frye, a plastic and reconstructive surgeon at UCHealth Yampa Valley Medical Center and UCHealth Plastic and Reconstructive Surgery Clinic in Fort Collins, outline this latest treatment below.
A streamlined process: Removing more serious skin cancer, especially from areas around ears or nose, may require two procedures on two separate days: first, the skin cancer is removed and studied under a microscope to ensure all cancerous cells have been taken out, and then later, the defect is closed or reconstructed.
But now, two local surgeons and a pathologist have coordinated their work so the process may be completed in one procedure.
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“Dr. Sigmon cuts the cancer out, the pathologist looks at it and I close it – a lot of those are happening simultaneously,” Frye said. “The procedure could usually take multiple days, whereas this can take us a couple of hours. Coordinating all three steps and getting them to work together this efficiently is something you don’t see very often.”
Benefits to a one-step procedure: Not only is the streamlined process more convenient for the patient, it can allow for a faster recovery.
“Before, a patient may have left with a bandage on an open wound. Certainly, that limits their activities and what they can do,” Sigmon said. “The more efficient, elegant way is to have the cancer removed and the area reconstructed at the same time.”
Doing all of the work at once decreases risk of infection and other complications.
“A dressing that looked fine when the patient left can suddenly start bleeding, and there’s risk of the wound getting infected the longer it’s left open,” Frye said. “There are a lot of negatives to leaving a wound like that open.”
Once the cancer is removed, healthy cells are built up in the defect through the use of a skin graft or a technique known as local tissue advancement. For instance, if a portion of the ear is removed due to skin cancer, Frye may lift up the skin behind the ear, sew the ear back in place, then later divide it.
“It’s a two-stage procedure with amazing results, even if a larger portion of the ear has to be removed,” Frye said. “A lot of time after the reconstruction, it’s very hard to tell that there was ever an issue.”
Taking as little as possible: One tenet of cancer surgery is to remove the entire cancer while leaving as much healthy tissue as possible. “We take out what we need to in order to get the cancer out, but we work hard to preserve as much normal tissue as possible,” Frye said.
Fixing old scars: There’s good news for people who previously had skin cancer and ended up with an unsightly scar.
“We also provide scar revision for patients who’ve had poor outcomes before,” Sigmon said. “There are a lot of people who will say, ‘I’ve got this new thing on my skin, but what about this old scar – can you fix that?’ They’re happy to hear that yes, we can fix that.”
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