Minor Surgery

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Where will it take place?

Your procedure will take place at West Walk Surgery and Dr Sollazzi will be assisted by one of our practice Health Care Assistants.  As we are a training practice, medical students or GP registrars may be present, but if you are not happy with this, please let us know.

Can I eat as normal on the day of the procedure?

Yes.

Can I continue to take my medication?

There is no need to stop taking any of your medication but if you are taking any medication to thin your blood such as Aspirin / Clopidogrel / Dipyridamole / Warfarin / Apixaban / Rivaroxaban / Dabigatran or similar, you need to ensure that you have discussed this with your doctor during the pre-procedure telephone consultation.

Will I have to sign a consent form?

Yes. Before the doctor performs the procedure we need to ensure that you have been fully informed about the nature of the operation and the risks involved. Even at this late stage you can still decide not to proceed. An explanation about the complications and risks is detailed below, please make sure you understand this information fully, and ask your doctor any questions that you might have.

Will it hurt?

Your procedure will be carried out under a local anaesthetic which is injected into the skin around the area to be operated on. This can sting as it goes in, but very shortly the area goes numb. You may be able to feel a pulling sensation and pressure at times but you should not feel pain. Sometimes more local anaesthetic is needed during the procedure, so, if you experience any pain during the procedure, inform the doctor or nurse immediately. You will remain awake throughout.

The anaesthetic commonly wears off after a couple of hours, after which the area may be a little sore. We advise that you take some simple analgesia for this such as paracetamol or ibuprofen if you can tolerate this.

Will I need stitches?

This will depend on what procedure is carried out. If you do have stitches the doctor will tell you when you should come back to have them taken out; you will also be advised if you need to come back to see the practice nurse for any dressing changes.

Please inform the doctor if you:

• Have any known allergies, especially to anaesthetics, antibiotics, latex or dressings
• Have a pacemaker or similar implanted device
• Have any metalwork or joint replacements
• Have problems with lying flat for up to thirty minutes
• Have problems with wound healing or suffer with any medical conditions that may affect the wound e.g. Diabetes or Rheumatoid Arthritis

Can I drive afterwards?

We generally advise that someone comes with you to take you home after the procedure, or arrange a taxi to take you home.

When will I be informed of any biopsy results?

Results are usually available within three weeks. If there is anything unexpected with the biopsy the doctor will contact you directly.  Otherwise, you can review your results on the NHS App.

Holidays / Special Events

If you are travelling abroad or on holiday or attending a special event within three weeks of surgery, please reschedule your procedure by phoning 01454 272200. This is because of the risk of post-surgical complications, and dressing and stitches will need to be removed. There may also be bruising or swelling, so you may not look or feel your best for a special event.

Potential Risks and Complications

Infection

1 in 100 risk. Sometimes the treated area can become infected. This gives rise to pain, swelling and redness, or there may be some pus present. This can cause delayed wound healing and might require further surgery. Please contact your GP as soon as possible, or the Out of Hours Service / A&E. Very rarely the infection can spread into the blood stream and cause sepsis, or an overwhelming infection. This is an emergency and can become life threatening.

If you have had a recent infection in your skin lesion (such as an infected cyst), we must avoid operating for at least 6 weeks after the infection has settled, to reduce the risk of infection.

Wound Dehiscence (wound breaking open)

The most likely time for this to occur is just after the stitches have been removed or if the wound has become infected. Further procedures and specialist input might be required.
If you are a smoker, you can reduce the risk of this happening by stopping smoking. Even stopping for a single day will improve wound healing, but the longer the better (for help with quitting smoking please call us to book in with our smoking cessation team)

Pain

The wound may be painful for 24-48 hours after the local anaesthetic wears off. If the pain is not improving after 48 hours, please call us. Very rarely the pain can be permanent.

Nerve Damage

Sensation: When an area of skin is removed, some small nerves in the skin will be cut. This may result in a small area of numbness around the wound, or can lead to chronic pain. Although recovery usually occurs, normal sensation can take many months to return and occasionally reduced sensation or pain may be permanent.

Movement: It is extremely rare to cause damage to nerves that deal with movement. However there are certain areas, especially on the face and neck, where surgery could cause damage to such nerves, especially if the nerves are abnormally placed or hidden within a tumour.

Recurrence

We will do our best to ensure that the skin lesion being removed is complete, but this might not always be possible. In these instances the original skin complaint might recur.

Non-Resolution of Symptoms

Sometimes the procedure performed will not be successful in alleviating the symptoms as intended. If this is the case, further procedures or treatment options might be needed if available.

Scarring

Every minor surgery procedure will leave a permanent scar – it is impossible to remove anything without leaving a scar. As a general rule, the length of the scar is three times the width of the lump to be removed. Some people will heal with a much more prominent and thickened scar than others. It is impossible to predict if this will occur. Avoid any sports or exercise that might stretch the scar.

Keloid Scarring

This is an over-reaction of the fibrous tissue/scar in your skin. It does not happen immediately but develops a few weeks after surgery. Keloid scars are due to an individual’s inherent tendency to form scar tissue. They are more common on the front of the chest, upper arms and upper back, and in scars which have not been sufficiently immobilised. They are also more common in African-Caribbean skin types. They can become very painful and tender, and cause cosmetic embarrassment. Further procedures might become necessary to try and improve your symptoms.

Bleeding or Bruising

It is normal for a small amount of bleeding to occur immediately after minor surgery. Pressure and elevation are usually enough to stop bleeding. Very occasionally a wound may bleed sufficiently to need re-stitching, or a small blood vessel may need re-coagulation. Our nurses can review patients at the surgery if such a problem occurs (or the Out of Hours Service when we are closed).

Allergic Reaction

Any dressing or medication has the potential to precipitate an allergic reaction, even in someone who has previously encountered the same dressing or medication without problem. Symptoms can vary from discomfort, pain, redness or swelling to life threatening anaphylactic reaction. A severe allergy to the local anaesthetic is extremely rare.
The adrenaline in the local anaesthetic can rarely cause a feeling of rapid heartbeat (palpitations).  It is used to reduce bleeding, but we can avoid using the adrenaline if this has happened to you before. If you have had problems with local anaesthetic in the past, please let us know.

We hope that your minor surgery experience at West Walk Surgery is as straightforward as possible.  Remember that if you have any other queries or concerns please contact your doctor or practice nurse who will be happy to help.