New to shave excision... help! - Cancer: Skin Message Board

nate911 · 03-14-2009, 12:22 AM

Hi!

So my father was diagnosed with melanoma a few years ago, and since I have had 4 dysplastic nevi removed (3 by total excision/stitches). I am 26, and none have returned positive. The last time I went (about a week ago) the doctor removed quite a large (about 1 - 1.5cm) flat dysplastic nevus. However, this time this particular dermotologist used a shave excision?

When I got home, I was horrified to find a large gaping hole in my back. He just told me to "keep it bandaged and keep polysporin on it." I have no idea what the healing process should be like, and how long this will take!

Can anyone provide me with some advice on how the healing process will work here? I'm terrified of this large hole not "filling in" as it still it quite sore and still deep! It seems to be just starting to "fill in" a bit but only on certain sides, and the edges seem "raised" compared to the skin around it! From what I've read, for such a large flat mole, he should have done a complete biopsy using sutures.

Thank you in advance!

Chele60 · 03-16-2009, 09:53 AM

Hello and welcome!

It does seem odd that your doctor used a shave biopsy in your case, especially with your history and family background. I have had 4 shave biopsies, and 3 were quite sizable so the doctor cauterized them. (I wasn't thrilled with that, but I also wasn't all that educated about the process, either) The remaining shave biopsy I've had, was actually quite small, and not very bothersome as far as healing went. (Though it did turn out to be melanoma)

I would think the only reason the doctor would have shaved so wide an area would be if he hadn't needed to go deep, yet you state that the wound is rather deep. I'm afraid all I can give you is my concern and sympathy, and suggest you follow the doctors recommendations, unless infection or the area becomes too sore. Perhaps some one else has more experience with this.

nate911 · 03-16-2009, 11:06 AM

Thank you for your reply!

This one was cauterized like yours was, so what happened with yours as it healed? The doctor virtually told me nothing on length of time/bandage/etc. so I have no idea if I should be keeping it covered with polysporin? Or if I should be letting it dry out? What did you do and how long did it take for those cauterized ones!?

Thanks again!

Nathan

Chele60 · 03-17-2009, 09:31 AM

Well, the three I had were on my torso, on the "bra line." And mine were not as big as yours seem to be. I kept an antibiotic ointment on them, and when at home, attempted to keep them free of any bindings or bandages. Unfortunately, when out of the house, because of the need to wear a bra, I needed to cover the wounds with bandages to help prevent chaffing. I usually wore a couple so I had extra padding.

It's been about 16 years, but I remember the first few days being very uncomfortable. The wounds gradually became less sensitive as they healed, but there was about a week and half where they were still sensitive to touch. And, as I said, I think mine were smaller than what you are dealing with, so you might have a little tougher time.

My suggestion would be to try to keep bandages off the wound when you can, but keep an antibiotic ointment on at all times. Put a bandage on to prevent rubbing/chaffing - that can be uncomfortable! For the size you have, you might have discomfort for about a week or so, sensitivity for about 2 weeks. It depends on how long your body takes to heal and what your threshold for pain is.

SophieB1 · 03-18-2009, 03:45 PM

A shave biopsy is a very common procedure, and should normally take 10 days to two weeks to heal. You should keep it covered with a bandaid, and it will probably end up scarring, but if you keep it clean, you should not have to worry about infection. I would recommend using Aquaphor instead of polysporin unless you actually see signs of infection. I have had several shave biopsies done on my back, and had scars for a few years, but these scars eventually go away.

The reason for doing a shave biopsy is to look at the cells under a microscope and see if they are atypical. This tells the doctor whether or not s/he needs to do a wider excision to remove all of the cancer/atypical nevus. I was actually surprised to read that you have had excisions with stitches in the past without first having had a biopsy done. It seems like that might be unnecessarily traumatic, especially since most moles end up being benign (three of my grandparents and my father have had melanoma, so I don't take this lightly; however, every mole I have ever had removed has been benign).

I worked for a dermatologist for a long period of time, and I am certain that this is generally a safe procedure. However, if the wound is actually "gaping" like you say it is, I would seek a second opinion from my GP/internist. You should not be able to see subcutaneous fat (I don't know if you can) -- it should be a much more superficial wound than that. Have you been to this doctor before?