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Old 03-19-2013, 05:29 PM   #1
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What is the procedure like for wide excision surgery?

Hello, this is the first time i have posted here. My dad was just diagnosed with a superficial melanoma on his shoulder. He is scheduled to have a 1cm around excision. He has dementia and lives in an assisted living facility, they aren't always on top of follow up medical care as they should be. My question, for planning purposes, is two part. First how long does the surgery usually take from arrival to departure, and what is aftercare like? I am trying to decide if I should have him with me for a while or return him "home" which he would prefer. I have guidelines from the Dr, but am hoping for some real life experiences. Thank you,

C


 
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Old 03-20-2013, 11:24 AM   #2
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Re: What is the procedure like for wide excision surgery?

I could not imagine what you are going through with a parent who has dementia. This is hard enough to go through when everyone is fully able to comprehend what is happening.

I had a wide excision 6 years ago. Different doctors do this differently, but due to your father's dementia, they will probably handle it the same way they did mine. The surgery will be outpatient. Your father will most likely go into surgery in the morning and be released sometime in the afternoon. All prep for surgery will need to be followed. He will most likely be put under an anethesia - though some doctors will do this using a local. I was given the option of having a "twilight" and absolutely would recommend that. As soon as the doc or nurses in recovery feel he is ready to leave, you can take him. He will be given meds for pain and it will be up to him to determine if he is in enough pain to take them. My melanoma was on my lt knee, and I was in quite a bit of pain for the first 2 days.

Recovery will be to basically take it easy, and to not overextend the area. When they do a wide excision, the remove skin tissue from all sides of where the melanoma was - and that includes from underneath. I wasn't expecting that. Depending on what part of his shoulder this is, it may be a "meaty" part, or, if it's on his shoulderblade, they may take it all the way down to the bone. (Or, what feels like it!) And, because a good deal of skin is now gone and they need to stitch it up (or glue or staple or tape or whatever), the wound will feel "tight." This won't be so bad if it's in a location that doesn't move so much or is on his non-dominant side. However, if this is on the part of shoulder that gets a lot of "bending" or it's his dominant side, he may feel quite a bit of discomfort. Sort of like his skin doesn't "fit." Mine was right at the top of my left knee, and I could not bend my knee comfortably for almost a year.

He will probably not be able to shower or get that area wet until he sees his doctor, so he will need to take sponge baths. The dressing will most likely stay on and be removed when he sees his doctor, which will be within a week. Whoever his caretaker is will have to look at the area to insure there is no swelling, puffiness, or other signs of infection.

The immediate recovery period is about a week, and that is time between surgery and the next time he will see his doctor. I've known some people who had the surgery in the afternoon, and were out doing their regular activities that evening. I couldn't. It was painful for me - they took a LOT of skin. My opinion? Plan on taking him home with you and see how it goes. If things go okay and he seems to do well with it and he's not in pain, then by all means, let him go "home." It's just hard to tell exactly how each person might react, and I would err on the side of caution, especially since he has dementia.

Good luck!

 
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