In skin surgery, always use local anaesthesia
containing adrenaline to reduce bleeding.
(Give the anaesthetic 10 minutes before the incision to allow the adrenaline
to achieve its vasoconstrictive effect.)
Only cut if you could see the surgical field.
(Blind cutting may produce irregular edge and damage important structures;
make sure the field is not obscured by blood or shadows etc.)
Cut under tension and suture without tension.
(Cutting without tension can cause irregular skin wound and suture
under tension increases wound dehiscence and scar.)
The scar from excising a skin lesion will always
be longer than the lesion itself.
(Always discuss this with the patient preoperatively to reduce patient's
Avoid extending incision outside the periorbital
region to reduce scar.
(The thicker skin outside the periorbital region tends to give more
prominent scar than the thinner periorbital region.)
Do not excise any lacerated periorbital skin during
primary repair unless it is necrotic.
(The skin on the face has good blood supply and often survive despite
Send all excised skin lesion for histology even
if it appears clinically benign.
(Histology of seemingly benign lesion can yield surprises. Cases of
metastasis or sebaceous cell carcinoma may appear benign clinically.)