Preoperative evaluation is performed based on your past medical history in combination with the preoperative assessment if general anaesthesia is required. At the same time, a detailed assessment of the pathology of the disease is performed, as well as detailed data regarding possible therapeutic approaches and indicated treatment, depending on your case.

Preoperative check includes mainly blood tests, chest X-ray, ECG or even more specialized tests, depending on the case, in order to ensure the safest treatment for you. Finally, preoperative check is completed following MDT (Multi-Disciplinary Team) meeting if necessary, discussing with an Oncologist and a radiotherapist the proper treatment plan. The decisions are always taken based on international guidelines. Surgical excision with histologically negative margins is the recommended and first-line treatment for primary cutaneous melanoma of any thickness, as well as for melanoma in situ. Surgical margins should be based on tumor thickness. Depth of excision is recommended to (but not including) the fascia. Adjuvant therapy is determined by the Oncologist while functional and aesthetic reconstruction is a primary goal, if possible.

Methods such as radiation, cryoablation, diathermy and photodynamic therapy (PDT) have been recommended and are useful for specific malignancies to specific patients. However, surgical removal remains the gold standard in treating a malignant skin tumor- Dr Karmiris’ option in most of the cases. The extent of the excision depends on the type of the tumor, the size and the area of the body where the tumor is located. Minor lesions are treated under local anaesthesia with wide excision and direct closure or by using a skin graft or adjacent tissues (local flaps) for reconstruction. Bigger lesions, may need general anaesthesia and more composite flaps for reconstruction. All skin lesions are removed and sent for histological examination in order for the patient to be informed of the definite diagnosis, as well as for histologically negative margins. Patient’s stay in hospital depends on the extent of the surgery and his past medical history.

Dr Karmiris will explain you in detail all the surgical options, will answer your questions and will recommend you the most appropriate solution, for an optimal result.

The patient after the end of the surgical procedure, in case of local anaesthesia will be discharged on the same day. He will have a silicone dressing depending on the removal area while Dr Karmiris will give you particular instructions on how to take care of your incisions immediately post-op, what medication you should take and when you will be seen for a follow up. Sutures are removed depending on the operated area, that is at 7 days in face area and 14 days in torso. In case of general anaesthesia, the patient might spend 1-2 days in the Hospital, depending on the extent of the operation.

Complications can happen and depend on the extent of surgery and patient’s condition. Postoperative bleeding (formation of haematoma) and inflammation may occur in a general percentage of 1-2%, while there is also possibility of seroma, incomplete excision and need for revision. Dr Karmiris will answer all your questions regarding the risk of your skin lesion and the protocol that needs to be followed based on international bibliography.

For more information regarding skin malignancies, book today your appointment with Dr Nikos Karmiris.

The doctor will answer all the questions and will help you to find the most appropriate therapy, depending on your case.