Fusiform excision

The fusiform excision technique is commonly used by physicians for removing skin and subcutaneous lesions. The technique requires basic skills in anesthetic administration, lesion excision, and suture closure. Physicians experienced in skin surgery can often perform the procedure unsupervised after two to five precepted sessions. The fusiform excision technique should be used to biopsy any suspicious pigmented lesions because prognosis may depend on the depth of the lesion. A properly designed fusiform excision has a length-to-width ratio of 3 to 1 and produces a 30-degree angulation at both edges of the wound. The skin edges should be everted during the closure to improve final scar appearance. Malignant growths may require a second procedure to provide a wider margin of excision around the lesion. Post-excisional wound infections are uncommon with use of proper aseptic technique.