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Procedure Recording Form

Fusiform Excision

Patient name: _________________ Date: ____________ Age: _____

How long has the growth been noted? __________________

Symptoms Associated with the Lesion

Procedure Description:

The patient gave informed consent for the procedure. Other options were discussed, and the patient elected to undergo fusiform excision technique. The fusiform excision was drawn with the long axis parallel to the lines of least skin tension. The area was prepped with povidone-iodine solution. The area was anesthetized using the solution circled below, with the solution infiltrated beneath and to the sides of the lesion. The patient tolerated the anesthetic well.

The skin was reprepped with povidone-iodine solution and draped with sterile drapes. The incision was made vertically into the skin using a no. 15 blade. The central fusiform island of skin was grasped in the corner with Adson forceps, and the scalpel blade was used to undermine the lesion in the level of the fat. Once the fusiform island was excised, the tissue was immediately placed in formalin and sent for histologic assessment. Bleeding from the wound was controlled by applying direct pressure with gauze and placing hemostats on bleeding vessels. The lateral skin edges were then undermined in the level of the fat using a no. 15 blade. A deep-buried, interrupted, absorbable polyglactin (Vicryl) suture was placed down to the level of the fascia to close dead space beneath the wound and provide hemostasis. The skin edge was everted with placement of interrupted nylon skin sutures.

The patient tolerated the procedure well. Direct wound pressure was applied for 10 minutes following the procedure. The wound was squeezed to remove any residual blood from beneath the wound. The skin was cleaned, antibiotic ointment was applied, and a gauze pressure dressing was applied with an elastic bandage. Extensive instructions were given to the patient.

Anesthetic solution: Lidocaine    1%    2%    with/without epinephrine

Subcutaneous suture: Vicryl    3-0    4-0    5-0    6-0

Skin suture: Nylon    3-0    4-0    5-0    6-0

Complications: ____________________________________________________

Follow-up for wound check: ____________________________________________________

Follow-up for suture removal: ____________________________________________________

Impression:

Plan:

Physician: _________________________ CC: ____________________________

Adapted with permission from Zuber TJ. Office procedures. Baltimore: Lippincott Williams & Wilkins, 1999.