Shave Biopsy

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • To obtain a tissue sample for diagnostic testing
  • To obtain a deep tissue culture
  • To perform an excision for curative or cosmetic purposes
CONTRAINDICATIONS
  • Significant coagulopathy.
  • Allergy to any materials or anesthetics to be used.
  • Partial-thickness biopsies are contraindicated if melanoma is suspected.
EQUIPMENT
  • Nonsterile gloves
  • Alcohol wipes
  • Local anesthetic (0.5 to 1 mL of 1% to 2% lidocaine with or without epinephrine), syringe with an 18-gauge needle for drawing medicine from the anesthetic vial, and a 27- or 30-gauge needle for injection
  • A single-edge flexible razor blade or scalpel blade (No. 10 or 15) or sharp tissue scissors
  • Hemostatic agents (Monsel's solution, aluminum chloride, or gel foam)
  • Antibiotic ointment and adhesive bandage
  • Specimen container, usually containing formalin
ANATOMY
  • The epidermis is the outermost, epithelial layer, exterior to the dermis.
  • The subcutaneous tissue consists of adipose tissue and larger blood vessels and nerves.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Shave excisions require moist healing.
  • Protect the wound with a dressing for 24 to 48 hours.
  • Continued oozing might be expected, so use a pressure dressing over non-stick gauze.
  • Wounds on the scalp or face may be dressed with a thin layer of antibiotic ointment.
  • It is best to cover the wounds at night to avoid drying.
  • Instruct the patient to return if signs of wound infection become apparent.
  • Notify the patient of biopsy results and the need for any further treatment.
COMPLICATIONS
  • Pain: Generally insignificant.
  • Infection: Rare with adequate wound care.
  • Excessive bleeding: Almost nonexistent.
  • Scarring: Always a possibility. Hypopigmentation may occur in the area. Some hemostatic agents can cause hyperpigmentation.
  • Missing the correct diagnosis: Unless the lesion is totally removed, the worst area could be missed. Shave biopsy should never be done for a suspected melanoma.
  • Allergic reactions: To topical antibiotics, the anesthetic, dressings, and other agents.
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