Micrographically Controlled Surgery

When a total excision is concerned, this method combines maximum safety with minimal tissue loss, which in turn produces the best aesthetic and functional results. The relapse rates after this surgery are significantly lower than after a conventional excision (1 - 2% vs. 5 - 20%).

The intervention is carried out in at least two stages. 

First, the tumour is excised bowl-shaped, with a small safety margin. Then, the excision is marked and transported by courier to our partner laboratory in Zurich. An accurate incision allows the excision to be processed in such a way that its entire lateral and basal edges can be assessed histologically. If parts of the tumour are detectable at the edges of the incision, they can be located with precision thanks to the markings. In this case, the corresponding areas are recut, and the post-excision is processed again, using the same frozen section procedure. The procedure will be repeated until all incision margins are tumour-free. Only then is the defect treated, which, depending on its size and location, is carried out using primary wound closure, flap graft, full-thickness skin graft or open wound healing.

While in a flap graft, skin is removed from the surrounding area, moved and used to cover the wound, for a full-thickness skin graft, skin is removed from a donor site and used to close the wound. Usually, donor regions for a skin graft are either the fold behind the ear or the area around the collarbone, directly sutured and shut again after the skin removal. The transplanted skin is fixed in place with a pressure bandage and will appear dark red for some time. As time and some months go by, the transplant will adapt itself more and more to its environment.

In the case of multidisciplinary problems, we call upon plastic surgery specialists.