Squamous Cell Carcinoma (SCC) Treatment in Kent, Surrey, Sussex and London

What happens

Most SCCs are removed under local anaesthetic as a day case, although larger ones may need a general anaesthetic. Mr Kumar removes the SCC with a margin of healthy skin, usually a little wider than for a BCC, because SCC is more likely to spread. The size of the margin depends on how thick the SCC is and where it is.

Closing the wound

If there is enough loose skin, the wound is closed directly in a neat line, shaped as a narrow ellipse so the skin lies flat. The scar is usually around three times longer than the SCC. Otherwise a local flap or skin graft is used.

Checking the results

A pathologist examines the tissue to confirm the margins are clear and to look at features such as depth and how the cells are growing. Results usually take two to three weeks. If the SCC has higher-risk features, your case is discussed at the specialist skin cancer MDT, which may recommend a scan, further surgery or other treatment.

Recovery and follow-up

• Keep the dressing dry, and keep the area raised if it is on a leg or arm.
• Stitches come out after 5 to 14 days.
• Regular follow-up appointments and skin checks are arranged, as having one SCC raises the chance of another.

Local flaps

A local flap moves nearby skin, still attached to its own blood supply, into the wound. Because the skin comes from right next to the wound, it matches the colour, texture and thickness of the surrounding skin very well. This is why flaps are often the first choice on the face, for example on the nose, cheek, lip or forehead.

The skin is advanced, rotated or transposed into place, and the scars are planned to sit in natural creases and lines where possible. The final scar is usually longer than the original wound, but often less noticeable.

Skin grafts

A skin graft is a thin layer of skin taken from another part of the body and placed over the wound, where it picks up a new blood supply over the following week.

• Full-thickness graft: taken from an area with spare skin, such as in front of or behind the ear, the neck or above the collarbone. The donor site is stitched closed. Used for smaller wounds, especially on the face.
• Split-thickness graft: a very thin shaving of skin, usually from the thigh, for larger wounds. The donor site heals like a graze over about two weeks.

Which is right for you?

Mr Kumar chooses the best option based on the size and position of the wound, your skin and your general health, and explains the plan before your operation. Reconstruction is usually done at the same operation as the removal, or on the same day after Mohs surgery.

Recovery

• A padded dressing protects a graft for 5 to 7 days and must be kept dry.
• Stitches are usually removed after 5 to 14 days, depending on the area.
• Swelling and redness settle over several weeks, and scars keep improving for 12 to 18 months.
• Please avoid smoking, which reduces the blood supply and increases the risk of a graft or flap not healing.

Specific risks

These include bleeding, infection, part of a graft or flap not surviving, a difference in colour or contour, a raised or puffy appearance of a flap, and occasionally the need for further treatment such as scar massage, a steroid injection or a minor revision.