Wide local excision

Surgery to remove a larger area of healthy skin from around where the melanoma was, is known as a wide local excision. How much skin is removed depends on whether any melanoma cells might have been left behind in the surrounding skin, how deep the melanoma is and the position of the melanoma on the body.

You may have the wide local excision under a local anaesthetic in the day surgery unit. The doctor will put in stitches to close up the area where they remove the skin. This can feel a little tight at first. But as it heals, the surrounding skin will stretch and the tightness should ease.

Sentinel lymph node biopsy

If your melanoma is deeper than 1mm (stage 1B to 2C), you might be offered a sentinel lymph node biopsy. This is a test to find the first lymph node or nodes that a melanoma may spread to, and then check for the presence of cancer cells. You would have a sentinel lymph node biopsy at the same time as your operation to remove the melanoma.


Skin grafts[i]

Sometimes your doctor needs to remove a large area of skin, you might have a skin graft to help repair it. A skin graft is a layer of skin taken from another part of the body and placed over the area where the melanoma was removed. The place where the skin is taken from is known as the donor site. The place where it is moved to is called the grafted area. The amount of skin that’s taken depends on the area to be covered. Your doctor or specialist nurse will tell you more about this.

The grafted area

The grafted area may be secured with stitches. You’ll have a dressing over it, which will be left in place while the graft heals. The skin graft will connect with the blood supply in the area. This usually takes 5–7 days. It will look red and swollen to begin with, but eventually it will heal, and the redness will fade.

The donor site


After skin graft surgery

After a skin graft, it is usually possible to go home on the same day.



Skin flaps

A skin flap is a slightly thicker layer of skin than a graft. It is taken from an area very close to where the melanoma was. The flap is cut away but left partially connected so it still has a blood supply. It’s moved over the wound and stitched in place. If you have a skin flap, you may need to stay in hospital for up to four days.

Skin flap surgery is very specialised and it is usually done by a plastic surgeon. If you need a skin flap, your doctor will be able to tell you more about it.

See other treatment options

[i] NHS. Plastic surgery: How it’s performed. Last accessed November 2018.