What should you know about melanoma in situ surgery?

Because melanoma in situ is limited to the outer skin layer, the usual surgical aim is to remove the affected area and a border of nearby skin. The size and shape of the border depend on the site, the visible changes and the pathology findings. Local anaesthetic often numbs the area while the surgeon removes the tissue. The wound may be closed with stitches, left to heal gradually, or reconstructed when the site needs special care.

The removed tissue is examined to assess the margins. If cells reach an edge, your team may discuss another procedure. [Excisional Surgery](/treatments/surgical-dermatology/excisional-surgery/) explains the general approach.

Tell the surgical team about medicines that affect bleeding, allergies, diabetes, immune conditions and previous problems with wound healing. Follow instructions about washing, dressings and activity. Keep the wound protected from rubbing and direct sun while it heals, and attend the appointment for stitch removal if one is arranged. Do not judge the final scar while the tissue is still swollen or pink; its appearance changes during healing. Keep the pathology and operative information for future visits.

Call the surgical team if pain, redness, warmth or swelling is increasing rather than settling, or if the wound opens, drains pus, develops a spreading rash, or continues bleeding after firm pressure. Fever with a worsening wound also needs prompt advice. Get urgent help for heavy bleeding, faintness, breathing difficulty or swelling affecting the mouth or throat.

Ask where the incision will be, how the wound will be closed, what margin is planned, when the final pathology will be available, how movement or appearance may be affected, and who to contact after hours. Ask whether a plastic or reconstructive surgeon should be involved for a sensitive location.