Consent for BCC excision from lower eyelid + FTSG
On your LA minor ops list is a fit and healthy patient who is booked to have “excision of BCC from right lower eyelid and full thickness skin graft”
On examination he has a well defined nodular BCC over the right lower eyelid.
You have 5 minutes to counsel the patient about the surgery in detail, explaining the nature of the operation, and in doing so gain their informed consent for the procedure.
Good morning sir, my name is __________ and i am one of the plastic surgery registrars. I will be performing your operation today.
We are going to be removing a skin cancer from your right lower eyelid and then using a skin graft from the back of your ear to reconstruct the defect. [If you wish you may draw a diagram to accompany your explanation but it is not strictly necessary].
I am going to mark the lesion and then explain to your what is going to happen before, during and after the operation and then the risks and complications of the procedure. You can then ask me any questions and after that I will get you to sign a consent form.
Pre-operative and anaesthetic
- Change into gown and go into operating theatre
- LA infiltration around lesion and graft site- painful
- Prep and drape
- Excise lesion with 3mm margin
- Reconstruct with skin graft
- Stitched into place
- Tie over dressing
- May go home today
- Escort home and someone to look after
- Nurse head up and don't lean forward
- Analgesia for pain
-If any significant post-op bleeding -use pressure/come back
- Cannot drive home but may drive later on
- Off work for a few days
- Plastics dressing clinic in 1 week for graft check
-OPD clinic in 6-8 weeks for results
Risks and complications
General - infection, bleeding, pain, scarring/colour mismatch
Specific - graft failure, recurrence, incomplete excision requiring further surgery, ectropion/difficult to close eye