Dr Geoffrey Fairris DM FRCP

Surgery Without Stitches

Summary

• Curettage is the most widely used method because it removes as little tissue as possible to leave the best cosmetic result.
• Excellent wound care is required in order to achieve the best results.
  
• Curettage is also the most convenient and economical treatment.
• Skin lesions that are flat or partly underneath the surface of the skin must be cut out and the skin edges drawn together with stitches.

What are the advantages of Curettage?
What are the disadvantages of Curettage?
How does Curettage work?
Which areas respond best to Curettage?
When is Surgery that involves stitches a better option?
Is Curettage safe?
Does Curettage hurt?
How should I prepare for Curettage?
What is involved during Curettage?
How will I look immediately after Curettage?
Is there any important Curettage aftercare?
How long after Curettage will I notice an improvement?
How much does Curettage cost?
What side-effects does Curettage produce?
Who shouldn't have Curettage?

What are the advantages of Curettage?

Curettage leaves an excellent cosmetic result; does not require the surgical site to be rested, has few complications and is economical. If the resulting wound is less than half a millimetre deep, this will often leave an almost invisible mend. However, the deeper the wound, the more likely that the eventual scar will be white.

What are the disadvantages of Curettage?

Deeper and wider curettage can take several weeks to heal, especially if the wound is on the trunk or limbs.

How does Curettage work?

A curved surgical blade is used to remove the unwanted bit of skin. The wound if then sealed with an airtight dressing until it heals.

Which areas respond best to Curettage?

Curettage works well especially well on the face, trunk, arms and thighs providing that the wound is shallow and less than a centimetre in diameter. On the lower legs, the wounds tend to take several weeks to heal.

When is Surgery that involves stitches a better option?

Larger or deeper wounds take an inconveniently long time to heal and often leave a poor cosmetic result. Drawing the wound edges together with stitches is a better option.

If the skin lesion is flat or growing under the surface of the skin, surgery involving stitches is needed.

Is Curettage safe?

Curettage is usually carried out under local anaesthetic and so is extremely safe.

Does Curettage hurt?

The injection of local anaesthetic is uncomfortable, especially on the face. After that the procedure is painless. The best surgeons, like the best dentists, will inject the local anaesthetic very slowly, give it time to work and test it out carefully before they start operating.

How should I prepare for Curettage?

No special preparation is needed.

What is involved during Curettage?

The skin lesion is removed with a sharp blade leaving a small graze. Often it is necessary to cauterise the graze to stop it bleeding, particulary if you are taking aspirin.

How will I look immediately after Curettage?

The wound will be covered with a plaster and sometimes there may be a little bruising from the injection.

Is there any important Curettage aftercare?

The local anaesthetic lasts 2-4 hours. Once it wears off, the wound is not normally painful. However, if the wound hurts, take paracetamol-based painkillers and avoid those containing aspirin or ibuprofen. After that, you will need to follow the wound care instructions that will vary with the type of dressing that is used.

How long after Curettage will I notice an improvement?

Approximate healing times are: seven to ten days for small, shallow wounds, two to three weeks for larger shallow wounds and four to twelve weeks for deeper wounds and those below the knee.

How much does Curettage cost?

See Prices

What side-effects does Curettage produce?

The healed wound will be pink for between two months if on the face and for up to two years if on the lower leg. If exposed to strong sunlight during the first few months, the wound may become browner than the surrounding skin. This colour mismatch can take several months to disappear. Some wounds, particularly deeper ones, heal to leave a permanent white mark. Thick scars can occur, mainly in people under 25 years of age.

Who shouldn't have Curettage?

It is probably best to avoid injections of local anaesthetic during the first twelve weeks of pregnancy when possible.