[Verified Answer]: LOCATION: Outpatient, Hospital PATIENT:…

LOCATION: Outpatient, Hospital PATIENT: Tom Boll SURGEON: Gary Sanchez, MD PREOPERATIVE DIAGNOSIS: Lesions, left lower extremity POSTOPERATIVE DIAGNOSIS: Undetermined lesion, left lower extremity, most likely benign with clear margins. SURGICAL FINDINGS: There was a 2-cm (centimeter) diameter, raised erythematous lesion with a central pore of keratin. (This is keratosis.) Frozen section showed clear margins. Although it essentially looked benign, there is some question of well-differentiated squamous cell carcinoma, and this is reserved as a possible diagnosis. SURGICAL PROCEDURE: Excision of lesion, left lower extremity ANESTHESIA: Spinal DESCRIPTION OF PROCEDURE: Under satisfactory spinal anesthesia, the patient’s left leg was prepped with Betadine scrub and solution and draped in a routine sterile fashion. The lesion was excised with a 1-cm margin laterally and with a 2-cm margin proximally and distally tagging the superomedial aspect with a silk suture. Dissection was carried down to the deep layer of fascia, and bleeding was electrocoagulated. One 2-0 Monocryl suture was used subcuticularly to take tension off the wound, and then the skin was closed with interrupted vertical mattress sutures of 3-0 Prolene. We submitted the specimen for frozen section, and the frozen-section diagnosis was probably benign with the possibility of well-differentiated squamous cell carcinoma. The pathology report leaned in favor of this being a benign lesion; however, we went well around the lesion. I returned to the operating room, rescrubbed, and regloved and placed a Xeroform dressing, Kerlix fluffs over the wound, and Kerlix fluffs around the malleoli on the heels, wrapping the foot and leg from the foot to the knee with a Kerlix roll times two, Kling times two, and two Sof-Rol. The patient tolerated the procedure well and left the operating room in good condition.