ABSTRACT
Preop Most often, the primary lesion has been resected either by a punch or excisional
biopsy. For lesions on the trunk, or proximal extremity, primary closure is the norm. Most patients can undergo elliptical excision of the scar and tumor bed under lo cal anesthetic, with or without intravenous sedation. In general, a proper excision involves resection of the scar and tumor bed, with an appropriate margin of normal tissue, and an en bloc resection of the subcutaneous tissues down to the underlying muscular fascia. There is no evidence that removal of the underlying fascia improves local control or survival, and thus it is usually spared.
