So today we're going to be talking about the procedure of an electrodesiccation and curettage, or ED &C for short.
Now this is a procedure that we use to treat skin cancers that are primarily located on the top of the skin.
So if you look at this model here, this represents the top of the skin,
this is the middle, and then down below is going to be the fat layer of the skin.
So if we're using a procedure that basically just scrapes this top layer off,
but the tumor is down here in the middle layer of the skin,
you can kind of see how the procedure might not be as effective.
Also, if we're treating a procedure that's on the surface of the skin, but diving down one of these hair follicles,
the diving down of this hair follicle gives the cancer depth. And so again,
treating something that just works on the surface part of the skin,
but the cancer has depth,
probably is not going to be effective.
So this ED & C or electrodesiccation and curettage is really best used for cancers that are found
just on the top portion of the skin.
These skin cancers are called squamous cell in situ or
superficial basal-cell cancers.
So if your dermatologist is recommending this ED & C procedure for a
skin cancer that has depth, a basal-cell cancer that has depth, or a squamous cell cancer that has depth,
you need to have a conversation with them about why they chose this procedure, and if they still think it's the appropriate procedure
for your skin cancer. Now the ED & C procedure is a relatively simple,
relatively quick procedure, that has relatively little downtime. All that happens for this is that you come in and we locally numb the area,
just like your biopsy.
Okay, so what we have here is a superficial
basal-cell cancer on the shoulder of
a patient. And this was already biopsied and as you can see, you can see this little red outline right here, and
that red outline is from the biopsy, and that's also kind of how
superficial basal cells work. So I'm going to clean it with some cold alcohol.
And then we're gonna numb it with a needle, so here's a little poke and a burn.
And then we clean it, and then we use a scraping device to scrape the top portion of your skin off.
So this is what we call a curette, it's just a scraper, and we scrape the top portion off.
Now as you can kind of logically
guess, this procedure just works on the top portion of the skin. Therefore,
we really only want to be treating cancers that are on the top portion of the skin. And then we use a
burning device or an electric device to kind of char the area and stop the oozing and bleeding, and
then we scrape it again and char it and scrape it again ---.
So now what I'm doing is burning the top, and this is the desiccation part.
And all we're doing is burning the top portion of it.
We continue that until we think that we've gotten below and around the skin cancer.
Now you might ask, "Well, how are you gonna tell that by just a scrape?" And the answer is that
cancers come out like the bruised part of an apple.
They're usually very friable and there's not only a palpatory sense when you're scraping,
but there's also an auditory sense that you can use to determine if you've gotten around the skin cancer. Now this is a fairly subjective
technique, because it relies a lot on
your provider's ability to determine if they've gotten around this bruised part of an apple.
And because it is relatively subjective
it doesn't have as high a cure rate as some of the other treatment modalities that rely more on looking at it under the microscope.
So, please have a conversation with your dermatologist, because the cure rates for an ED & C are somewhere between
85 and maybe as high as 95%
if used for superficial non-melanoma skin cancers. If this procedure is used for cancers that have depth
into the skin, whether that depth is down a hair follicle or
has inherent depth to it,
then the cure rates are going to be
much lower and you really need to have a conversation with your dermatologist about why they're not recommending other treatment procedures.
When we start scraping and we feel normal skin, solid, normal, healthy skin,
that is our clue
that we've gotten all of the cancer out and now we're just working on healthy, good skin.
So I will burn this one more time, and then we're done. Now after we're done with the scraping and burning,
we'll simply clean the area, apply a little bit of Vaseline, and a gauze and send you home.
So now we are done with the procedure.
We're applying a little
cleaning agent.
Now we're applying a little Vaseline.
Nonstick gauze, and
then we'll put
some tape on the top of it.
All you do is clean it gently with little soap and water every day, and then reapply the Vaseline and reapply the gauze for
approximately two to three weeks until the healing process is complete.
Now the scar that's left behind, instead of usually a
linear scar with a surgical procedure that requires sutures, this scar is going to look like a little
cigarette burn. So it's going to be a little circle, usually or oval,
the size of the cancer that will look like a cigarette burn for the rest of your life.
So oftentimes this ED & C procedure is not the optimal procedure on an area of high
cosmetic importance, like your face.
So again, please have a conversation with your local dermatologist,
if they've chosen the ED & C procedure for you so that you can be sure that you're getting the care that
you deserve, and that you want.
An ED & C, um,
it was not a big deal. I don't have a great recollection because I think it was so easy.
They numbed me up and did a little scraping and then we bandaged it up and it healed. And I've got a little scar there,
about the size of the tip of my thumb, but other than that it wasn't any big deal.
I think
beforehand, and I think they told me pretty much what was going to happen, and so it wasn't a big concern and because I've had
all these surgeries, this was an easy way out without having another surgery for me.