A punch biopsy is a common technique for obtaining skin samples to test for skin disorders. It is easy to learn but should be performed by a specialist. Results rarely change treatment processes unless melanoma is found, which requires further surgery. During the procedure, the patient may be anesthetized, and the area for the biopsy is selected and cleared before using the biopsy tool to remove the skin sample. The wound is then closed and treated with an antibiotic ointment and bandage.
A punch biopsy is the removal of tissue for examination using an instrument called a punch. This incision is the most common technique used to obtain skin samples to be tested for a variety of skin disorders. A punch biopsy involves the use of basic surgical skills and is easy to learn, although it should always be performed by a specialist.
Unless a patient or doctor suspects a specific problem, a skin biopsy is generally not recommended. This is because the results rarely change the normal treatment processes. A punch biopsy generally diagnoses problems such as melanoma, skin malignancies, benign growths, inflammatory lesions, or chronic skin conditions.
If melanoma is found, further surgery is recommended, and the patient is often referred to a melanoma center for excision and removal. Other skin malignancies can be removed with a small piece of skin. Benign growths can be left alone or removed; it is generally left to the patient. Inflammatory lesions require further medical tests to determine the cause, and the biopsy identifies specific chronic skin disorders so that treatment can be implemented.
During a punch biopsy, the patient may be anesthetized so that they do not feel pain. Materials used for this step include nonsterile gloves, gauze soaked in an iodine solution, a syringe filled with lidocaine and epinephrine, a 30-gauge needle, and a container of formalin. First, the area for the biopsy must be selected. For best results, the most unusual looking site within the lesion or the edge of a growing lesion is typically used. This area should be cleared with the iodine solution before applying the lidocaine/epinephrine mixture with the 30 gauge needle, anesthetizing the patient.
After this step, the doctor should switch to sterile gloves. Additional supplies for the remainder of the procedure include the biopsy tool, a needle holder, iris scissors, a 21-gauge, 1-inch (3.18 cm) needle, and a sterile drape. Now the doctor needs to identify where there is the least skin tension. The skin should be taut around the site perpendicular to the lines of least skin tension. This stretching will result in an elliptical shaped wound that will heal more easily.
The punch biopsy tool should be held vertically to the skin and rotated downward, penetrating the dermis and lodged in the subcutaneous fat. The skin sample should be lifted with the anesthesia needle and scissors used to cut the sample from the tissue. The wound is then closed and an antibiotic ointment and bandage are applied.
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