A punch biopsy is a procedure used to obtain a tissue sample from the body. Punch biopsies are often used to diagnose skin cancer. A small sample of skin is taken and then analyzed under a microscope in a lab. Punch biopsies may also be used to diagnose cervical cancer, vulvar cancer, or conditions that could lead to cancer.3
In this blog we describe what to expect during a punch biopsy, as well as the risks and recovery process.
A punch biopsy is a procedure that uses a sharp, hollow instrument to remove a tissue sample. The size of the sample is about the same as a pencil eraser and is examined under a microscope by a pathologist in a lab. The sample can then be used to diagnose certain types of cancer.
A punch biopsy is performed in an outpatient clinic and takes about 15 minutes.4
For this in-office procedure, your healthcare provider will start by cleaning the area of the skin with an alcohol wipe or disinfectant product. They will then inject a local anesthetic into the skin to numb the area for the biopsy.
To take a punch biopsy, your healthcare provider will insert the hollow, circular scalpel into the skin and gently rotate it clockwise and counterclockwise to cut down to the layer of fatty tissue beneath the skin. A punch biopsy usually cuts about 4 millimeters into the skin.3
Once the tissue sample is removed, your healthcare provider may place stitches to prevent bleeding. This will depend on how deep the biopsy site is and how much it is bleeding. They will let you know when to expect results and how to follow up.
Diagnosing Skin Cancer
Who Does It?
Most skin biopsies are performed by a dermatologist. For a cervical biopsy, your gynecologist will likely handle the procedure. Other healthcare providers who are able to diagnose conditions, such as physician's assistants and nurse practitioners, may also perform a punch biopsy.
Types of Skin Biopsies
In addition to a punch biopsy, other common skin biopsy options include:
Shave biopsy: Top layers of skin are shaved off with a scalpel.
Local excision: The skin sample is removed with a scalpel.
Mohs surgery: Thin layers of skin are removed by a surgeon and then examined under a microscope during the procedure.
Curettage and electrodesiccation: The skin sample is scraped off with a tool called a curette, then an electric needle called an electrode kills any remaining cancer cells.
Choosing the Right Biopsy for a Skin Cancer Type
A punch biopsy is used to diagnose rashes, and conditions in the skin that go deeper than the epidermis. A punch biopsy is also used to diagnose benign growths, inflammatory lesions, skin conditions (eczema and psoriasis), and certain types of skin cancer (melanoma).5
How to Prepare
To prepare for a punch biopsy, sit down and talk with your healthcare provider about what to expect. Ask questions and take notes to help you remember the details.
Be sure that your practitioner has a current list of your medications and allergies. Let them know if you have a bleeding disorder or are taking any blood-thinning medications as this could result in a dangerous amount of bleeding after the biopsy.
To prepare for a cervical punch biopsy, refrain from sex and the use of tampons or vaginal creams for 24 hours before the procedure.6
Your healthcare provider will discuss your eligibility for a punch biopsy with you based on your physical exam findings and overall health. A punch biopsy is usually recommended when cancer is suspected. If you have a bleeding disorder, your healthcare provider will work with you to determine if a punch biopsy is safe for you.
After a punch biopsy, your healthcare provider will explain how your tissue sample will be tested and when to expect results.
Once the biopsy is complete, your practitioner will cover the area with a bandage and give you instructions on how to care for it at home. If they placed stitches, ask if the stitches need to be removed or if they will dissolve on their own. At home, keep your biopsy site clean, dry, and covered until it heals.
Possible risks of a punch biopsy include bleeding, scarring, and infection. If your biopsy site won’t stop bleeding or shows signs of infection, call your healthcare provider right away. Signs of an infection include worsening pain, swelling, redness, pus drainage, and a fever.
If you have a bleeding disorder or are currently taking blood-thinning medication, a punch biopsy may not be safe for you.
A punch biopsy is a diagnostic procedure used to detect rashes, benign growths, and chronic skin conditions. It may also be used to diagnose skin conditions that can lead to cancer. During a punch biopsy, your healthcare provider will use a hollow, circular scalpel to remove a tissue sample. The sample is then examined under a microscope in a lab to look for signs of cancer.
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