NHS Consultant-led Skin Plastic Surgery

Cotswold Surgical Partners is a Consultant-led and Care Quality Commission regulated provider of NHS and Private Dermatology, Plastic Surgery and Medical Aesthetics Skin Care in locations across Wiltshire.

NHS Referrals for Skin Plastic Surgery

The overarching aim of our service is to provide local capacity for patients with high risk lesions such as BCCs (Basal Cell Carcinomas) and/or other non-cancerous and non-malignant lesions requiring removal by surgery (where funding approval has been sought and received) that would otherwise be referred on to a main hospital. It aims to ensure patients can be treated faster, and away from a secondary care setting to support hospital wait times and offer patient choice.  It also increases total secondary care hospital capacity for the delivery of skin surgery for patients.

Further information on NHS referral routes can be found here.

Why be referred to Cotswold Surgical Partners

• Excellent clinical care
• Low infection rates
• Efficient service with low wait times compared to national average
• High level of patient satisfaction and engagement. Check out our reviews here.
• Your own GP will be kept informed of the procedure you have had and any histopathology results.
• A robust, efficient and flexible administrative service co-ordinating the entire experience, from referral to follow-up appointment.

Types of Skin Plastic Surgery

Cotswold Surgical Partners offer two types of skin surgery, depending upon the size, location and clinical need of a lesion. If you have an appointment in a hospital or clinic but do not need to stay overnight, it means you’re being treated as an outpatient or a day patient. You may be having an appointment for treatment, diagnosis or a procedure. More information on the types of surgical procedure we complete can be found here.

Outpatient

A simple procedure completed in an outpatient setting, that does not require admitting into an operating theatre.

Day Case

These are more involved Skin Plastic Surgery procedures than an outpatient, that require a formal admission and discharge process into/out of an operating theatre. You may need some recovery time with us after the operation, but you will be able to go home the same day.

Your appointment

Once we have received your NHS referral one of our Patient Care Team will contact you to make an appointment. This may be to arrange surgery as part of a “See and Treat” pathway, or to arrange an initial assessment appointment to meet your surgeon first.

During this telephone call a number of health checks will be completed and important information provided. An appointment confirmation email/letter will then be sent alongside a procedure guide. This will summarise the booking guidance, which will include:

• Ensure you bring a chaperone with you, unless specifically agreed in advance. Please note: we cannot guarantee that surgery will proceed if you arrive without a Chaperone present. If this is not possible, or your plans change, please contact us as soon as possible.
• The appointment is for a surgical procedure in an operating theatre. A period of aftercare may be required, which could include post-operative care review visits. You will be issued with aftercare guidance relevant to your completed procedure and our nursing team will support you.
• Certain procedures, dependant upon the lesion and the location, may require a period of rest to allow the wound to heal. If you have any travel or physical activities planned for the days following your procedure please talk to us beforehand to ensure surgery is safe to continue.

Before your operation

Guidance varies depending upon whether you are having your Skin Plastic Surgery in a Day Case or Outpatient setting. Upon booking our Patient Care Co-Ordinator will provide you with your appointment confirmation letter and procedure guide to clarify what you need to know. The guidance below is focused on a Day Case operation.

What you should do before your Skin Plastic Surgery:

• For all Day Case procedures you will need a chaperone to accompany you to the operation. This is not required for an Outpatient appointment. Our Patient Co-Ordinator will confirm this with you and include it in your confirmation.
• It would be advisable to not drive for the rest of the day but further instruction will be provided dependent upon the location of your surgery.
• Medications – please let your us know if you are taking any blood thinning medications like Warfarin, Apixaban, Aspirin or other forms of blood thinning medication prior to your appointment. If you are taking Warfarin we will ask to have your INR level checked one day before your operation by your GP surgery. Please inform us of the INR result as soon as possible, before attending for your planned procedure.
• Allergies – please let us know if you are allergic to any medicines, dressings, latex or any forms of local anaesthesia.
• Pacemaker – please let us know if you have a pacemaker. Having a pacemaker is not going to stop your operation but we are unable to proceed with surgery should you have a Defibrillating Pacemaker (ICD).
• Hearing aid – should we need to remove your hearing aid during the surgery (due to the location of surgery) we will ensure that you are able to communicate with us clearly and you understand what is happening.
• Exercise – please avoid any heavy exercise like tennis, football, swimming or golf or workloads whilst the stitches are in place. In some cases, we may ask you to stop exercising for up to two-four weeks after the surgery.
• If you have any travel plans 2-4 weeks after your surgery, please inform us prior to your operation date as we may not be able to proceed if certain follow-up appointments are required.

On the day of the Skin Plastic Surgery please:

• Eat normally and take all your regular medications unless advised otherwise.
• Arrange for someone to drive you to the appointment.
• Do not wear make up or jewellery if you are having facial surgery (including foundation, mascara, eye shadow and lipstick).

Parking and arriving for surgery:

Free onsite parking is available. Once parked, please register at reception.

During your Skin Plastic Surgery

1. Changing for surgery – we will always respect your dignity and ask you to remove minimum clothing to allow adequate access to site of surgery. Usually we usually ask you to change into a hospital gown. Our clinical team will advise you on the procedure and clothing requirements as part of the admission process prior to meeting your Surgeon.
2. Marking the area of the skin – the area to be removed will be marked with a skin marker pen.
3. Local anaesthesia – the numbing effect of the anaesthesia will last between two-four hours after the surgery; therefore if we are performing any procedures around your mouth you need to avoid drinking or eating anything hot for up for up to three hours after the surgery.
4. Though we cannot allow the person who has travelled with you to join you in surgery, they are more than welcome to wait in our reception area. For this reason we ask that you only bring one person with you. Our reception team will ensure they are well looked after.
5. Please note we are an 18+ service only and kindly ask that children are not brought to your appointment.

After your operation

Depending on the procedure that is completed, full instructions, both written and verbal, will be provided on the day of surgery for you to take home, along with contact information should you require any further or on-going support.

The type of stitch we use depends on the operation and your skin. Some stitches are dissolvable; others need to be removed. Clear instructions will be provided on the day of surgery about when and where these need to be removed.

Risks and side effects Of Skin Plastic Surgery

Prior to your surgery, known risks and side effects for the procedure will be explained to you fully. A consent form detailing these will be discussed, which you and your Surgeon will sign to allow the procedure to continue.

Following your procedure you will be provided with procedure specific verbal and written instructions on how to care for the surgical site, what to look out for and guidance on who to contact if you have any questions or concerns. We cannot provide this prior to your surgery as often procedures change on the day up until the Surgeon has seen you and the lesion/s.

Results

The skin sample you have had taken will be sent to the Laboratory for a report. You will usually be advised of the results by letter in approximately six weeks or at your next Outpatients appointment. If you have not received any communication from us within six weeks please follow the guidance in your post-operative letter.

Aftercare

Following your operation you will be provided with documentation detailing how to care for operation site and contact information should you have any questions, concerns or worries in the days/weeks after the procedure. Please ensure to keep hold of this information and follow the direction as and when needed.

Contact us

Our team based in our Skin Care Centre in Royal Wootton Bassett are here to help you if you have any questions about your NHS referral or procedure. You can get in touch through our ‘Contact Us’ page today.

We provide a range of both day surgeries and minor skin operations under local anaesthetic. Working in partnership with several Plastic Surgeons, each with their own speciality, we can ensure that you receive honest, realistic advice and support on a range of surgical procedures such as skin cancer excisions and other minor surgeries that do not require general anaesthetic.

Download your procedure guide [page 1] [page 2]