Punch Biopsy


Punch Biopsy Consent Form


Nitrile exam gloves (1 pair)

Sterile gloves (1 pair)

Disposable punch (3 total: sizes 3.0, 4.0, and 5.0)

Iris scissors, straight (1 pair)

Needle driver (1 pair)

Toothed pickup (1)

Suture: Assorted (if specific suture not requested by provider)

ChloraPrep 3 mL stick (1)

Alcohol Swabs (4)

1% or 2% lidocaine:  If fingers, toes, penis, or nose - then without epinephrine.  Otherwise with epinephrine.   (1 vial)

10 ml syringe (1)

18 gauge 1.5 inch needle (1)

27 gauge 1.25 inch needle (1)

Exam-room sheet (1 sheet, if necessary due to location of area to be excised.  For instance if biopsy site is in groin or for females on the chest.)

Chux pads (3)

Formalin cups (one cup per biopsy specimen)

Paper medical tape (1 roll)

Sterile 4x4 gauze (10)

Sterile 2x2 gauze (5)

Steri strips (1)

Coban roll (1)

Band-aid (1)

Petroleum jelly or Antibiotic jelly (1 packet)

Procedure Note


The procedure was explained in detail and informed consent was obtained from the patient.  Timeout performed.  The area was prepped and draped in a sterile fashion, and infiltrated with 1% lidocaine with epinephrine for local anesthesia.  A _ mm punch biopsy was used to _completely/partially remove the lesion, and the specimen was placed in placed in specimen jar and sent for analysis.  Closure was performed with _ simple interrupted sutures using _ethilon suture.  Petroleum ointment and a bandage were applied.  EBL was less than 1 ml.  Good hemostasis.  There were no complications.  Wound care and post-procedure warning signs were discussed. Patient voiced understanding.  Patient was instructed to follow up for fever, erythema, swelling, pain, or purulent discharge from the wound.  The patient voiced understanding.  Suture removal in _ days.  The patient tolerated the procedure well.

Time Until Suture Removal

Duration of time to leave sutures