Designing a device to treat skin lesions

Abstract

A skin lesion is an abnormal tissue formation on the skin, examples are skin cancers and nevi (moles and birthmarks). Every day, thousands of people have a skin lesion removed, for a number of different reasons. The lesion could be malignant (like skin cancers), show a risk of malignancy or removal could be for cosmetic or practical reasons. The skin lesion can either be removed in the hospital, by a dermatologist or surgeon, or by the patient’s GP. While it is a relatively simple procedure many people are referred to the hospital, where the costs are higher and two staff members, a surgeon or dermatologist and a nurse, are occupied for performing this procedure. In order to decrease the time and cost per procedure, as well as improve the situation for the patient, general practitioners have to be enabled to complete a skin lesion excision on their own. A new device could help achieve this goal. The device should be appealing and easy to work with and should make the experience for the patient as comfortable as possible. This graduation project started with an analysis phase in which a clear understanding of the skin lesion removal procedure was formed. Through interviews with GPs, surgeons and a dermatologist, as well as observations of minor surgery in both the hospital and at the GP, a list of requirements for the design was created. The GPs that already did minor surgery did not experience great difficulty performing skin lesion excisions, but they were interested in techniques that are faster and give better wound healing than currently employed methods. Using a function diagram the necessary functions to perform a skin lesion excision were identified, these six functions formed the basis for a morphologic chart. Wound closure is the step that takes the most time while performing a skin lesion excision with the methods currently available (mainly suturing), so it was clear this is the most important thing that can be improved with the use of a new design. Solutions for each function were generated and combined to generate several concepts with a new excision and wound closure method. The chosen design features an adhesive dressing that is applied to the skin around the lesion before the procedure, the GP performs the excision supported by the dressing and the wound is then zipped shut. Further iterations and testing were done to improve and detail the design. The final design, the Zip-Xcision, was subsequently evaluated by five GPs. These tests and interviews yielded further recommendations for improvement of the design, but also showed that this is a promising direction for wound closure in skin lesion excisions. It saves time and removes the need for the patient to return to the GP for suture removal. Clinical trials are needed to assess the effect of the new wound closure method on the number of infections that occur and the aesthetics of the scar.