Professional Certificate of Skin Cancer Surgery

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Choose your Delivery format

The course is delivered fully online with the option to attend an eight-hour practical workshop. The modules are set up in such a way that you are not required to be online at specific times but can view and replay video lectures at your convenience. The suggested timeline is weekly learning over 15 weeks, with 12 weeks of teaching followed by the submission of required activities.  There are no face-to-face requirements for exams which can be conveniently completed online.

Course Outline

Module 1 – Theory, Anatomy and Principles of Skin Cancer Surgery

This module introduces the theory and anatomical considerations relating to basic skin cancer surgery. It outlines the clinical requirements including how to set up the procedure room, the instruments and other equipment and supplies. The module incorporates skin anatomy and skin tension lines when considering the position and direction of an ellipse. The principles of, and how to do an ellipse are covered including undermining, haemostasis, suturing, dressings and aftercare. The suturing section incorporates the various types of sutures and needles. Skin anatomy and significant nerves are discussing including symptoms of damaged nerves. The later part of the module covers the importance of taking photos, procedural notes and patient consent.

Module 2 – Suturing, Perfecting the ellipse and Local anaesthetic

This module builds on the foundation knowledge taught in module one. This includes essential skills in knot tying, administering local anaesthetic, the role of diathermy/electrosurgery, surgical margins, instruments and surgery preparation. It then goes through the planning and design of an ellipse that includes cleaning the pork belly, loading a scalpel blade, marking out, excising and undermining an ellipse. The various common sutures are demonstrated including interrupted, deep, vertical mattress, horizontal mattress, pulley, marini and running sutures. Descriptions are provided on what each suture option is used for to determine the best sutures for closing a particular wound.

Module 3 – Skin grafting and the principles of flaps

This module introduces the skin graft technique, explains the difference between full thickness and split skin grafts, how they work and the stages of graft survival. The rationale for choosing the most appropriate skin graft when performing skin cancer surgery is outlined. The modules takes a step by step approach from excising the tumour to harvesting and closing the donor tissue site. Suitable techniques for suturing the donor tissue into the defect are discussed. Surgery preparation including patient considerations and maximising the wound environment for skin healing. The module includes a practical demonstration on the practical implementation of planning skin grafts using pork belly. It includes how to plan skin grafts based on the size of the defects, the donor area and preserving tissue during the procedure. Depending on the type of lesion, information is provided on when to perform a skin graft as opposed to wedge excision on the ear.

Module 4 – Pivotal (rotation) flaps

This module focusses on pivotal flaps, the theory, principles and then practical demonstrations on pork belly. The fundamentals are discussed including what is a skin flap, options for closure and aesthetic considerations. Potential complications are outlined. In the practical planning section, the design of rotation flaps including graphical images, assists with the planning of rotation flaps. The primary movement is for the flap to rotate into the defect with a leading edge, whilst the secondary movement is the arc defect resulting as an effect of the primary intention. With rotation flaps, dog ears are likely and techniques to remove dog ears are included. Degrees of rotation limitations are mentioned. Both schematic and clinical images assist with understanding rotation flap principles. Information on suture approach and placement are outlined for the rotation flap defect. Clinical cases are featured throughout the module.

Module 5 – Rhombus (rhomboid) flaps

This module focusses on rhomboid flaps and opens with theory of this transposition flap, the principles and then practical demonstrations on pork belly. The fundamentals are discussed including what is a skin flap, options for closure and aesthetic considerations. The importance of appropriate undermining is detailed. Careful patient evaluation, design planning and skilful meticulous technique are critical in minimising complications. In the practical planning section, the schematics of rhomboid flaps including graphical images, assists with the planning of rhomboid flaps. The primary movement is the transposing of the flap tissue over and into the defect, whilst the secondary movement is the donor or adjacent tissue defect created as a result of the primary transposition. With rhomboid flaps, dog ears are likely and techniques to remove dog ears are included. Both schematic and clinical images assist with understanding rhomboid flap principles. Information on suture approach and placement are outlined for the rhomboid flap defect. Modified rhomboid flaps are introduced.

Module 6 – Advancement flaps

This module focusses on advancement flaps and variations of the advancement flap including single and helical advancement, A-T, H-plasty and lateral advancement. Selecting the type of flap depends on the location of the defect and optimising aesthetic outcomes. Clinical case images demonstrate the marking out and planning of advancement flaps considering skin tension lines and then closing the wound. Unit two discusses the mathematic rules applied to advancement flaps. It includes practical demonstrations of advancement flaps using pork belly including undermining and outlining the suturing approach. Several advancement flap variants are also demonstrated on pork belly.

Module 7 – Wound care and managing complications

The module commences with understanding the phases of wound healing and how this relates to skin cancer surgery procedures. The various types of wound dressings are outlined including what dressings are used for a particular type of wound. Information on the use of antibiotic medications, movement whilst wounds are healing and considerations of when to remove sutures are outlined. Resources that can be applied for clinical use are provided. Unit two outlines what to do to manage complications that may occur. These include bleeding, haematoma, dehiscence, infection, splitting sutures, hypertrophic and keloid scarring and hypergranulation. Unit three introduces Mohs surgery, explains its application for pathology and its relevance to skin cancer surgery. Unit four discusses Medicare Australia and remuneration for skin cancer surgery procedures. Unit 5 outlines the medico legal considerations in Australia and the role of medical insurance.

Module 8 – Case studies

This module is an interactive opportunity to receive expert feedback on planning skin cancer surgery. A recording is presented for each of the six case studies describing the patient and the lesion that requires skin cancer surgery. Participants are asked to draw their surgery plans for each case including margins, and consider specific issues that may relate to that surgery or suggest other treatment options. A template guide is provided for each case.

Course Inclusions

For your one-off investment, you will receive unlimited access to all course content, additional learning materials, ongoing post-course support and more.

• Online pre-course activity to be completed in your own time.
• Eight online video modules to be viewed, replayed and completed at your convenience.
• All presentation slides and further learning materials available for permanent access and download.
• Instruments and consumables for practical sessions in the optional practical workshop.
• Post-course online assessment to be completed in your own time within six months of the course start date.
• Ongoing post-course support in monthly webinars with the opportunity to discuss cases with course presenters.
• Access to the HealthCert Community with additional free learning opportunities, special offers and other benefits.

*Participants who choose to complete the online course components only will receive the Professional Certificate of Skin Cancer Surgery Principles.

If you choose to attend the optional practical workshop and there is cause for postponement or you cannot travel due to Covid-19 restrictions, full workshop refund, transfer or alternative learning opportunities will be available for you. View full refunds and cancellation policy here.

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