Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T22:10:19.577Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of surgeons' marking of excision margins for superficial facial skin cancer lesions

Published online by Cambridge University Press:  19 May 2008

S Ghosh ,
S Duvvi ,
P Goodyear ,
E Reddy  and
A Kumar
S Ghosh*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Warrington General Hospital, Warrington, UK
S Duvvi
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Warrington General Hospital, Warrington, UK
P Goodyear
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Warrington General Hospital, Warrington, UK
E Reddy
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Warrington General Hospital, Warrington, UK
A Kumar
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Warrington General Hospital, Warrington, UK
*
Address for correspondence: Mr Samit Ghosh, 8 Wood Heath Way, Eastham, Wirral CH62 0BQ, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

We established a series of exercises that evaluated surgeons' marking of excision margins, and we sought to identify factors influencing such marking.

Methods:

Twenty-four participants were asked to draw preset margins (3, 4, 5, 8 or 10 mm) on a series of life-size images representing noncosmetically and cosmetically sensitive facial sites, and also to draw circles of set diameters (3, 5 and 8 mm) on white paper. Margins were measured with vernier callipers calibrated to 0.05 mm.

Results:

In the small margin (3 mm) and noncosmetically sensitive exercises, the mean margins drawn were greater than required. When a 10 mm margin was required in cosmetically sensitive areas and nonsensitive areas, the margin was consistently underestimated in the former group by all participants (p < 0.05).

Conclusion:

Surgeons marking facial lesions for excision should use a measurement of scale, in order to eliminate the inherent tendency to underestimate the margin required for large excisions and for cosmetically sensitive areas.

Keywords

SkinNeoplasmSurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 2 , February 2009 , pp. 195 - 198
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Bialy, TL, Whalen, J, Veledar, E, Lafreniere, D, Spiro, J, Chartier, T et al. Mohs micrographic surgery vs traditional surgical excision: a cost comparison analysis. Arch Dermatol 2004;140:736–42Google Scholar
2Haigh, PI, DiFronzo, LA, McCready, DR. Optimal excision margins for primary cutaneous melanoma: a systematic review and meta-analysis. Can J Surg 2003;46:419–26Google Scholar
3Motley, R, Kersey, P, Lawrence, C. Multiprofessional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma. Br J Plast Surg 2003;56:85–91Google Scholar
4Telfer, NR, Colver, GB, Bowers, PW. Guidelines for the management of basal cell carcinoma. British Association of Dermatologists. Br J Dermatol 1999;141:415–23Google Scholar
5Breuninger, H, Dietz, K. Prediction of subclinical tumor infiltration in basal cell carcinoma. J Dermatol Surg Oncol 1991;17:574–8Google Scholar
6Wolf, DJ, Zitelli, JA. Surgical margins for basal cell carcinoma. Arch Dermatol 1987;123:340–4Google Scholar
7Wettstein, R, Kalbermatten, DF, Rieger, U, Farhadi, J, Harr, T, Pierer, G. High magnification assessment improves complete resection of facial tumors. Ann Plast Surg 2006;57:517–20Google Scholar
8Lalla, R, Brown, TL, Griffiths, RW. Where to draw the line: the error in marking surgical excision margins defined. Br J Plast Surg 2003;56:603–6CrossRefGoogle ScholarPubMed
9Griffiths, RW, Suvarna, SK, Stone, J. Basal cell carcinoma histological clearance margins: an analysis of 1539 conventionally excised tumours. Wider still and deeper? J Plast Reconstr Aesthet Surg 2007;60:41–7Google Scholar
10Nemet, AY, Deckel, Y, Martin, PA, Kourt, G, Chilov, M, Sharma, V et al. Management of periocular basal and squamous cell carcinoma: a series of 485 cases. Am J Ophthalmol 2006;142:293–7Google Scholar
11Talbot, S, Hitchcock, B. Incomplete primary excision of cutaneous basal and squamous cell carcinomas in the Bay of Plenty. N Z Med J 2004;23:117(1992):U848Google Scholar
12Rowe, DE, Carroll, RJ, Day, CL Jr.Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol 1992;26:976–90Google Scholar