Dermatology & Skin Cancer Center, Leawood, Kansas, USA.
Dermatol Surg. 2010 Feb;36(2):194-7. doi: 10.1111/j.1524-4725.2009.01426.x. Epub 2009 Dec 21.
Dermatologic surgeons rely on several methods to identify surgical sites (patients and their spouses, diagrams of surgical sites, gauze dermabrasion, biopsy-site scars, and referring physician identification), but it is not uncommon for several weeks to pass before surgery, allowing biopsy sites to become inconspicuous with healing. Practicing in a culture in which medical lawsuits continue to soar, it is prudent for dermatologists and dermatologic surgeons to locate surgical sites precisely using the most accurate and irrefutable means to protect themselves against costly lawsuits.
To determine the value of preoperative biopsy-site photography in accurately identifying surgical sites before Mohs micrographic surgery.
Two hundred seventy-one surgical sites were evaluated in the study. Patients with preoperative biopsy-site photography of cutaneous malignancies undergoing Mohs micrographic surgery were enrolled in the study. The day of the surgery, patients and physicians were asked to identify the surgical sites.
The patient incorrectly identified 45 of 271 surgical sites (16.6%), and the physician incorrectly identified 16 of 271 surgical sites (5.9%). The surgeon and the patient both incorrectly identified 12 of 271 sites (4.4%). All surgical sites were correctly identified with preoperative biopsy-site photography.
皮肤科医生依靠多种方法来识别手术部位（患者及其配偶、手术部位图、纱布磨皮、活检部位疤痕和转诊医生识别），但在手术前通常会有几周的时间，允许活检部位随着愈合而变得不明显。在医疗诉讼继续飙升的文化背景下，皮肤科医生和皮肤科外科医生谨慎地使用最准确和无可争议的方法来定位手术部位，以保护自己免受昂贵的诉讼，这是明智的。
确定术前活检部位摄影在 Mohs 显微手术前准确识别手术部位的价值。
本研究评估了 271 个手术部位。接受 Mohs 显微手术的皮肤恶性肿瘤术前活检部位摄影的患者被纳入研究。在手术当天，要求患者和医生识别手术部位。
患者错误识别了 271 个手术部位中的 45 个（16.6%），医生错误识别了 271 个手术部位中的 16 个（5.9%）。医生和患者均错误识别了 271 个部位中的 12 个（4.4%）。所有手术部位均通过术前活检部位摄影正确识别。
