Salopek T G, Slade J M, Marghoob A A, Rigel D S, Kopf A W, Bart R S, Friedman R J
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA.
J Am Acad Dermatol. 1995 Sep;33(3):451-61. doi: 10.1016/0190-9622(95)91391-2.
During the past few decades there has been increasing interest and training in dermatologic surgery.
Our purpose was to determine to what extent members of the American Academy of Dermatology (AAD) are involved in the surgical management of patients with malignant melanomas (MMs), comparing 1982 with 1992.
Members of the AAD practicing in the United States (N = 7412) were sent a questionnaire that surveyed their role in the definitive treatment of patients with MMs and the surgical margins of normal-appearing skin that they used or recommended for melanomas of various thicknesses.
Sixty-four percent of the respondents stated that they performed the definitive surgery for in situ melanoma in 1992, a 14% increase from 1982. Although a significantly greater percentage of dermatologists were performing the definitive surgery for invasive melanoma in 1992 (28%) compared with 1982 (14%), the majority continued to refer their patients to surgical colleagues for definitive treatment. There has been a narrowing of surgical margins recommended or used for melanomas of all thicknesses. In addition, regional differences of the role of the dermatologist in surgical management of patients with MM were observed.
An increasing proportion of dermatologists are involved in the surgical management of patients with MMs. Most dermatologists appear to be in accord with the guidelines for surgical margins currently recommended in the literature.
在过去几十年中，人们对皮肤科手术的兴趣和培训不断增加。
我们的目的是确定美国皮肤科协会（AAD）成员在恶性黑色素瘤（MM）患者手术治疗中的参与程度，比较1982年和1992年的情况。
向在美国执业的AAD成员（N = 7412）发送问卷，调查他们在MM患者确定性治疗中的作用以及他们对不同厚度黑色素瘤所使用或推荐的外观正常皮肤的手术切缘。
64%的受访者表示他们在1992年进行了原位黑色素瘤的确定性手术，比1982年增加了14%。尽管1992年进行浸润性黑色素瘤确定性手术的皮肤科医生比例（28%）明显高于1982年（14%），但大多数人仍将患者转诊给外科同事进行确定性治疗。对于所有厚度的黑色素瘤，推荐或使用的手术切缘有所缩小。此外，观察到皮肤科医生在MM患者手术管理中的作用存在地区差异。
越来越多的皮肤科医生参与到MM患者的手术管理中。大多数皮肤科医生似乎与目前文献中推荐的手术切缘指南一致。
