Use of an audit to improve surgical treatment of facial basal cell carcinoma

• Published in: European journal of plastic surgery 2013, Vol.36 (1), p.1-6
• Main Authors: Fortuin, Shai, Kadouch, Daniel J. M., Kadouch, Jonathan A., Decates, Tom, Marck, Klaas W., Karim, Refaat B.
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Paper; Plastic Surgery
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-012-0751-x

Background Basal cell carcinoma ( BCC ) is the most prevalent form of skin cancer and the choice of current treatment strategies depends on several criteria including patient age, size of the lesion, histological subtype, and localization. Methods A retrospective chart review was conducted including all patients with facial BCCs, together with neck, ear, and scalp, who underwent surgical excision between January 2005 and December 2010. An audit was designed to compare the outcome of two subsequent study phases. Results During the first 4-year study period, a total amount of 273 tumors were excised in 251 patients (mean age, 65.6 years; 112 males, 139 females). The overall rate of positive margins was 44/273 (16.1 %). In the second study period, a total amount of 244 tumors were excised in 228 patients (mean age 63.4 years; 105 males, 123 females). In this group, 17 excisions had positive excision margins on pathohistological report (7.0 %) Conclusions Our findings demonstrate that performing an internal audit may improve treatment quality and therefore may be helpful in optimizing the effectiveness of present treatment modalities and their costs and the development of standards and guidelines. Level of Evidence Level III, risk/prognostic study.