Where Is It? The Utility of Biopsy‐Site Photography

BACKGROUND With wrong‐site surgery being one of the major causes of medical lawsuits in the United States, tools to confirm location are essential. A previous survey of 300 Mohs surgeons revealed that 14% of malpractice cases were due to wrong‐site surgery. In dermatologic surgery, photography is he...

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Bibliographic Details
Published in:Dermatologic surgery 2010-02, Vol.36 (2), p.198-202
Main Authors: KE, MALCOLM, MOUL, DANIELLE, CAMOUSE, MELISSA, AVRAM, MATHEW, CARRANZA, DAFNIS, SORIANO, TERESA, LASK, GARY
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Biopsy
Dermatology
Diagnostic Errors
Female
Humans
Male
Medical Errors - prevention & control
Medical sciences
Middle Aged
Photography
Pilot Projects
Preoperative Care
Reproducibility of Results
Skin Neoplasms - pathology
Skin Neoplasms - surgery
Skin plastic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
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Summary:BACKGROUND With wrong‐site surgery being one of the major causes of medical lawsuits in the United States, tools to confirm location are essential. A previous survey of 300 Mohs surgeons revealed that 14% of malpractice cases were due to wrong‐site surgery. In dermatologic surgery, photography is helpful in precisely locating biopsy sites. OBJECTIVES We present a case series of 34 biopsy‐proven cutaneous head and neck malignancies performed in our university‐based dermatology clinic, comparing the reliability of patient and blinded dermatologist identification with that of biopsy‐site photography. RESULTS Of 34 biopsy sites, the patient and the blinded dermatologist incorrectly identified four (12%). The patient alone incorrectly identified an additional six biopsy sites, resulting in a total of 10 (29%) cases incorrectly identified by the patient. There were no instances in which the patient correctly identified the biopsy site and the blinded dermatologist incorrectly identified it. CONCLUSION In our current medical environment, in which more than 90% of health care is delivered in a clinic setting, wrong‐site surgery is certainly underreported. In adopting a zero‐tolerance policy for wrong‐site surgeries, biopsy‐site photography saves time, money, and potential frustration, hopefully eliminating the number of excisions performed on the wrong site. The authors have indicated no significant interest with commercial supporters.
ISSN:1076-0512
1524-4725
DOI:10.1111/j.1524-4725.2009.01425.x