Incompletely excised skin cancer rates: a prospective study of 31 731 skin cancer excisions by the Western Australian Society of Plastic Surgeons

Abstract

The incomplete excision of malignant skin lesions is an established measure of the standard of surgical care. It is one of the clinical indicators established by the Royal Australasian College of Surgeons and the Australian Council on Healthcare Standards. The purpose of this study was to identify the rate of incomplete excisions of skin cancers by a group of plastic surgeons in Western Australia and to present the data in a way that enhances the audit process. Since 1996, 25 plastic surgeons in Western Australia have been collecting prospective data on incomplete clearances of skin cancer excisions in private practice. A standard data entry form is used and data were collected by clerical staff, independent of the surgeon, and submitted annually to the Western Australian Society of Plastic Surgeons. A lesion was considered to be incompletely excised if tumour was found on histological examination to be present at the excision margin of a specimen. From 1996 to 2002, 25 plastic surgeons performed 31,731 skin lesion excisions over a period of 6 years. Incomplete margins were found on histopathological examination of 1277 lesions (4.02%). Nineteen surgeons performed over 500 procedures. The 4.02% rate of incomplete lesion excisions compares favourably to the results of other series. Further development of the audit will yield valuable information on skin lesion management in Western Australia.