Nonpersistence of XXXX After Diagnostic Shave Biopsy: Reconstruction When Specimen Is Negative During Surgery.

@entity1 @entity41 @entity5 @entity1491
BACKGROUND: Initial tissue sampling for diagnosis of suspected @entity1491 ( @entity1491 ) is typically performed using a shave biopsy technique or punch biopsy. METHODS: Our realization of no residual @entity1491 findings after excision in some @entity1 with biopsy-proven @entity1491 diagnosed through a shave biopsy prompted us to conduct a retrospective study of all consecutive @entity1 with 127 BCCs who were treated in our department between 2006 and 2012. All @entity1 with incompletely excised BCCs after shave biopsy diagnosis were operated on by a single surgeon (R.G.), eliminating variables in preoperative evaluation and surgical technique including margin control and reconstructive approach. @entity1 demographics, initial @entity1491 site, size, subtype, duration between shave biopsy and surgery, size of excision, findings of intraoperative frozen section analysis, type of closure technique, and final pathology reports were analyzed. RESULTS: There were 108 residual BCCs diagnosed after surgical excision. Most of the108 BCCs were nodular (52) or micronodular (21) subtype. Eighteen BCCs were treated with excision and primary closure. Flap procedure was performed in 64 BCCs after excision. Twenty-six defects after excision were reconstructed using skin grafts. There was no evidence of residual @entity1491 in 15% of BCCs (19 @entity1 ) after surgical treatment. In other words, shave biopsy was found to be curative in 15% of BCCs. Seven @entity1 in no residual @entity1491 group received excision and primary closure. Eleven @entity1 underwent flap reconstruction, whereas only 1 @entity1 required skin grafting. Most of the @entity1 in this group had nodular or micronodular type @entity1491 (14/19). CONCLUSIONS: We were not able to identify any clinically significant predictors of residual versus no residual @entity1491 , at least within the context of the current study. Although most @entity1 diagnosed with @entity1491 had @entity41 for which they received surgical treatment, 15% of @entity1 had to undergo primary closure, skin graft, or flap procedure for negative residual @entity1491 . We would like to promote greater awareness on the subject among plastic surgeons treating BCCs. And, it is extremely important that the informed consent should include statements regarding possible reconstructive procedures even in the case of nonpersistent @entity5 from medicolegal standpoint.
