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Skin Lesion Excision Audit August 2013 – December 2013.

Published byAbner Joseph Modified over 9 years ago

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Presentation on theme: "Skin Lesion Excision Audit August 2013 – December 2013."— Presentation transcript:

1 Skin Lesion Excision Audit August 2013 – December 2013

2 Aims To monitor – -Number of skin lesions removed from August 2013 – December 2013 -Excision margins (if requested, if commented on, and if complete or incomplete) -Types of pathology -Number of patients requiring further interventions following initial histology report

3 Suggestions from previous audit Repeat audit cycle Do all excision biopsies need to have excision margins requested? Decision for pathology? Compare rate of margin reporting and extent of excision for malignant lesions with previous audits

4 Method Patients identified from theatre op book -Name & DOB -Surgeon -Type of op Pathology reports on SCI store -Was excision margin requested? -Was excision margin commented on in report? -Lesion histology If further action required SCI store document search

5 Results 32 operations identified from operation book Two excluded – not skin lesions 33 lesions excised from 30 patients Two planned repeat operations

6 Number of excisions by surgeon

7 Types of histology

8 Excision margins Rate of margin request by surgeon -13% (10% in previous audit) -25% of malignant lesions (29% in previous audit) Rate of margin reporting by pathologist -63% (39% in previous audit) -75% for malignant lesions (100% in previous audit)

9 Excision margin extent 33 lesions from 30 patients -16 (48%) complete excision -4 (12%) incomplete excision -1 (3%) ‘probably complete’ excision -12 (36%) no comment 4 malignant lesions -3 had margin reports -3 incomplete excisions

10 Excision margin extent Comparison of extent of excision of lesions between audit periods. Jan – March 2011 April – Nov 2011 Dec – May 2012 June – Dec 2012 Jan – July 2013 Aug – Dec 2013 Complete excision (%) 87.583.3?88.24081 Incomplete excision (%) 12.516.7?11.86019 Number812?171021

11 Lesions requiring further action Of the 4 lesions incompletely excised... 1 benign lipoma- -No further action 1 SCC - -CT neck and thorax: NAD -Has been listed for repeat excision 1 SCC – -CT neck and thorax: Marked thickening of the left pinna. Suspicion of invasion of the parotid gland. Borderline left Level IV lymph node (However, had OE at the time) -Awaiting FU this month +/- repeat CT 1 BCC – -OPD 4/12

12 Suggestions Audit if ‘excision biopsy’ written in request. Is this adequate to prompt excision margins by pathology? Repeat audit cycle

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