Introduction: Waikato DHB plastics department performs local anaesthetic cases of skin cancers for ambulatory patients in an outpatient setting. To cope with rising patient volume a new model was created. Patients are reviewed, booked and triaged by a consultant plastic surgeon as either for Skin Shop or main operating theatre. The surgical procedures are carried out in operating theatres by registrars at various levels of training and experience along side a MOSS.
Aim: To determine margin of excision either complete, incomplete or narrow as a measure of the quality of service provided by our Skin Shop.
Method: Margin excisions (complete, narrow, incomplete) from Skin Shop were prospectively collected and analysed from 2014 to 2016. A database was constructed to allow further future analysis of the data.
Results: 3250 lesions were excised from our Skin Shop between 2014 to 2016 from 1574 patients. Complete excision margins were 92.6% (2994), narrow excisions were 4.2% (136) and incomplete excisions were 3.2% (103). Higher rates of incomplete and narrow excisions were observed around the time of registrar changeover.
Conclusion: Our current model of management of skin cancers for ambulatory patients under local anaesthetic has complete excision rates within the recommendations of current literature. Our model of Skin shop may provide a cost effective solution of managing skin cancer in the ambulatory setting at a tertiary plastic surgery unit.