The Value of Preoperative Biopsy-Site Photography for Identifying Cutaneous Lesions

BACKGROUND Dermatologic surgeons rely on several methods to identify surgical sites (patients and their spouses, diagrams of surgical sites, gauze dermabrasion, biopsy-site scars, and referring physician identification), but it is not uncommon for several weeks to pass before surgery, allowing biopsy sites to become inconspicuous with healing. Practicing in a culture in which medical lawsuits continue to soar, it is prudent for dermatologists and dermatologic surgeons to locate surgical sites precisely using the most accurate and irrefutable means to protect themselves against costly lawsuits. OBJECTIVES To determine the value of preoperative biopsy-site photography in accurately identifying surgical sites before Mohs micrographic surgery. METHODS Two hundred seventy-one surgical sites were evaluated in the study. Patients with preoperative biopsy-site photography of cutaneous malignancies undergoing Mohs micrographic surgery were enrolled in the study. The day of the surgery, patients and physicians were asked to identify the surgical sites. RESULTS The patient incorrectly identified 45 of 271 surgical sites (16.6%), and the physician incorrectly identified 16 of 271 surgical sites (5.9%). The surgeon and the patient both incorrectly identified 12 of 271 sites (4.4%). All surgical sites were correctly identified with preoperative biopsy-site photography.