AB062. SOH23ABS_152. An audit of excision margins of non-melanomatous skin cancers in a procedural outpatient clinic

Background: Non-melanomatous skin cancer (NMSC) is the most common malignancy worldwide, with over 12,000 cases diagnosed in Ireland annually. Most low-risk lesions can be successfully treated in the outpatient setting with surgical excision under local anaesthesia. A complete excision with clear histological margins reduces the risk of local recurrence. A close margin is defined by the British Association of Dermatologists as <1 mm.

Methods: A retrospective audit of skin lesion excisions performed in a procedural outpatient clinic was conducted over a 3-month period. Demographic data were obtained from a prospectively maintained clinical database and excision margins were obtained from histopathological reports. The primary endpoint was the rate of complete excisions. Following the first audit cycle, a departmental teaching session was arranged to update clinicians on the latest guidelines from the British Association of Dermatologists and a second cycle planned to re-audit compliance.

Results: A total of 224 skin lesions were excised during the study period, of which 12.9% were NMSCs (n=29; 62% basal cell carcinoma, 38% squamous cell carcinoma). Of these, 7 had histological margins that warranted re-excision as per guidelines.

Conclusions: An awareness of guidelines from expert consensus groups regarding NMSC excision margins is vital to ensure completeness of excisions and reduce local recurrence rates. Regular self-audit and departmental audit alongside regular education sessions are useful tools to increase compliance rates and improve patient outcomes.

Keywords: Complete excision; excision margins; histological margins; non-melanomatous skin cancer (NMSC); skin lesions