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“One Blade, Two Cuts?” a Multidisciplinary Survey Investigating Practice Variability of Scalpel Blade Change For Simultaneous Excision of Multiple Skin Lesions in the Same Patient Publisher Pubmed



Pietkiewicz P1, 2 ; Stefaniak A2, 3 ; Giedziun P2, 4 ; Calik J2, 5 ; Lewandowicz M2, 6 ; Mazur E2, 7 ; Cantisani C8 ; Navarretedechent C9 ; Akay BN10 ; Szepietowski JC3 ; Rosendahl C11, 12
Authors
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Authors Affiliations
  1. 1. Zwierzyniecka Medical Center, Poznan, Poland
  2. 2. Polish Dermatoscopy Group, Poznan, Poland
  3. 3. Department of Dermatology, Venereology and Allergology, Wroclaw, Poland
  4. 4. Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wroclaw, Poland
  5. 5. Department of Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
  6. 6. Department of Surgical Oncology, Breast Cancer Unit, Regional Oncology Center, Lodz, Poland
  7. 7. Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
  8. 8. Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, Rome, Italy
  9. 9. Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
  10. 10. Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
  11. 11. Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
  12. 12. Tehran University of Medical Sciences, Tehran, Iran

Source: International Journal of Dermatology Published:2025


Abstract

Background: Skin cancer incidence increases globally, requiring effective preventive measures and evidence-based treatment strategies. Current guidelines advocate for surgical excision as a first-line treatment for most early skin cancers. The study investigated practices regarding changing scalpel blades when excising multiple skin lesions in the same patient during the same visit (CSB) and explored how beliefs about iatrogenic seeding influence individual norms of practice. Methods: A multidisciplinary survey was conducted among 173 medical specialists involved in skin cancer care. Participants provided demographic information, years of experience, and practices regarding CSB in four clinical scenarios (first excised tumor: basal cell carcinoma, squamous cell carcinoma, melanoma suspect, and evident melanoma). Practice variations based on specialty, experience, and beliefs about seeding risk were statistically assessed. Results: Surgeons exhibited a significantly higher tendency to change blades compared to non-surgeons across all diagnoses. Iatrogenic seeding (56.52%) and clinical training (18.84%) were the main reasons provided for CSB. Beliefs about seeding risk did not differ significantly between specialties. Conclusions: Although the practice of CSB lacks strong scientific rationale, the approach to this practice significantly varies among different medical specialties. Healthcare professionals should critically evaluate and standardize evidence-based practices to ensure optimal patient care and mitigate potential harm. © 2024 the International Society of Dermatology.
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