title: Double-bladed scalpel: a new option for harvesting margins in head and neck cancers.
abstract: BACKGROUND
  In advanced head and neck tumors margins are very rarely comprehensively checked by frozen sections. The goal of this study was to analyze a new proposal for harvesting margins using a double-bladed scalpel.
  
  
  METHODS
  Thirty-eight patients underwent a comprehensive resection of advanced head and neck tumors with a double-bladed scalpel. Margins were mapped and checked by frozen sections, while tumor resection continued. When positive margins were identified, they were excised again, and checked by frozen sections.
  
  
  RESULTS
  Thirty-three patients (87%) had clear skin and soft tissue margins at frozen sections. Five patients (13%) had focal skin and soft tissue-positive margins at frozen sections, which were re-excised. Two patients (5%) had skin and soft tissue-positive margins only at permanent sections. One was reoperated and 1 received radiation therapy. The 3-year local control rate was 58%.
  
  
  CONCLUSIONS
  In this preliminary study, the double-bladed scalpel appeared to be an interesting option for complete intraoperative evaluation of surgical margins of advanced head and neck tumors.
authors.affiliation: Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil. cerneamd@uol.com.br
authors.forename: Claudio R
authors.initials: CR
authors.lastname: Cernea
authors.forename: Otavio
authors.initials: O
authors.lastname: Velasco
authors.forename: Marcos Q T
authors.initials: MQ
authors.lastname: Gomes
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vellutini
authors.forename: Flavio C
authors.initials: FC
authors.lastname: Hojaij
authors.forename: Dorival
authors.initials: D
authors.lastname: de Carlucci
authors.forename: Sunao
authors.initials: S
authors.lastname: Nishio
authors.forename: Julio
authors.initials: J
authors.lastname: Morais-Besteiro
authors.forename: Luis C
authors.initials: LC
authors.lastname: Ishida
authors.forename: Alberto R
authors.initials: AR
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005629:Frozen Sections; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments