Double-bladed scalpel: a new option for harvesting margins in head and neck cancers.
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.
Cernea
Claudio R
CR
Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil. cerneamd@uol.com.br
Velasco
Otavio
O
Gomes
Marcos Q T
MQ
Vellutini
Eduardo
E
Hojaij
Flavio C
FC
de Carlucci
Dorival
D
Nishio
Sunao
S
Morais-Besteiro
Julio
J
Ishida
Luis C
LC
Ferraz
Alberto R
AR
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