title: Methods of labeling skin surgical specimens.
abstract: BACKGROUND
  Accurate pre-operative or intra-operative labeling of the skin is often necessary to mark exactly the surgical excision lines. Pre-operative "unsterile" permanent skin labeling systems are needed for example for vein and sentinel lymph node surgery; here the dyes must resist two surgical skin disinfection procedures. In contrast, excision borders are labeled during surgery using a "sterile" skin marking system.
  
  
  METHODS
  Many commercial and non-commercial pre- and intra-operative skin labeling systems are available, such as autologous patient blood, fluorescence triphenylmethane dyes and commercial skin markers. The available skin marking systems have specific advantages and disadvantages. We review the different labeling systems, offering guidelines to help choose a cost-effective system appropriate for a given surgical procedure.
  
  
  RESULTS
  The Edding permanent markers 400 und 3000 are well suited for preoperative skin labeling and less expensive than commercial skin labeling systems. Autologous patient blood and eosin are well suited for intra-operative labeling and are most cost effective. Eosin Y is widely used and well suited for labeling of dark skin, bone, cartilage, and muscle tissue and spares the expense of expensive commercial skin markers.
  
  
  CONCLUSIONS
  Knowledge of the many commercial and non-commercial pre- and intra-operative skin labeling systems and their advantages and disadvantages helps to reduce the use of relatively expensive commercial skin markers.
authors.affiliation: University Department of Dermatology, Eberhard Karls University, Tübingen, Germany. manfred.kneilling@med.uni-tuebingen.de
authors.forename: Manfred
authors.initials: M
authors.lastname: Kneilling
authors.forename: Helmut
authors.initials: H
authors.lastname: Breuninger
authors.forename: Andrea
authors.initials: A
authors.lastname: Kastl
authors.forename: Peter
authors.initials: P
authors.lastname: Heeg
authors.forename: Hans Martin
authors.initials: HM
authors.lastname: Häfner
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.forename: Matthias
authors.initials: M
authors.lastname: Möhrle
mesh_terms: D004396:Coloring Agents; D062109:Dermatologic Surgical Procedures; D006801:Humans; D007281:Ink; D011300:Preoperative Care / Q000379:methods*; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D004396:Coloring Agents