Where is it? The utility of biopsy-site photography.
BACKGROUND
With wrong-site surgery being one of the major causes of medical lawsuits in the United States, tools to confirm location are essential. A previous survey of 300 Mohs surgeons revealed that 14% of malpractice cases were due to wrong-site surgery. In dermatologic surgery, photography is helpful in precisely locating biopsy sites.


OBJECTIVE
We present a case series of 34 biopsy-proven cutaneous head and neck malignancies performed in our university-based dermatology clinic, comparing the reliability of patient and blinded dermatologist identification with that of biopsy-site photography.


RESULTS
Of 34 biopsy sites, the patient and the blinded dermatologist incorrectly identified four (12%). The patient alone incorrectly identified an additional six biopsy sites, resulting in a total of 10 (29%) cases incorrectly identified by the patient. There were no instances in which the patient correctly identified the biopsy site and the blinded dermatologist incorrectly identified it.


CONCLUSIONS
In our current medical environment, in which more than 90% of health care is delivered in a clinic setting, wrong-site surgery is certainly underreported. In adopting a zero-tolerance policy for wrong-site surgeries, biopsy-site photography saves time, money, and potential frustration, hopefully eliminating the number of excisions performed on the wrong site.
Ke
Malcolm
M
Division of Dermatology, University of California at Los Angeles, Los Angeles, California, USA. mke@mednet.ucla.edu
Moul
Danielle
D
Camouse
Melissa
M
Avram
Mathew
M
Carranza
Dafnis
D
Soriano
Teresa
T
Lask
Gary
G
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D010781:Photography; D010865:Pilot Projects; D011300:Preoperative Care; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*