title: The cockade technique--a closed wound variant of 3D histology-guided surgery.
abstract: BACKGROUND
  3D histology-guided surgery provides high cure rates and tissue-sparing for the treatment of basal cell carcinomas (BCCs). The cockade technique is a closed wound variant of 3D histology-guided surgery, which has previously been designed to provide low postoperative complication rates and good feasibility in the office-setting.
  
  
  OBJECTIVE
  We examined the postoperative complication rates and feasibility of the cockade technique with a new double-bladed scalpel in the routine office setting.
  
  
  METHODS
  145 patients with 213 BCCs of the head and neck areas were treated between July 2010 and August 2012. All patients underwent 3D histology-guided surgery with the cockade technique. The rates of postoperative surgical site infection (SSI) and postoperative bleeding were recorded. Also the feasibility of the cockade technique was examined.
  
  
  RESULTS
  0.9 % of BCCs sites developed SSI, while no postoperative bleeding problems or hematomas were recorded. 94 % of the BCCs were completely excised in two surgical stages. The cockade technique allowed flexible scheduling of operation room use. In addition, the small margin strips taken by the new double-bladed scalpel could be evaluated microscopically without gaps.
  
  
  CONCLUSIONS
  The cockade technique is a practical method with low complication rates for the treatment of BCCs and can be easily integrated into outpatient care.
authors.affiliation: Dermatologic office Schatz, Barth & Degitz, München, Germany.
authors.forename: Georg A
authors.initials: GA
authors.lastname: Barth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods / Q000706:statistics & numerical data; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006652:Histological Techniques; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods* / Q000706:statistics & numerical data; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000295:instrumentation / Q000379:methods; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013525:Surgical Instruments; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult