Related Experiment Video
Updated: Jun 17, 2026
Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
Published on: June 7, 2019
Controlling the histological margin for non-melanoma skin cancer conveniently using a double-bladed scalpel
Satoru Aoyagi1, Hiroo Hata, Erina Homma
1Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. saoyagi@med.hokudai.ac.jp
Background:
In some countries, intraoperative histological evaluation to control the surgical margin for non-melanoma skin cancer is widely used instead of Mohs micrographic surgery. Nevertheless, this evaluation by frozen section analysis is usually limited to suspicious areas.
Objectives:
To evaluate the efficacy of double-bladed scalpel for intraoperative histological margin control for non-melanoma skin cancers.
Methods:
Between 2005 and 2009, 10 basal cell carcinomas and 5 squamous cell carcinomas were underwent complete histological margin control in which a double-bladed scalpel was used during the surgery at the Hokkaido University Hospital in Japan.
Results:
The mean number of re-excisions required for complete tumor resection was 1.4 times. Nine (60%) of the 15 patients obtained histological clearance of all surgical margins at the first re-excision. The mean size of total surgical margin was 6.1 mm (range: 2-12 mm). The median time from the first tumor excision to reconstruction was 124 min. No local recurrences have been reported.
Conclusions:
This method may be used as an alternative for complete histological margin control at many hospitals where it is difficult to perform Mohs micrographic surgery.
Insights
A double-bladed scalpel effectively controls surgical margins for non-melanoma skin cancer, reducing re-excisions and local recurrence. This method offers an alternative to Mohs surgery where it
Area of Science:
- Dermatologic Surgery
- Oncology
- Surgical Pathology
Background:
- Intraoperative histological evaluation for non-melanoma skin cancer margins is common in some countries, often replacing Mohs micrographic surgery.
- Current frozen section analysis for margin control is typically limited to suspicious areas, potentially leaving residual tumor.
Purpose of the Study:
- To assess the effectiveness of a double-bladed scalpel for comprehensive intraoperative histological margin control in non-melanoma skin cancers.
Main Methods:
- A prospective study involving 15 patients (10 basal cell carcinomas, 5 squamous cell carcinomas) at Hokkaido University Hospital between 2005 and 2009.
- Complete histological margin control was performed using a double-bladed scalpel during surgical excision.
Main Results:
- An average of 1.4 re-excisions were needed for complete tumor removal.
- Sixty percent (9/15) of patients achieved clear margins after the first re-excision.
- No local recurrences were reported during the follow-up period.
Conclusions:
- The double-bladed scalpel facilitates complete histological margin assessment for non-melanoma skin cancers.
- This technique provides a viable alternative for complete margin control in healthcare settings where Mohs micrographic surgery is not readily available.
