Chemosurgery for skin cancer: fixed tissue and fresh tissue techniques

Complete microscopical control of the excision of cancer of the skin is achieved by removing tissues layer by layer and examining the undersurface of each layer by means of frozen sections. If the cancer is extensive and complicated or if it is of a type readily spread over an excisional surface, the tissues are fixed in situ with zinc chloride prior to excision (chemosurgery, fixed tissue technique). If the cancer is not too extensive or complicated, the tissues are excised in the fresh, unfixed state (chemosurgery, fresh tissue technique). Both techniques are highly reliable; for example, in two consecutive series of basal cell carcinomas treated chemosurgically, the five-year rate of cure was 99.3% for the 9,351 lesions removed by the fixed tissue technique and 97% for the 127 lesions removed by the fresh tissue technique.