Stretch Test

Abstract

Basal cell carcinoma (BCC) is the most common malignant tumor in the world. Total tumor ablation is the gold standard of treatment. Our aim in this study was to evaluate the effectiveness of a new clinical method, we dubbed the "stretch test," in reducing the incidence of incomplete excision of BCC. All BCCs excised between October 2001 and June 2007, by 1 plastic surgeon, served as the treatment population. Until September 2004, BCCs were excised in the traditional manner and this group served as a control. From October 2004, the stretch test was used in all patients with BCC and this group served as a study group. Overall, the incomplete excision rate was 3.7% (22/596). The rate of incompletely excised BCC until 2004 was 6.4% (16/249) and it decreased significantly (P < 0.05) from 2004 to 1.7% (6/347) in the group in which the stretch test maneuver was used. We found a significant decrease in the rate of incomplete excision of BCC when the stretch test was employed. This reduces the need for reexcision, improves patient recovery, and satisfaction, and helps reduce healthcare costs.

“Stretching Dermoscopy” to Delineate the Margins of Basal Cell Carcinoma on Photodamaged Telangiectatic Skin

“…Dermoscopy alone has been used for preoperative margin delineation of BCC during classic surgery and also to reduce the number of stages in Mohs micrographic surgery (MMS), but data on the latter are controversial { 5 , 6 ]. Similarly, skin traction by itself has been described as an important preoperative step to maximize the contrast between BCC and surrounding normal skin during naked eye examination [ 4 ]. In the present case, the tumor was cleared after one stage of MMS.…”

“…Stretching the skin around the tumor has been proposed to improve the assessment of its margins by enhancing the macroscopic visualization of the opalescent color that corresponds to the stromal alterations of BCC ( Figure 1 ) [ 4 ].…”