Objectives: Comparing surgical excision margins in head and neck BCCs using knife versus electro surgery under 2.5× magnifications.

Study design: A prospective controlled trial.

Methods: Intervention group: Of 135 cases of surgical excisions of dermatological lesions excised over a 6 month period, 85 continuous cases of head and neck BCCs performed by a single operator at one North London centre were operated exclusively with electro-surgery under magnification. Antiplatelet agents were not stopped pre operatively. Control group: Retrospective analysis of 55 cases of BCCs excised with a knife. Data collected includes lesion site, size, margins, complications. Exclusion criteria: All benign and malignant pathology except for BCC of head and neck. Outcome measures: Number of positive surgical margins.

Results: There was no significant difference between the demographics of the two groups. The complication in the control group while numerically more, were not statistically significant. The surgical margins in the intervention group was significantly better. The number of cases with close margins were higher in the intervention group p = 0.018.

Conclusion: Electrosurgery under magnification is a safe and effective method of excision of BCCs in the vascular head and neck region. The clinical margins are better visualized