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eDermReg (MPR, Skin Biopsy)

eCUSUM

 

Diagnostic Skin Biopsy Registry

Diagnostic skin biopsy is a procedure in which a sample of living skin is removed from the body for histopathological examination. It is usually performed to make or confirm a diagnosis of skin disease or to assess the treatment response. Outcome of a skin biopsy depends greatly on the skill of the doctor/surgeon. With good surgical supervision and aseptic training, outcome is good with absence of post-biopsy infection, and adequate tissue collected for histopathological interpretation. Hence, monitoring and evaluating competency of doctors, especially trainees' performance in performing skin biopsy are essential in ensuring patient safety and standard of care. Monitoring is performed using Cumulative Sum (CUSUM) charting.

 

 Objectives

1. Monitor the performance and competency of trainees in performing skin biopsies
2. Determine the factors affecting the outcome of skin biopsies
3. Assess the concordance rates between pre-biopsy clinical diagnosis and histopathological diagnosis from skin biopsy
 

Inclusion criteria

All diagnostic skin biopsies which include incisional, excisional and punch biopsies.

 

Exclusion criteria

Patients with pre-existing skin infection are excluded from post-biopsy wound infection CUSUM charting.

 

Target groups

All doctors who perform skin biopsy

1. Medical officers
2. Dermatology trainees
3. Dermatologists

 

Source data providers (SDP)

All dermatology centres are encouraged to participate

2 phases:

Phase 1: HKL (pilot) - 3 months

Phase 2: MOH hospitals, universities, private centres

 

Outcome parameters and standards

No Outcome Parameters Acceptable performance Unacceptable performance
1. Rate of wound infection within 14 days post-biopsy < 2% > 4%
2. Tissue sample representative of skin lesion and adequate for histopathological interpretation > 85% < 80%