Dermatologic surgical practices are largely based on experience gained during residency. Surgical practices in all disciplines have not been tested to the same extent that medications have. Providing uniform delivery of a surgical procedure requires protocols specifying the steps in the technique and rigid adherence to performance. Even for a widely performed procedure such as ED&C, there are regional and institutional differences in performance (eg, 1, 2, or 3 cycles of curettage followed by electrodessication, electrodessication extended 2, 3, 4, or 5 mm beyond the surface exposed by curettage).
Robinson JK. Evidence-Based Choice of Treatment of NMSCComment on “Recurrence After Treatment of Nonmelanoma Skin Cancer”. Arch Dermatol. 2011;147(5):546. doi:10.1001/archdermatol.2011.86