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We previously demonstrated that in our region up to 14% of patients with CM were having a surgical intervention in primary care before referral to secondary care. We wanted to know if the measures we had put in place had resulted http://www.selleckchem.com/products/PD-0325901.html in a reduction in this figure. Histopathology and clinical records of patients with CM who were diagnosed initially in the first six months of 2006 & 2007 were retrospectively audited. Similar cases for the same period were re-audited in 2008 and 2009. In the initial audit period, 11% and 14% of melanomas had a surgical intervention in primary care before referral to secondary care in 2006 and 2007 respectively. As a result, it became the skin MDT's standard policy to make primary care practitioners more aware of the published guidelines. Our re-audit has shown that this figure has declined to 4.51% and 4.15% for 2008 and 2009 respectively [P? http://www.selleckchem.com/products/3-methyladenine.html only did the number of excisions decrease but also the percentage of patients receiving an incomplete excision at primary biopsy by GPs fell from 63% in 2006/2007 to 52% in 2008/2009 (P?=?0.2, RRR?=?23.4%). We have achieved a significant reduction in patients with CM having a surgical intervention in primary care before referral to secondary care. As a result, patients less commonly have an initial incomplete excision and therefore have fewer procedures in total to treat their melanoma. This is more cost effective use of NHS resources and shortens the patient's pathway to complete excision of their CM. This audit demonstrates good communication between primary and secondary care can improve patient outcomes. 34 Setting up an efficient and effective sentinel node biopsy service for malignant melanoma patients-the Norfolk and Norwich Experience M. Moncrieff1,2, M. Fawzy1, J. Garioch1 1Norfolk and Norwich University Hospital, Norwich, UK; 2University of East Anglia, Norwich, UK Sentinel lymph node biopsy (SLNB) provides prognostic information and the Department of Health states that it should be available across the country by 2012. We review the setting up a melanoma SLNB service with specific consideration to resources, service implication and patient outcomes. In total, 164 patients underwent SLNB for melanoma from August http://www.selleck.cn/products/Cisplatin.html 2008 until March 2010. The median time for SLN excision was 26?min. The median total operative time (melanoma excision and SLNB) was 65?min, compared with 22?min for melanoma excision performed during the previous 19?months. The complication rate was 8.5% (mostly seromas) and only 1.2% required operative treatment. After the initial outlay for two gamma probes, it was possible to deliver the service within the national tariff, though there is a potential loss of funds for Nuclear Medicine. There was a significant increase in demand for the service in the second half of the study period (P?