Despite more than a century of debate, the optimum excision margins for cutaneous melanoma are still unclear. The question is mundane to the uninformed, but to patients and to health-care providers it is of great importance. A wider excision margin might be oncologically safer, but the closure method needed is more often a skin graft or a complex flap, resulting in greater morbidity and increased cost compared with a narrow margin. In one large trial, 46% of patients treated with 4-cm margins had a skin graft compared with only 11% with 2-cm margins.
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