Background - RSTN



4560458-38862000National audit of Non-Melanoma Skin Cancer excisions by Plastic Surgery in the United Kingdom (NMSC: PlastUK)Protocol version 2.3NMSC: PlastUK working groupGrant Nolan, Anna Allan, Benjamin Smeeton, Justin Wormald, Ailbhe Kiely, Matthew Gardiner, Rowan Pritchard Jones, Abhilash Jain BackgroundNon-melanoma skin cancer includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). They are the commonest cancers in the United Kingdom (UK) accounting for 20% of all new malignancies ADDIN EN.CITE <EndNote><Cite><Author>National Cancer Intelligence Network (NCIN)</Author><Year>2013</Year><IDText>Non-melanoma skin cancer in England, Scotland, Northern Ireland, and Ireland</IDText><DisplayText><style face="superscript">1</style></DisplayText><record><titles><title>Non-melanoma skin cancer in England, Scotland, Northern Ireland, and Ireland</title></titles><contributors><authors><author>National Cancer Intelligence Network (NCIN),</author></authors></contributors><added-date format="utc">1571626495</added-date><ref-type name="Generic">13</ref-type><dates><year>2013</year></dates><rec-number>238</rec-number><last-updated-date format="utc">1571626523</last-updated-date></record></Cite></EndNote>1. The UK incidence is 124-148 per 100 000 person years ADDIN EN.CITE <EndNote><Cite><Author>National Cancer Registration and Analysis Service (NCRAS)</Author><Year>2013</Year><IDText>Non-melanoma skin cancer: Incidence and </IDText><DisplayText><style face="superscript">2</style></DisplayText><record><titles><title>Non-melanoma skin cancer: Incidence and &#xA; mortality rates in England, Scotland, and Northern &#xA; Ireland</title></titles><contributors><authors><author>National Cancer Registration and Analysis Service (NCRAS),</author></authors></contributors><added-date format="utc">1571626295</added-date><ref-type name="Generic">13</ref-type><dates><year>2013</year></dates><rec-number>237</rec-number><last-updated-date format="utc">1571626353</last-updated-date></record></Cite></EndNote>2. Annually skin cancer (including melanoma) is estimated to cost the NHS over ?180 million in 2020 ADDIN EN.CITE <EndNote><Cite><Author>Vallejo-Torres</Author><Year>2014</Year><IDText>Measuring current and future cost of skin cancer in England</IDText><DisplayText><style face="superscript">3</style></DisplayText><record><dates><pub-dates><date>Mar</date></pub-dates><year>2014</year></dates><keywords><keyword>Cost of Illness</keyword><keyword>England</keyword><keyword>Forecasting</keyword><keyword>Health Care Costs</keyword><keyword>Humans</keyword><keyword>Skin Neoplasms</keyword><keyword>burden of disease</keyword><keyword>cost</keyword><keyword>cost of illness</keyword><keyword>skin cancer</keyword></keywords><urls><related-urls><url> current and future cost of skin cancer in England</title><secondary-title>J Public Health (Oxf)</secondary-title></titles><pages>140-8</pages><number>1</number><contributors><authors><author>Vallejo-Torres, L.</author><author>Morris, S.</author><author>Kinge, J. M.</author><author>Poirier, V.</author><author>Verne, J.</author></authors></contributors><edition>2013/04/03</edition><language>eng</language><added-date format="utc">1571595342</added-date><ref-type name="Journal Article">17</ref-type><rec-number>234</rec-number><last-updated-date format="utc">1571595342</last-updated-date><accession-num>23554510</accession-num><electronic-resource-num>10.1093/pubmed/fdt032</electronic-resource-num><volume>36</volume></record></Cite></EndNote>3. The reported incidence is rising (30% in the last decade), likely due to increased reporting and historic exposure to ultraviolet radiation. The mainstay of treatment for non-melanoma skin cancer is surgical excision with a ‘cuff’ of normal tissue, which allows examination of the histological subtype and accurate assessment of margins: excision confirms the tumours complete removal. The outcome is highly dependent upon achieving clear margins; just 1%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QYXNjYWw8L0F1dGhvcj48WWVhcj4xOTY4PC9ZZWFyPjxJ

RFRleHQ+UHJvZ25vc2lzIG9mICZxdW90O2luY29tcGxldGVseSBleGNpc2VkJnF1b3Q7IHZlcnN1

cyAmcXVvdDtjb21wbGV0ZWx5IGV4Y2lzZWQmcXVvdDsgYmFzYWwgY2VsbCBjYXJjaW5vbWE8L0lE

VGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij40LCA1PC9zdHlsZT48

L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+QXByPC9kYXRlPjwv

cHViLWRhdGVzPjx5ZWFyPjE5Njg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkZhY2lhbCBOZW9wbGFzbXM8L2tl

eXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVu

Y2UsIExvY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5d29yZD5T

dXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48

dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzU2NDc0MDE8L3VybD48L3Jl

bGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAzMi0xMDUyPC9pc2JuPjx0aXRsZXM+PHRpdGxlPlBy

b2dub3NpcyBvZiAmcXVvdDtpbmNvbXBsZXRlbHkgZXhjaXNlZCZxdW90OyB2ZXJzdXMgJnF1b3Q7

Y29tcGxldGVseSBleGNpc2VkJnF1b3Q7IGJhc2FsIGNlbGwgY2FyY2lub21hPC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPlBsYXN0IFJlY29uc3RyIFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxl

cz48cGFnZXM+MzI4LTMyPC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxh

dXRob3JzPjxhdXRob3I+UGFzY2FsLCBSLiBSLjwvYXV0aG9yPjxhdXRob3I+SG9iYnksIEwuIFcu

PC9hdXRob3I+PGF1dGhvcj5MYXR0ZXMsIFIuPC9hdXRob3I+PGF1dGhvcj5DcmlrZWxhaXIsIEcu

IEYuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1

YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU2MjMxPC9hZGRlZC1kYXRlPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjc8

L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU2MjMxPC9s

YXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT41NjQ3NDAxPC9hY2Nlc3Npb24tbnVtPjxl

bGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDk3LzAwMDA2NTM0LTE5NjgwNDAwMC0wMDAwNjwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40MTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPlBhcms8L0F1dGhvcj48WWVhcj4xOTk0PC9ZZWFyPjxJRFRleHQ+QmFz

YWwgY2VsbCBjYXJjaW5vbWFzOiBkbyB0aGV5IG5lZWQgdG8gYmUgZm9sbG93ZWQgdXA/PC9JRFRl

eHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5BcHI8L2RhdGU+PC9wdWItZGF0ZXM+

PHllYXI+MTk5NDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29y

ZD48a2V5d29yZD5BZ2UgRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxr

ZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93

LVVwIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxh

c20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UHJvZ25vc2lzPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5UaW1lIEZhY3RvcnM8L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvNzUyMDA2MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4wMDM1LTg4MzU8

L2lzYm4+PHRpdGxlcz48dGl0bGU+QmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBkbyB0aGV5IG5lZWQg

dG8gYmUgZm9sbG93ZWQgdXA/PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUiBDb2xsIFN1cmcg

RWRpbmI8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTA5LTExPC9wYWdlcz48bnVt

YmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UGFyaywgQS4gSi48

L2F1dGhvcj48YXV0aG9yPlN0cmljaywgTS48L2F1dGhvcj48YXV0aG9yPldhdHNvbiwgSi4gRC48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYxNDg8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIyNjwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYxNDg8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjc1MjAwNjM8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT4zOTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5QYXNjYWw8L0F1dGhvcj48WWVhcj4xOTY4PC9ZZWFyPjxJ

RFRleHQ+UHJvZ25vc2lzIG9mICZxdW90O2luY29tcGxldGVseSBleGNpc2VkJnF1b3Q7IHZlcnN1

cyAmcXVvdDtjb21wbGV0ZWx5IGV4Y2lzZWQmcXVvdDsgYmFzYWwgY2VsbCBjYXJjaW5vbWE8L0lE

VGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij40LCA1PC9zdHlsZT48

L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+QXByPC9kYXRlPjwv

cHViLWRhdGVzPjx5ZWFyPjE5Njg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkZhY2lhbCBOZW9wbGFzbXM8L2tl

eXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVu

Y2UsIExvY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5d29yZD5T

dXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48

dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzU2NDc0MDE8L3VybD48L3Jl

bGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAzMi0xMDUyPC9pc2JuPjx0aXRsZXM+PHRpdGxlPlBy

b2dub3NpcyBvZiAmcXVvdDtpbmNvbXBsZXRlbHkgZXhjaXNlZCZxdW90OyB2ZXJzdXMgJnF1b3Q7

Y29tcGxldGVseSBleGNpc2VkJnF1b3Q7IGJhc2FsIGNlbGwgY2FyY2lub21hPC90aXRsZT48c2Vj

b25kYXJ5LXRpdGxlPlBsYXN0IFJlY29uc3RyIFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxl

cz48cGFnZXM+MzI4LTMyPC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxh

dXRob3JzPjxhdXRob3I+UGFzY2FsLCBSLiBSLjwvYXV0aG9yPjxhdXRob3I+SG9iYnksIEwuIFcu

PC9hdXRob3I+PGF1dGhvcj5MYXR0ZXMsIFIuPC9hdXRob3I+PGF1dGhvcj5DcmlrZWxhaXIsIEcu

IEYuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1

YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU2MjMxPC9hZGRlZC1kYXRlPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjc8

L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU2MjMxPC9s

YXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT41NjQ3NDAxPC9hY2Nlc3Npb24tbnVtPjxl

bGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDk3LzAwMDA2NTM0LTE5NjgwNDAwMC0wMDAwNjwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40MTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPlBhcms8L0F1dGhvcj48WWVhcj4xOTk0PC9ZZWFyPjxJRFRleHQ+QmFz

YWwgY2VsbCBjYXJjaW5vbWFzOiBkbyB0aGV5IG5lZWQgdG8gYmUgZm9sbG93ZWQgdXA/PC9JRFRl

eHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5BcHI8L2RhdGU+PC9wdWItZGF0ZXM+

PHllYXI+MTk5NDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29y

ZD48a2V5d29yZD5BZ2UgRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxr

ZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+Rm9sbG93

LVVwIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxh

c20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UHJvZ25vc2lzPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5UaW1lIEZhY3RvcnM8L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvNzUyMDA2MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4wMDM1LTg4MzU8

L2lzYm4+PHRpdGxlcz48dGl0bGU+QmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBkbyB0aGV5IG5lZWQg

dG8gYmUgZm9sbG93ZWQgdXA/PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUiBDb2xsIFN1cmcg

RWRpbmI8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTA5LTExPC9wYWdlcz48bnVt

YmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UGFyaywgQS4gSi48

L2F1dGhvcj48YXV0aG9yPlN0cmljaywgTS48L2F1dGhvcj48YXV0aG9yPldhdHNvbiwgSi4gRC48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYxNDg8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIyNjwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYxNDg8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjc1MjAwNjM8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT4zOTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 4, 5 of lesions recur with clear margins compared to 31-41%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Hb2xkYmVyZzwvQXV0aG9yPjxZZWFyPjE5OTc8L1llYXI+

PElEVGV4dD5Bc3Nlc3NtZW50IGFuZCBzdXJnaWNhbCB0cmVhdG1lbnQgb2YgYmFzYWwgY2VsbCBz

a2luIGNhbmNlcjwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQi

PjYsIDc8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0

ZT5PY3Q8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MTk5NzwveWVhcj48L2RhdGVzPjxrZXl3b3Jk

cz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5z

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzkzNDI1MTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDA5NC0xMjk4PC9pc2Ju

Pjx0aXRsZXM+PHRpdGxlPkFzc2Vzc21lbnQgYW5kIHN1cmdpY2FsIHRyZWF0bWVudCBvZiBiYXNh

bCBjZWxsIHNraW4gY2FuY2VyPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkNsaW4gUGxhc3QgU3Vy

Zzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz42NzMtODY8L3BhZ2VzPjxudW1iZXI+

NDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5Hb2xkYmVyZywgRC4gUC48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYzMzY8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIyODwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYzMzY8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjkzNDI1MTA8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT4yNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPkdyaWZmaXRoczwvQXV0

aG9yPjxZZWFyPjE5OTk8L1llYXI+PElEVGV4dD5BdWRpdCBvZiBoaXN0b2xvZ2ljYWxseSBpbmNv

bXBsZXRlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNhcmNpbm9tYXM6IHJlY29tbWVuZGF0aW9ucyBm

b3IgbWFuYWdlbWVudCBieSByZS1leGNpc2lvbjwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjE5OTk8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+QWRvbGVzY2VudDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwv

a2V5d29yZD48a2V5d29yZD5BZ2UgRGlzdHJpYnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8

L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3

b3JkPkVuZ2xhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdv

cmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3

b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzEwMzQz

NTg2PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIyNjwvaXNibj48dGl0

bGVzPjx0aXRsZT5BdWRpdCBvZiBoaXN0b2xvZ2ljYWxseSBpbmNvbXBsZXRlbHkgZXhjaXNlZCBi

YXNhbCBjZWxsIGNhcmNpbm9tYXM6IHJlY29tbWVuZGF0aW9ucyBmb3IgbWFuYWdlbWVudCBieSBy

ZS1leGNpc2lvbjwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjQtODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+

PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkdyaWZmaXRocywgUi4gVy48L2F1dGhvcj48

L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRh

dGUgZm9ybWF0PSJ1dGMiPjE1NzIwMzI3ODU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI2NjwvcmVjLW51bWJlcj48

bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMzI3ODU8L2xhc3QtdXBkYXRlZC1k

YXRlPjxhY2Nlc3Npb24tbnVtPjEwMzQzNTg2PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJl

c291cmNlLW51bT4xMC4xMDU0L2JqcHMuMTk5OC4zMDE4PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48dm9sdW1lPjUyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Hb2xkYmVyZzwvQXV0aG9yPjxZZWFyPjE5OTc8L1llYXI+

PElEVGV4dD5Bc3Nlc3NtZW50IGFuZCBzdXJnaWNhbCB0cmVhdG1lbnQgb2YgYmFzYWwgY2VsbCBz

a2luIGNhbmNlcjwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQi

PjYsIDc8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0

ZT5PY3Q8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MTk5NzwveWVhcj48L2RhdGVzPjxrZXl3b3Jk

cz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5z

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzkzNDI1MTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDA5NC0xMjk4PC9pc2Ju

Pjx0aXRsZXM+PHRpdGxlPkFzc2Vzc21lbnQgYW5kIHN1cmdpY2FsIHRyZWF0bWVudCBvZiBiYXNh

bCBjZWxsIHNraW4gY2FuY2VyPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkNsaW4gUGxhc3QgU3Vy

Zzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz42NzMtODY8L3BhZ2VzPjxudW1iZXI+

NDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5Hb2xkYmVyZywgRC4gUC48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYzMzY8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIyODwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTYzMzY8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjkzNDI1MTA8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT4yNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPkdyaWZmaXRoczwvQXV0

aG9yPjxZZWFyPjE5OTk8L1llYXI+PElEVGV4dD5BdWRpdCBvZiBoaXN0b2xvZ2ljYWxseSBpbmNv

bXBsZXRlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNhcmNpbm9tYXM6IHJlY29tbWVuZGF0aW9ucyBm

b3IgbWFuYWdlbWVudCBieSByZS1leGNpc2lvbjwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjE5OTk8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+QWRvbGVzY2VudDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwv

a2V5d29yZD48a2V5d29yZD5BZ2UgRGlzdHJpYnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8

L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoaWxkPC9rZXl3b3JkPjxrZXl3

b3JkPkVuZ2xhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdv

cmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3

b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzEwMzQz

NTg2PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIyNjwvaXNibj48dGl0

bGVzPjx0aXRsZT5BdWRpdCBvZiBoaXN0b2xvZ2ljYWxseSBpbmNvbXBsZXRlbHkgZXhjaXNlZCBi

YXNhbCBjZWxsIGNhcmNpbm9tYXM6IHJlY29tbWVuZGF0aW9ucyBmb3IgbWFuYWdlbWVudCBieSBy

ZS1leGNpc2lvbjwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjQtODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+

PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkdyaWZmaXRocywgUi4gVy48L2F1dGhvcj48

L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRh

dGUgZm9ybWF0PSJ1dGMiPjE1NzIwMzI3ODU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9Ikpv

dXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI2NjwvcmVjLW51bWJlcj48

bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMzI3ODU8L2xhc3QtdXBkYXRlZC1k

YXRlPjxhY2Nlc3Npb24tbnVtPjEwMzQzNTg2PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJl

c291cmNlLW51bT4xMC4xMDU0L2JqcHMuMTk5OC4zMDE4PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48dm9sdW1lPjUyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE.DATA 6, 7 with involved margins. Recurrent lesions are more difficult to treat and often require a more extensive reconstruction to cover the defect. Radiotherapy is another treatment modality which offers an alternative to surgery for the treatment of non-melanoma skin cancer. It may be used for primary lesionsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UZWxmZXI8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxJ

RFRleHQ+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5v

bWE8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij44LCA5PC9z

dHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVsPC9k

YXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdv

cmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNyeW9zdXJnZXJ5PC9r

ZXl3b3JkPjxrZXl3b3JkPkN1cmV0dGFnZTwva2V5d29yZD48a2V5d29yZD5FdmlkZW5jZS1CYXNl

ZCBNZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5HdWlkZWxpbmUgQWRoZXJlbmNlPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5QaG90b2NoZW1vdGhlcmFweTwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xODU5

MzM4NTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRp

dGxlcz48dGl0bGU+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBj

YXJjaW5vbWE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5

LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4zNS00ODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlRlbGZlciwgTi4gUi48L2F1dGhvcj48YXV0aG9y

PkNvbHZlciwgRy4gQi48L2F1dGhvcj48YXV0aG9yPk1vcnRvbiwgQy4gQS48L2F1dGhvcj48YXV0

aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgRGVybWF0b2xvZ2lzdHM8L2F1dGhvcj48L2F1dGhv

cnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0MDwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjE4NTkzMzg1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNl

LW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDguMDg2NjYueDwvZWxlY3Ryb25pYy1yZXNvdXJj

ZS1udW0+PHZvbHVtZT4xNTk8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5N

b3RsZXk8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJRFRleHQ+TXVsdGlwcm9mZXNzaW9uYWwg

Z3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgdGhlIHBhdGllbnQgd2l0aCBwcmltYXJ5

IGN1dGFuZW91cyBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVz

PjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+

PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3

b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5Qcm9nbm9zaXM8L2tleXdvcmQ+

PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U29jaWV0aWVzLCBNZWRp

Y2FsPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzExODQxMzYyPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjAwMDctMDk2MzwvaXNibj48dGl0bGVzPjx0aXRsZT5NdWx0aXByb2Zlc3Np

b25hbCBndWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiB0aGUgcGF0aWVudCB3aXRoIHBy

aW1hcnkgY3V0YW5lb3VzIHNxdWFtb3VzIGNlbGwgY2FyY2lub21hPC90aXRsZT48c2Vjb25kYXJ5

LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTgt

MjU8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5Nb3RsZXksIFIuPC9hdXRob3I+PGF1dGhvcj5LZXJzZXksIFAuPC9hdXRob3I+PGF1dGhvcj5M

YXdyZW5jZSwgQy48L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgRGVybWF0

b2xvZ2lzdHM8L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgUGxhc3RpYyBT

dXJnZW9uczwvYXV0aG9yPjxhdXRob3I+Um95YWwgQ29sbGVnZSBvZiBSYWRpb2xvZ2lzdHMsIEYu

Y3VsdHkgb2YgQ2xpbmljYWwgT25jb2xvZ3k8L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRv

cnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MjY4OTg8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxyZWMtbnVtYmVyPjI0MTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4OTg8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjEx

ODQxMzYyPC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDQ2L2ou

MDAwNy0wOTYzLjIwMDEuMDQ2MTUueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4x

NDY8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UZWxmZXI8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxJ

RFRleHQ+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5v

bWE8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij44LCA5PC9z

dHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVsPC9k

YXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdv

cmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNyeW9zdXJnZXJ5PC9r

ZXl3b3JkPjxrZXl3b3JkPkN1cmV0dGFnZTwva2V5d29yZD48a2V5d29yZD5FdmlkZW5jZS1CYXNl

ZCBNZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5HdWlkZWxpbmUgQWRoZXJlbmNlPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5QaG90b2NoZW1vdGhlcmFweTwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xODU5

MzM4NTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRp

dGxlcz48dGl0bGU+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBj

YXJjaW5vbWE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5

LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4zNS00ODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlRlbGZlciwgTi4gUi48L2F1dGhvcj48YXV0aG9y

PkNvbHZlciwgRy4gQi48L2F1dGhvcj48YXV0aG9yPk1vcnRvbiwgQy4gQS48L2F1dGhvcj48YXV0

aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgRGVybWF0b2xvZ2lzdHM8L2F1dGhvcj48L2F1dGhv

cnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0MDwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjE4NTkzMzg1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNl

LW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDguMDg2NjYueDwvZWxlY3Ryb25pYy1yZXNvdXJj

ZS1udW0+PHZvbHVtZT4xNTk8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5N

b3RsZXk8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJRFRleHQ+TXVsdGlwcm9mZXNzaW9uYWwg

Z3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgdGhlIHBhdGllbnQgd2l0aCBwcmltYXJ5

IGN1dGFuZW91cyBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVz

PjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+

PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3

b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5Qcm9nbm9zaXM8L2tleXdvcmQ+

PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U29jaWV0aWVzLCBNZWRp

Y2FsPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzExODQxMzYyPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjAwMDctMDk2MzwvaXNibj48dGl0bGVzPjx0aXRsZT5NdWx0aXByb2Zlc3Np

b25hbCBndWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiB0aGUgcGF0aWVudCB3aXRoIHBy

aW1hcnkgY3V0YW5lb3VzIHNxdWFtb3VzIGNlbGwgY2FyY2lub21hPC90aXRsZT48c2Vjb25kYXJ5

LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTgt

MjU8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5Nb3RsZXksIFIuPC9hdXRob3I+PGF1dGhvcj5LZXJzZXksIFAuPC9hdXRob3I+PGF1dGhvcj5M

YXdyZW5jZSwgQy48L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgRGVybWF0

b2xvZ2lzdHM8L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNzb2NpYXRpb24gb2YgUGxhc3RpYyBT

dXJnZW9uczwvYXV0aG9yPjxhdXRob3I+Um95YWwgQ29sbGVnZSBvZiBSYWRpb2xvZ2lzdHMsIEYu

Y3VsdHkgb2YgQ2xpbmljYWwgT25jb2xvZ3k8L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRv

cnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MjY4OTg8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxyZWMtbnVtYmVyPjI0MTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4OTg8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjEx

ODQxMzYyPC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDQ2L2ou

MDAwNy0wOTYzLjIwMDEuMDQ2MTUueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4x

NDY8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 8, 9. It also has a role in the treatment of incompletely excised BCC and high-risk SCC as an adjunct to excision ADDIN EN.CITE <EndNote><Cite><Author>Geohas</Author><Year>1994</Year><IDText>Adjuvant radiotherapy after excision of cutaneous squamous cell carcinoma</IDText><DisplayText><style face="superscript">10</style></DisplayText><record><dates><pub-dates><date>Apr</date></pub-dates><year>1994</year></dates><keywords><keyword>Aged</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Combined Modality Therapy</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Mohs Surgery</keyword><keyword>Prognosis</keyword><keyword>Skin Neoplasms</keyword><keyword>Thorax</keyword></keywords><urls><related-urls><url> radiotherapy after excision of cutaneous squamous cell carcinoma</title><secondary-title>J Am Acad Dermatol</secondary-title></titles><pages>633-6</pages><number>4</number><contributors><authors><author>Geohas, J.</author><author>Roholt, N. S.</author><author>Robinson, J. K.</author></authors></contributors><language>eng</language><added-date format="utc">1574350314</added-date><ref-type name="Journal Article">17</ref-type><rec-number>2665</rec-number><last-updated-date format="utc">1574350314</last-updated-date><accession-num>8157790</accession-num><electronic-resource-num>10.1016/s0190-9622(94)70073-7</electronic-resource-num><volume>30</volume></record></Cite></EndNote>10. In practice however, radiotherapy is rarely utilised for primary lesions as it does not allow examination of the margins to confirm clearance. In the UK, surgical excision of skin cancer is mainly performed in secondary care ADDIN EN.CITE <EndNote><Cite><Author>NHS</Author><Year>2013</Year><IDText>2013/14 NHS STANDARD CONTRACT FOR CANCER: SKIN (ADULT)</IDText><DisplayText><style face="superscript">11</style></DisplayText><record><urls><related-urls><url> NHS STANDARD CONTRACT FOR CANCER: SKIN (ADULT)</title></titles><contributors><authors><author>NHS England</author></authors></contributors><added-date format="utc">1571626685</added-date><ref-type name="Generic">13</ref-type><dates><year>2013</year></dates><rec-number>239</rec-number><last-updated-date format="utc">1571626716</last-updated-date></record></Cite></EndNote>11 where it is more cost effective ADDIN EN.CITE <EndNote><Cite><Author>George</Author><Year>2008</Year><IDText>A prospective randomised comparison of minor surgery in primary and secondary care. The MiSTIC trial</IDText><DisplayText><style face="superscript">12</style></DisplayText><record><dates><pub-dates><date>May</date></pub-dates><year>2008</year></dates><keywords><keyword>Ambulatory Care</keyword><keyword>Elective Surgical Procedures</keyword><keyword>England</keyword><keyword>Female</keyword><keyword>Health Expenditures</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Medical Staff, Hospital</keyword><keyword>Middle Aged</keyword><keyword>Minor Surgical Procedures</keyword><keyword>Nails, Ingrown</keyword><keyword>Pain Measurement</keyword><keyword>Physicians, Family</keyword><keyword>Primary Health Care</keyword><keyword>Professional Competence</keyword><keyword>Prospective Studies</keyword><keyword>Quality of Health Care</keyword><keyword>Safety</keyword><keyword>Skin Diseases</keyword></keywords><urls><related-urls><url> prospective randomised comparison of minor surgery in primary and secondary care. The MiSTIC trial</title><secondary-title>Health Technol Assess</secondary-title></titles><pages>iii-iv, ix-38</pages><number>23</number><contributors><authors><author>George, S.</author><author>Pockney, P.</author><author>Primrose, J.</author><author>Smith, H.</author><author>Little, P.</author><author>Kinley, H.</author><author>Kneebone, R.</author><author>Lowy, A.</author><author>Leppard, B.</author><author>Jayatilleke, N.</author><author>McCabe, C.</author></authors></contributors><language>eng</language><added-date format="utc">1572032921</added-date><ref-type name="Journal Article">17</ref-type><rec-number>267</rec-number><last-updated-date format="utc">1572032921</last-updated-date><accession-num>18505669</accession-num><volume>12</volume></record></Cite></EndNote>12 and consequently makes up a significant proportion of the workload for Dermatology and Plastic Surgery. There is joint guidance from the National Institute for Health and Care Excellence (NICE) and the British Association of Dermatologists (BAD) on the treatment of skin cancer which includes the planned surgical marginsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3RsZXk8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJ

RFRleHQ+TXVsdGlwcm9mZXNzaW9uYWwgZ3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2Yg

dGhlIHBhdGllbnQgd2l0aCBwcmltYXJ5IGN1dGFuZW91cyBzcXVhbW91cyBjZWxsIGNhcmNpbm9t

YTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjgsIDk8L3N0

eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5DYXJjaW5vbWEsIFNxdWFtb3VzIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5Tb2NpZXRpZXMsIE1lZGljYWw8L2tleXdvcmQ+PC9rZXl3b3Jkcz48

dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJt

ZWQvMTE4NDEzNjI8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAwNy0wOTYzPC9p

c2JuPjx0aXRsZXM+PHRpdGxlPk11bHRpcHJvZmVzc2lvbmFsIGd1aWRlbGluZXMgZm9yIHRoZSBt

YW5hZ2VtZW50IG9mIHRoZSBwYXRpZW50IHdpdGggcHJpbWFyeSBjdXRhbmVvdXMgc3F1YW1vdXMg

Y2VsbCBjYXJjaW5vbWE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4xOC0yNTwvcGFnZXM+PG51bWJlcj4xPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1vdGxleSwgUi48L2F1dGhvcj48YXV0

aG9yPktlcnNleSwgUC48L2F1dGhvcj48YXV0aG9yPkxhd3JlbmNlLCBDLjwvYXV0aG9yPjxhdXRo

b3I+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0czwvYXV0aG9yPjxhdXRob3I+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBQbGFzdGljIFN1cmdlb25zPC9hdXRob3I+PGF1dGhvcj5S

b3lhbCBDb2xsZWdlIG9mIFJhZGlvbG9naXN0cywgRi5jdWx0eSBvZiBDbGluaWNhbCBPbmNvbG9n

eTwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFn

ZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjg5ODwvYWRkZWQtZGF0ZT48cmVmLXR5

cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQxPC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjg5ODwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTE4NDEzNjI8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNDYvai4wMDA3LTA5NjMuMjAwMS4wNDYxNS54PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjE0Njwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPlRlbGZlcjwvQXV0aG9yPjxZZWFyPjIwMDg8L1llYXI+PElEVGV4dD5H

dWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYTwvSURU

ZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVsPC9kYXRlPjwvcHViLWRhdGVz

Pjx5ZWFyPjIwMDg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBC

YXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNyeW9zdXJnZXJ5PC9rZXl3b3JkPjxrZXl3b3Jk

PkN1cmV0dGFnZTwva2V5d29yZD48a2V5d29yZD5FdmlkZW5jZS1CYXNlZCBNZWRpY2luZTwva2V5

d29yZD48a2V5d29yZD5HdWlkZWxpbmUgQWRoZXJlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFu

czwva2V5d29yZD48a2V5d29yZD5QaG90b2NoZW1vdGhlcmFweTwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVy

bD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xODU5MzM4NTwvdXJsPjwvcmVs

YXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+R3Vp

ZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWE8L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwYWdlcz4zNS00ODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0

aG9ycz48YXV0aG9yPlRlbGZlciwgTi4gUi48L2F1dGhvcj48YXV0aG9yPkNvbHZlciwgRy4gQi48

L2F1dGhvcj48YXV0aG9yPk1vcnRvbiwgQy4gQS48L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNz

b2NpYXRpb24gb2YgRGVybWF0b2xvZ2lzdHM8L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRv

cnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MjY4MTk8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxyZWMtbnVtYmVyPjI0MDwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE4

NTkzMzg1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ou

MTM2NS0yMTMzLjIwMDguMDg2NjYueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4x

NTk8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Nb3RsZXk8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJ

RFRleHQ+TXVsdGlwcm9mZXNzaW9uYWwgZ3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2Yg

dGhlIHBhdGllbnQgd2l0aCBwcmltYXJ5IGN1dGFuZW91cyBzcXVhbW91cyBjZWxsIGNhcmNpbm9t

YTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjgsIDk8L3N0

eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5DYXJjaW5vbWEsIFNxdWFtb3VzIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPlByb2dub3Npczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5Tb2NpZXRpZXMsIE1lZGljYWw8L2tleXdvcmQ+PC9rZXl3b3Jkcz48

dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJt

ZWQvMTE4NDEzNjI8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAwNy0wOTYzPC9p

c2JuPjx0aXRsZXM+PHRpdGxlPk11bHRpcHJvZmVzc2lvbmFsIGd1aWRlbGluZXMgZm9yIHRoZSBt

YW5hZ2VtZW50IG9mIHRoZSBwYXRpZW50IHdpdGggcHJpbWFyeSBjdXRhbmVvdXMgc3F1YW1vdXMg

Y2VsbCBjYXJjaW5vbWE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4xOC0yNTwvcGFnZXM+PG51bWJlcj4xPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1vdGxleSwgUi48L2F1dGhvcj48YXV0

aG9yPktlcnNleSwgUC48L2F1dGhvcj48YXV0aG9yPkxhd3JlbmNlLCBDLjwvYXV0aG9yPjxhdXRo

b3I+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0czwvYXV0aG9yPjxhdXRob3I+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBQbGFzdGljIFN1cmdlb25zPC9hdXRob3I+PGF1dGhvcj5S

b3lhbCBDb2xsZWdlIG9mIFJhZGlvbG9naXN0cywgRi5jdWx0eSBvZiBDbGluaWNhbCBPbmNvbG9n

eTwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFn

ZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjg5ODwvYWRkZWQtZGF0ZT48cmVmLXR5

cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQxPC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjg5ODwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTE4NDEzNjI8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNDYvai4wMDA3LTA5NjMuMjAwMS4wNDYxNS54PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjE0Njwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPlRlbGZlcjwvQXV0aG9yPjxZZWFyPjIwMDg8L1llYXI+PElEVGV4dD5H

dWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYTwvSURU

ZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVsPC9kYXRlPjwvcHViLWRhdGVz

Pjx5ZWFyPjIwMDg8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBC

YXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNyeW9zdXJnZXJ5PC9rZXl3b3JkPjxrZXl3b3Jk

PkN1cmV0dGFnZTwva2V5d29yZD48a2V5d29yZD5FdmlkZW5jZS1CYXNlZCBNZWRpY2luZTwva2V5

d29yZD48a2V5d29yZD5HdWlkZWxpbmUgQWRoZXJlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFu

czwva2V5d29yZD48a2V5d29yZD5QaG90b2NoZW1vdGhlcmFweTwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVy

bD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xODU5MzM4NTwvdXJsPjwvcmVs

YXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+R3Vp

ZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWE8L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwYWdlcz4zNS00ODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0

aG9ycz48YXV0aG9yPlRlbGZlciwgTi4gUi48L2F1dGhvcj48YXV0aG9yPkNvbHZlciwgRy4gQi48

L2F1dGhvcj48YXV0aG9yPk1vcnRvbiwgQy4gQS48L2F1dGhvcj48YXV0aG9yPkJyaXRpc2ggQXNz

b2NpYXRpb24gb2YgRGVybWF0b2xvZ2lzdHM8L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRv

cnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MjY4MTk8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxyZWMtbnVtYmVyPjI0MDwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE2MjY4MTk8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE4

NTkzMzg1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ou

MTM2NS0yMTMzLjIwMDguMDg2NjYueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4x

NTk8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 8, 9. Previous Dermatology national audits Two UK national audits have been undertaken by Dermatology to establish the incomplete excision rate and complications from non-melanoma skin cancer. UK Dermatology consultants submitted 10 consecutive cases of non-micrographic excision from 135 centres. The first cycle in 2014 of 2739 lesions had an incomplete excision rate of 2.3% ADDIN EN.CITE <EndNote><Cite><Author>Keith</Author><Year>2017</Year><IDText>British Association of Dermatologists&apos; national audit on nonmelanoma skin cancer excision, 2014</IDText><DisplayText><style face="superscript">13</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2017</year></dates><keywords><keyword>Clinical Audit</keyword><keyword>Dermatologic Surgical Procedures</keyword><keyword>Dermatology</keyword><keyword>Diagnosis, Differential</keyword><keyword>Humans</keyword><keyword>Melanoma</keyword><keyword>Neoplasm Seeding</keyword><keyword>Prevalence</keyword><keyword>Referral and Consultation</keyword><keyword>Skin Neoplasms</keyword><keyword>Societies, Medical</keyword><keyword>United Kingdom</keyword></keywords><urls><related-urls><url> Association of Dermatologists&apos; national audit on nonmelanoma skin cancer excision, 2014</title><secondary-title>Clin Exp Dermatol</secondary-title></titles><pages>46-53</pages><number>1</number><contributors><authors><author>Keith, D. J.</author><author>de Berker, D. A.</author><author>Bray, A. P.</author><author>Cheung, S. T.</author><author>Brain, A.</author><author>Mohd Mustapa, M. F.</author></authors></contributors><language>eng</language><added-date format="utc">1571244524</added-date><ref-type name="Journal Article">17</ref-type><rec-number>224</rec-number><last-updated-date format="utc">1571244524</last-updated-date><accession-num>28028856</accession-num><electronic-resource-num>10.1111/ced.12990</electronic-resource-num><volume>42</volume></record></Cite></EndNote>13. A second cycle in 2016 of 3290 reported an incomplete rate of 3.0% ADDIN EN.CITE <EndNote><Cite><Author>Keith</Author><Year>2019</Year><IDText>British Association of Dermatologists (BAD) National Audit on Non-Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists</IDText><DisplayText><style face="superscript">14</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2019</year></dates><urls><related-urls><url> Association of Dermatologists (BAD) National Audit on Non-Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists</title><secondary-title>Clin Exp Dermatol</secondary-title></titles><contributors><authors><author>Keith, D. J.</author><author>Bray, A. P.</author><author>Brain, A.</author><author>Mohd Mustapa, M. F.</author><author>Barrett, H. E.</author><author>Lane, S.</author><author>Emmerich, M.</author><author>Jakes, A.</author><author>Barrett, P. D.</author><author>de Berker, D. A. R.</author></authors></contributors><edition>2019/07/02</edition><language>eng</language><added-date format="utc">1571244524</added-date><ref-type name="Journal Article">17</ref-type><rec-number>223</rec-number><last-updated-date format="utc">1571244524</last-updated-date><accession-num>31265150</accession-num><electronic-resource-num>10.1111/ced.14034</electronic-resource-num></record></Cite></EndNote>14. There were no audit changes instigated following the original audit. In the subsequent audit cycle, they recommended histopathologists include all core data items in their reports but no changes to Dermatologists practice. This data gave an insight into the ‘typical’ lesion a dermatologist might encounter and their approach; a suspected BCC on the head and neck (58%), of mean diameter of 11mm which is excised and closed directly (88%) and not followed up in secondary care PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 13, 14.Other published audits In contrast there is a paucity of large-scale multi-centre data from Plastic Surgery units on their typical lesion or outcomes. Often Dermatology refer patients to Plastic Surgery (27-52% of referralsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUtMTc8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48

ZGF0ZT5EZWM8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3

b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3

b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwg

Q2VsbDwva2V5d29yZD48a2V5d29yZD5DaGVlazwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+

SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFn

ZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Tm9zZSBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3

b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRjb21lPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFk

dWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzIwMjI2NzUwPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNibj48dGl0bGVzPjx0aXRsZT5SaXNrIGFuZCBvdXRj

b21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25zdHIgQWVzdGhldCBTdXJnPC9zZWNvbmRh

cnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIwNTctNjM8L3BhZ2VzPjxudW1iZXI+MTI8L251bWJl

cj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+TWFsaWssIFYuPC9hdXRob3I+PGF1dGhv

cj5Hb2gsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5MZW9uZywgUy48L2F1dGhvcj48YXV0aG9yPlRh

biwgQS48L2F1dGhvcj48YXV0aG9yPkRvd25leSwgRC48L2F1dGhvcj48YXV0aG9yPk8mYXBvcztE

b25vdmFuLCBELjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEw

LzAzLzExPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1h

dD0idXRjIj4xNTcxOTkwNDU3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFy

dGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDU8L3JlYy1udW1iZXI+PGxhc3QtdXBk

YXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTkwNDU3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNj

ZXNzaW9uLW51bT4yMDIyNjc1MDwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+MTAuMTAxNi9qLmJqcHMuMjAxMC4wMS4wMTY8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2

b2x1bWU+NjM8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5HcmlmZml0aHM8

L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxJRFRleHQ+QmFzYWwgY2VsbCBjYXJjaW5vbWEgaGlz

dG9sb2dpY2FsIGNsZWFyYW5jZSBtYXJnaW5zOiBhbiBhbmFseXNpcyBvZiAxNTM5IGNvbnZlbnRp

b25hbGx5IGV4Y2lzZWQgdHVtb3Vycy4gV2lkZXIgc3RpbGwgYW5kIGRlZXBlcj88L0lEVGV4dD48

cmVjb3JkPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+

PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5z

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0

bWVudCBPdXRjb21lPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE3MTI2MjY1PC91cmw+PC9yZWxh

dGVkLXVybHM+PC91cmxzPjxpc2JuPjE3NDgtNjgxNTwvaXNibj48dGl0bGVzPjx0aXRsZT5CYXNh

bCBjZWxsIGNhcmNpbm9tYSBoaXN0b2xvZ2ljYWwgY2xlYXJhbmNlIG1hcmdpbnM6IGFuIGFuYWx5

c2lzIG9mIDE1MzkgY29udmVudGlvbmFsbHkgZXhjaXNlZCB0dW1vdXJzLiBXaWRlciBzdGlsbCBh

bmQgZGVlcGVyPzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3Ro

ZXQgU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40MS03PC9wYWdlcz48bnVt

YmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+R3JpZmZpdGhzLCBS

LiBXLjwvYXV0aG9yPjxhdXRob3I+U3V2YXJuYSwgUy4gSy48L2F1dGhvcj48YXV0aG9yPlN0b25l

LCBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA2LzA5LzAx

PC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxOTk5NjM4PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUi

PjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNzwveWVhcj48L2RhdGVzPjxyZWMtbnVtYmVy

PjI0NjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTk2

Mzg8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE3MTI2MjY1PC9hY2Nlc3Npb24t

bnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDA2LjA2LjAwOTwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42MDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPkJhcnJ5PC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48SURUZXh0PlRo

ZSBtYW5hZ2VtZW50IG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0PjxyZWNvcmQ+PGRh

dGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDY8L3ll

YXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdl

ZDwva2V5d29yZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5C

aW9wc3k8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

SXJlbGFuZDwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwg

QXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmVm

ZXJyYWwgYW5kIENvbnN1bHRhdGlvbjwva2V5d29yZD48a2V5d29yZD5Ta2luPC9rZXl3b3JkPjxr

ZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQt

dXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE2OTIxODI1PC91

cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAzMzItMzEwMjwvaXNibj48dGl0bGVzPjx0

aXRsZT5UaGUgbWFuYWdlbWVudCBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYXM8L3RpdGxlPjxzZWNv

bmRhcnktdGl0bGU+SXIgTWVkIEo8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTc5

LTgxPC9wYWdlcz48bnVtYmVyPjY8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+QmFycnksIEouPC9hdXRob3I+PGF1dGhvcj5Pb24sIFMuIEYuPC9hdXRob3I+PGF1dGhvcj5X

YXRzb24sIFIuPC9hdXRob3I+PGF1dGhvcj5CYXJuZXMsIEwuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0i

dXRjIj4xNTczMzMxMzg2PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGlj

bGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNzQ8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRl

ZC1kYXRlIGZvcm1hdD0idXRjIj4xNTczMzMxMzg2PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNz

aW9uLW51bT4xNjkyMTgyNTwvYWNjZXNzaW9uLW51bT48dm9sdW1lPjk5PC92b2x1bWU+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUtMTc8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48

ZGF0ZT5EZWM8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3

b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3

b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwg

Q2VsbDwva2V5d29yZD48a2V5d29yZD5DaGVlazwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+

SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFn

ZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Tm9zZSBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3

b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRjb21lPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFk

dWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzIwMjI2NzUwPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNibj48dGl0bGVzPjx0aXRsZT5SaXNrIGFuZCBvdXRj

b21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC90aXRs

ZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25zdHIgQWVzdGhldCBTdXJnPC9zZWNvbmRh

cnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIwNTctNjM8L3BhZ2VzPjxudW1iZXI+MTI8L251bWJl

cj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+TWFsaWssIFYuPC9hdXRob3I+PGF1dGhv

cj5Hb2gsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5MZW9uZywgUy48L2F1dGhvcj48YXV0aG9yPlRh

biwgQS48L2F1dGhvcj48YXV0aG9yPkRvd25leSwgRC48L2F1dGhvcj48YXV0aG9yPk8mYXBvcztE

b25vdmFuLCBELjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEw

LzAzLzExPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1h

dD0idXRjIj4xNTcxOTkwNDU3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFy

dGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDU8L3JlYy1udW1iZXI+PGxhc3QtdXBk

YXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTkwNDU3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNj

ZXNzaW9uLW51bT4yMDIyNjc1MDwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+MTAuMTAxNi9qLmJqcHMuMjAxMC4wMS4wMTY8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2

b2x1bWU+NjM8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5HcmlmZml0aHM8

L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxJRFRleHQ+QmFzYWwgY2VsbCBjYXJjaW5vbWEgaGlz

dG9sb2dpY2FsIGNsZWFyYW5jZSBtYXJnaW5zOiBhbiBhbmFseXNpcyBvZiAxNTM5IGNvbnZlbnRp

b25hbGx5IGV4Y2lzZWQgdHVtb3Vycy4gV2lkZXIgc3RpbGwgYW5kIGRlZXBlcj88L0lEVGV4dD48

cmVjb3JkPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+

PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5z

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0

bWVudCBPdXRjb21lPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE3MTI2MjY1PC91cmw+PC9yZWxh

dGVkLXVybHM+PC91cmxzPjxpc2JuPjE3NDgtNjgxNTwvaXNibj48dGl0bGVzPjx0aXRsZT5CYXNh

bCBjZWxsIGNhcmNpbm9tYSBoaXN0b2xvZ2ljYWwgY2xlYXJhbmNlIG1hcmdpbnM6IGFuIGFuYWx5

c2lzIG9mIDE1MzkgY29udmVudGlvbmFsbHkgZXhjaXNlZCB0dW1vdXJzLiBXaWRlciBzdGlsbCBh

bmQgZGVlcGVyPzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3Ro

ZXQgU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40MS03PC9wYWdlcz48bnVt

YmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+R3JpZmZpdGhzLCBS

LiBXLjwvYXV0aG9yPjxhdXRob3I+U3V2YXJuYSwgUy4gSy48L2F1dGhvcj48YXV0aG9yPlN0b25l

LCBKLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA2LzA5LzAx

PC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxOTk5NjM4PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUi

PjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNzwveWVhcj48L2RhdGVzPjxyZWMtbnVtYmVy

PjI0NjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTk2

Mzg8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE3MTI2MjY1PC9hY2Nlc3Npb24t

bnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDA2LjA2LjAwOTwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42MDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPkJhcnJ5PC9BdXRob3I+PFllYXI+MjAwNjwvWWVhcj48SURUZXh0PlRo

ZSBtYW5hZ2VtZW50IG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0PjxyZWNvcmQ+PGRh

dGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDY8L3ll

YXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdl

ZDwva2V5d29yZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5C

aW9wc3k8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

SXJlbGFuZDwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwg

QXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmVm

ZXJyYWwgYW5kIENvbnN1bHRhdGlvbjwva2V5d29yZD48a2V5d29yZD5Ta2luPC9rZXl3b3JkPjxr

ZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQt

dXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE2OTIxODI1PC91

cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAzMzItMzEwMjwvaXNibj48dGl0bGVzPjx0

aXRsZT5UaGUgbWFuYWdlbWVudCBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYXM8L3RpdGxlPjxzZWNv

bmRhcnktdGl0bGU+SXIgTWVkIEo8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTc5

LTgxPC9wYWdlcz48bnVtYmVyPjY8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+QmFycnksIEouPC9hdXRob3I+PGF1dGhvcj5Pb24sIFMuIEYuPC9hdXRob3I+PGF1dGhvcj5X

YXRzb24sIFIuPC9hdXRob3I+PGF1dGhvcj5CYXJuZXMsIEwuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0i

dXRjIj4xNTczMzMxMzg2PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGlj

bGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNzQ8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRl

ZC1kYXRlIGZvcm1hdD0idXRjIj4xNTczMzMxMzg2PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNz

aW9uLW51bT4xNjkyMTgyNTwvYWNjZXNzaW9uLW51bT48dm9sdW1lPjk5PC92b2x1bWU+PC9yZWNv

cmQ+PC9DaXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE.DATA 15-17) when they are unable to excise the lesion, which may be for a multitude of reasons; larger/invasive tumour; higher grade; cosmetically sensitive area; recurrent lesion; requiring a more complex reconstruction of the defect. All these factors may influence outcomes in terms of clear margins and complications. Multiple single centre and regional studies from Plastic Surgery units in the UK and abroad support this hypothesis. At least 28 published studies worldwide have reported the incomplete excision rate of non-melanoma skin cancer (or solely BCC/SCC) since 2000. While it is very easy to compare the final incomplete excision rate, this fundamentally misses the huge amount of variation in these studies which confound the results to the point that comparison is in some ways meaningless. See table 1. Plastic Surgeons more commonly operate on the head and neck which comprises between 74-86.4%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UaW1tb25zPC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48

SURUZXh0PkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE4LTIwPC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lu

b21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29y

ZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVuY2UsIExv

Y2FsPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzEyMTYwNTQ4PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIyNjwv

aXNibj48dGl0bGVzPjx0aXRsZT5Db21wbGV0ZSBleGNpc2lvbiBvZiBiYXNhbCBjZWxsIGNhcmNp

bm9tYXM8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBQbGFzdCBTdXJnPC9zZWNvbmRhcnkt

dGl0bGU+PC90aXRsZXM+PHBhZ2VzPjM2MjwvcGFnZXM+PG51bWJlcj40PC9udW1iZXI+PGNvbnRy

aWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlRpbW1vbnMsIE0uIEouPC9hdXRob3I+PGF1dGhvcj5I

ZXNzZWwsIEsuIEMuPC9hdXRob3I+PGF1dGhvcj5LcmFuaWRoaW90aXMsIE4uIE0uPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1k

YXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyOTMzPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNTA8L3JlYy1udW1iZXI+

PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyOTMzPC9sYXN0LXVwZGF0ZWQt

ZGF0ZT48YWNjZXNzaW9uLW51bT4xMjE2MDU0ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTA1NC9ianBzLjIwMDIuMzg0OTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+PHZvbHVtZT41NTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlN0b2xs

ZTwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+PElEVGV4dD5BIHNpbmdsZSBjZW50ZXIgcmV0cm9z

cGVjdGl2ZSBzdHVkeSBvbiA5NTkgZXhjaXNpb25zIG9mIG5vbi1tZWxhbm9tYSBza2luIGNhbmNl

ciBpbiAyMDExPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5Ob3Y8L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxMzwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgw

IGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29y

ZD48a2V5d29yZD5DYXJjaW5vbWEsIFNxdWFtb3VzIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+RXh0

cmVtaXRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQg

YW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPkhvc3BpdGFsaXphdGlvbjwva2V5

d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48a2V5

d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tl

eXdvcmQ+PGtleXdvcmQ+UmVjb25zdHJ1Y3RpdmUgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29y

ZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2NhbHA8

L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VG9yc288

L2tleXdvcmQ+PGtleXdvcmQ+VHVtb3IgQnVyZGVuPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFk

dWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzIzNzUxOTczPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNibj48dGl0bGVzPjx0aXRsZT5BIHNpbmdsZSBjZW50

ZXIgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvbiA5NTkgZXhjaXNpb25zIG9mIG5vbi1tZWxhbm9tYSBz

a2luIGNhbmNlciBpbiAyMDExPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25z

dHIgQWVzdGhldCBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjE2MzAtMjwv

cGFnZXM+PG51bWJlcj4xMTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5T

dG9sbGUsIEwuIEIuPC9hdXRob3I+PGF1dGhvcj5LamVya2VnYWFyZCwgVS4gSy48L2F1dGhvcj48

L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAxMy8wNi8xNDwvZWRpdGlvbj48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI1NzkxNTwv

YWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+

PHJlYy1udW1iZXI+MjMxPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0

YyI+MTU3MTI1NzkxNTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MjM3NTE5NzM8

L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYvai5ianBzLjIw

MTMuMDUuMDIxPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjY2PC92b2x1bWU+PC9y

ZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+MjAwMTwv

WWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lhbiBhZmZl

Y3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMgZm9yIGJh

c2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1dGlvbmFsIHJl

dHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRl

PkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRz

PjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9r

ZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVt

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3

b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3

b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5PZGRzIFJh

dGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdvcmQ+PGtl

eXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxh

c21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAtOTYyMjwv

aXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBwaHlzaWNp

YW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBtYXJnaW5z

IGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5zdGl0dXRp

b25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogQW0gQWNh

ZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8L3BhZ2Vz

PjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5GbGVpc2No

ZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxhdXRob3I+

QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1dGhvcj5I

YWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxhdXRob3I+

RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+PGF1dGhv

cj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhvcj5NYWl6

ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+TGVzaGlu

LCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5n

dWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0ZT48cmVm

LXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ3

PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwv

bGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lvbi1udW0+

PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9lbGVjdHJv

bmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjwvRW5k

Tm90ZT5=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UaW1tb25zPC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48

SURUZXh0PkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE4LTIwPC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SnVuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lu

b21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29y

ZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVuY2UsIExv

Y2FsPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzEyMTYwNTQ4PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIyNjwv

aXNibj48dGl0bGVzPjx0aXRsZT5Db21wbGV0ZSBleGNpc2lvbiBvZiBiYXNhbCBjZWxsIGNhcmNp

bm9tYXM8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBQbGFzdCBTdXJnPC9zZWNvbmRhcnkt

dGl0bGU+PC90aXRsZXM+PHBhZ2VzPjM2MjwvcGFnZXM+PG51bWJlcj40PC9udW1iZXI+PGNvbnRy

aWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlRpbW1vbnMsIE0uIEouPC9hdXRob3I+PGF1dGhvcj5I

ZXNzZWwsIEsuIEMuPC9hdXRob3I+PGF1dGhvcj5LcmFuaWRoaW90aXMsIE4uIE0uPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1k

YXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyOTMzPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNTA8L3JlYy1udW1iZXI+

PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyOTMzPC9sYXN0LXVwZGF0ZWQt

ZGF0ZT48YWNjZXNzaW9uLW51bT4xMjE2MDU0ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTA1NC9ianBzLjIwMDIuMzg0OTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+PHZvbHVtZT41NTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlN0b2xs

ZTwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+PElEVGV4dD5BIHNpbmdsZSBjZW50ZXIgcmV0cm9z

cGVjdGl2ZSBzdHVkeSBvbiA5NTkgZXhjaXNpb25zIG9mIG5vbi1tZWxhbm9tYSBza2luIGNhbmNl

ciBpbiAyMDExPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5Ob3Y8L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxMzwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgw

IGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29y

ZD48a2V5d29yZD5DYXJjaW5vbWEsIFNxdWFtb3VzIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+RXh0

cmVtaXRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQg

YW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPkhvc3BpdGFsaXphdGlvbjwva2V5

d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48a2V5

d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tl

eXdvcmQ+PGtleXdvcmQ+UmVjb25zdHJ1Y3RpdmUgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29y

ZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2NhbHA8

L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VG9yc288

L2tleXdvcmQ+PGtleXdvcmQ+VHVtb3IgQnVyZGVuPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFk

dWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzIzNzUxOTczPC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNibj48dGl0bGVzPjx0aXRsZT5BIHNpbmdsZSBjZW50

ZXIgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvbiA5NTkgZXhjaXNpb25zIG9mIG5vbi1tZWxhbm9tYSBz

a2luIGNhbmNlciBpbiAyMDExPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25z

dHIgQWVzdGhldCBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjE2MzAtMjwv

cGFnZXM+PG51bWJlcj4xMTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5T

dG9sbGUsIEwuIEIuPC9hdXRob3I+PGF1dGhvcj5LamVya2VnYWFyZCwgVS4gSy48L2F1dGhvcj48

L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAxMy8wNi8xNDwvZWRpdGlvbj48bGFu

Z3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI1NzkxNTwv

YWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+

PHJlYy1udW1iZXI+MjMxPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0

YyI+MTU3MTI1NzkxNTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MjM3NTE5NzM8

L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYvai5ianBzLjIw

MTMuMDUuMDIxPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjY2PC92b2x1bWU+PC9y

ZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+MjAwMTwv

WWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lhbiBhZmZl

Y3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMgZm9yIGJh

c2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1dGlvbmFsIHJl

dHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRl

PkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRz

PjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9r

ZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVt

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3

b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3

b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5PZGRzIFJh

dGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdvcmQ+PGtl

eXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxh

c21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAtOTYyMjwv

aXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBwaHlzaWNp

YW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBtYXJnaW5z

IGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5zdGl0dXRp

b25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogQW0gQWNh

ZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8L3BhZ2Vz

PjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5GbGVpc2No

ZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxhdXRob3I+

QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1dGhvcj5I

YWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxhdXRob3I+

RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+PGF1dGhv

cj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhvcj5NYWl6

ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+TGVzaGlu

LCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5n

dWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0ZT48cmVm

LXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ3

PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwv

bGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lvbi1udW0+

PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9lbGVjdHJv

bmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjwvRW5k

Tm90ZT5=

ADDIN EN.CITE.DATA 18-20 of the lesions they excise. Dermatologists operated on the head and neck less often at between 50-58.3%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0LCAyMCwgMjE8L3N0

eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxNzwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5DbGluaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9naWMgU3VyZ2ljYWwg

UHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9neTwva2V5d29yZD48a2V5d29y

ZD5EaWFnbm9zaXMsIERpZmZlcmVudGlhbDwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdv

cmQ+PGtleXdvcmQ+TWVsYW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gU2VlZGluZzwv

a2V5d29yZD48a2V5d29yZD5QcmV2YWxlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPlJlZmVycmFsIGFu

ZCBDb25zdWx0YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+

PGtleXdvcmQ+U29jaWV0aWVzLCBNZWRpY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlVuaXRlZCBLaW5n

ZG9tPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzI4MDI4ODU2PC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjEzNjUtMjIzMDwvaXNibj48dGl0bGVzPjx0aXRsZT5Ccml0aXNoIEFzc29j

aWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFsIGF1ZGl0IG9uIG5vbm1lbGFu

b21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkNs

aW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjQ2LTUzPC9w

YWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+S2Vp

dGgsIEQuIEouPC9hdXRob3I+PGF1dGhvcj5kZSBCZXJrZXIsIEQuIEEuPC9hdXRob3I+PGF1dGhv

cj5CcmF5LCBBLiBQLjwvYXV0aG9yPjxhdXRob3I+Q2hldW5nLCBTLiBULjwvYXV0aG9yPjxhdXRo

b3I+QnJhaW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Nb2hkIE11c3RhcGEsIE0uIEYuPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1k

YXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjQ8L3JlYy1udW1iZXI+

PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9sYXN0LXVwZGF0ZWQt

ZGF0ZT48YWNjZXNzaW9uLW51bT4yODAyODg1NjwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTExMS9jZWQuMTI5OTA8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2

b2x1bWU+NDI8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0

aG9yPjxZZWFyPjIwMTk8L1llYXI+PElEVGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1h

dG9sb2dpc3RzIChCQUQpIE5hdGlvbmFsIEF1ZGl0IG9uIE5vbi1NZWxhbm9tYSBTa2luIENhbmNl

ciBFeGNpc2lvbiAyMDE2IGluIGNvbGxhYm9yYXRpb24gd2l0aCB0aGUgUm95YWwgQ29sbGVnZSBv

ZiBQYXRob2xvZ2lzdHM8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkp1

bDwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDE5PC95ZWFyPjwvZGF0ZXM+PHVybHM+PHJlbGF0

ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzMxMjY1MTUw

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEzNjUtMjIzMDwvaXNibj48dGl0bGVz

Pjx0aXRsZT5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzIChCQUQpIE5hdGlv

bmFsIEF1ZGl0IG9uIE5vbi1NZWxhbm9tYSBTa2luIENhbmNlciBFeGNpc2lvbiAyMDE2IGluIGNv

bGxhYm9yYXRpb24gd2l0aCB0aGUgUm95YWwgQ29sbGVnZSBvZiBQYXRob2xvZ2lzdHM8L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+Q2xpbiBFeHAgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3Rp

dGxlcz48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+S2VpdGgsIEQuIEouPC9hdXRob3I+

PGF1dGhvcj5CcmF5LCBBLiBQLjwvYXV0aG9yPjxhdXRob3I+QnJhaW4sIEEuPC9hdXRob3I+PGF1

dGhvcj5Nb2hkIE11c3RhcGEsIE0uIEYuPC9hdXRob3I+PGF1dGhvcj5CYXJyZXR0LCBILiBFLjwv

YXV0aG9yPjxhdXRob3I+TGFuZSwgUy48L2F1dGhvcj48YXV0aG9yPkVtbWVyaWNoLCBNLjwvYXV0

aG9yPjxhdXRob3I+SmFrZXMsIEEuPC9hdXRob3I+PGF1dGhvcj5CYXJyZXR0LCBQLiBELjwvYXV0

aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLiBSLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRy

aWJ1dG9ycz48ZWRpdGlvbj4yMDE5LzA3LzAyPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1

YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9hZGRlZC1kYXRlPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjM8

L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9s

YXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMTI2NTE1MDwvYWNjZXNzaW9uLW51bT48

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9jZWQuMTQwMzQ8L2VsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZ

ZWFyPjIwMTA8L1llYXI+PElEVGV4dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjog

dGhlIGltcG9ydGFuY2Ugb2YgdHJhaW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRh

dGVzPjxkYXRlPkphbjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+

PGtleXdvcmRzPjxrZXl3b3JkPkFtYnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29y

ZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9s

b2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5I

dW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3Jk

Pk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXph

dGlvbjwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhj

aXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48

c2Vjb25kYXJ5LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48

cGFnZXM+MTE3LTIyPC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+U2FsbW9uLCBQLjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRo

b3I+PGF1dGhvcj5SYWRlbWFrZXIsIE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhv

cj48YXV0aG9yPlN0YW53YXksIEEuPC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwv

YXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5n

dWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9h

ZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

cmVjLW51bWJlcj4yNDM8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxOTQ2MTIyPC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwv

YWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEz

My4yMDA5LjA5NTQ4Lng8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1

bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+

MjAwMTwvWWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lh

biBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMg

Zm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1dGlv

bmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVz

PjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtl

eXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBD

ZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdv

cmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5P

ZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdv

cmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4g

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAt

OTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBw

aHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBt

YXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5z

dGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkog

QW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8

L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5G

bGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxh

dXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1

dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxh

dXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+

PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhv

cj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+

TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5n

PC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0

ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1i

ZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAx

MjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lv

bi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjwvRW5kTm90ZT4A

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0LCAyMCwgMjE8L3N0

eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2Rh

dGU+PC9wdWItZGF0ZXM+PHllYXI+MjAxNzwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29y

ZD5DbGluaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9naWMgU3VyZ2ljYWwg

UHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9neTwva2V5d29yZD48a2V5d29y

ZD5EaWFnbm9zaXMsIERpZmZlcmVudGlhbDwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdv

cmQ+PGtleXdvcmQ+TWVsYW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gU2VlZGluZzwv

a2V5d29yZD48a2V5d29yZD5QcmV2YWxlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPlJlZmVycmFsIGFu

ZCBDb25zdWx0YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+

PGtleXdvcmQ+U29jaWV0aWVzLCBNZWRpY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlVuaXRlZCBLaW5n

ZG9tPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8v

d3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzI4MDI4ODU2PC91cmw+PC9yZWxhdGVkLXVybHM+

PC91cmxzPjxpc2JuPjEzNjUtMjIzMDwvaXNibj48dGl0bGVzPjx0aXRsZT5Ccml0aXNoIEFzc29j

aWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFsIGF1ZGl0IG9uIG5vbm1lbGFu

b21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkNs

aW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjQ2LTUzPC9w

YWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+S2Vp

dGgsIEQuIEouPC9hdXRob3I+PGF1dGhvcj5kZSBCZXJrZXIsIEQuIEEuPC9hdXRob3I+PGF1dGhv

cj5CcmF5LCBBLiBQLjwvYXV0aG9yPjxhdXRob3I+Q2hldW5nLCBTLiBULjwvYXV0aG9yPjxhdXRo

b3I+QnJhaW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Nb2hkIE11c3RhcGEsIE0uIEYuPC9hdXRob3I+

PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1k

YXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJK

b3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjQ8L3JlYy1udW1iZXI+

PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9sYXN0LXVwZGF0ZWQt

ZGF0ZT48YWNjZXNzaW9uLW51bT4yODAyODg1NjwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1y

ZXNvdXJjZS1udW0+MTAuMTExMS9jZWQuMTI5OTA8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2

b2x1bWU+NDI8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0

aG9yPjxZZWFyPjIwMTk8L1llYXI+PElEVGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1h

dG9sb2dpc3RzIChCQUQpIE5hdGlvbmFsIEF1ZGl0IG9uIE5vbi1NZWxhbm9tYSBTa2luIENhbmNl

ciBFeGNpc2lvbiAyMDE2IGluIGNvbGxhYm9yYXRpb24gd2l0aCB0aGUgUm95YWwgQ29sbGVnZSBv

ZiBQYXRob2xvZ2lzdHM8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkp1

bDwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDE5PC95ZWFyPjwvZGF0ZXM+PHVybHM+PHJlbGF0

ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzMxMjY1MTUw

PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEzNjUtMjIzMDwvaXNibj48dGl0bGVz

Pjx0aXRsZT5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzIChCQUQpIE5hdGlv

bmFsIEF1ZGl0IG9uIE5vbi1NZWxhbm9tYSBTa2luIENhbmNlciBFeGNpc2lvbiAyMDE2IGluIGNv

bGxhYm9yYXRpb24gd2l0aCB0aGUgUm95YWwgQ29sbGVnZSBvZiBQYXRob2xvZ2lzdHM8L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+Q2xpbiBFeHAgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3Rp

dGxlcz48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+S2VpdGgsIEQuIEouPC9hdXRob3I+

PGF1dGhvcj5CcmF5LCBBLiBQLjwvYXV0aG9yPjxhdXRob3I+QnJhaW4sIEEuPC9hdXRob3I+PGF1

dGhvcj5Nb2hkIE11c3RhcGEsIE0uIEYuPC9hdXRob3I+PGF1dGhvcj5CYXJyZXR0LCBILiBFLjwv

YXV0aG9yPjxhdXRob3I+TGFuZSwgUy48L2F1dGhvcj48YXV0aG9yPkVtbWVyaWNoLCBNLjwvYXV0

aG9yPjxhdXRob3I+SmFrZXMsIEEuPC9hdXRob3I+PGF1dGhvcj5CYXJyZXR0LCBQLiBELjwvYXV0

aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLiBSLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRy

aWJ1dG9ycz48ZWRpdGlvbj4yMDE5LzA3LzAyPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1

YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9hZGRlZC1kYXRlPjxyZWYt

dHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjM8

L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjQ0NTI0PC9s

YXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMTI2NTE1MDwvYWNjZXNzaW9uLW51bT48

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9jZWQuMTQwMzQ8L2VsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZ

ZWFyPjIwMTA8L1llYXI+PElEVGV4dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjog

dGhlIGltcG9ydGFuY2Ugb2YgdHJhaW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRh

dGVzPjxkYXRlPkphbjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+

PGtleXdvcmRzPjxrZXl3b3JkPkFtYnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29y

ZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9s

b2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5I

dW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3Jk

Pk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXph

dGlvbjwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhj

aXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48

c2Vjb25kYXJ5LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48

cGFnZXM+MTE3LTIyPC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+U2FsbW9uLCBQLjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRo

b3I+PGF1dGhvcj5SYWRlbWFrZXIsIE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhv

cj48YXV0aG9yPlN0YW53YXksIEEuPC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwv

YXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5n

dWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9h

ZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48

cmVjLW51bWJlcj4yNDM8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxOTQ2MTIyPC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwv

YWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEz

My4yMDA5LjA5NTQ4Lng8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1

bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+

MjAwMTwvWWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lh

biBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMg

Zm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1dGlv

bmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVz

PjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtl

eXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBD

ZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdv

cmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5P

ZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdv

cmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4g

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAt

OTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBw

aHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBt

YXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5z

dGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkog

QW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8

L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5G

bGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxh

dXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1

dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxh

dXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+

PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhv

cj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+

TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5n

PC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0

ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1i

ZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAx

MjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lv

bi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjwvRW5kTm90ZT4A

ADDIN EN.CITE.DATA 13, 14, 20, 21 in all bar one study where it was 100% ADDIN EN.CITE <EndNote><Cite><Author>Macbeth</Author><Year>2009</Year><IDText>Audit of incomplete excision rates of basal cell carcinoma: analysis of 1972 cases from four U.K. regions</IDText><DisplayText><style face="superscript">22</style></DisplayText><record><dates><pub-dates><date>Sep</date></pub-dates><year>2009</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Clinical Competence</keyword><keyword>England</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Neoplasm, Residual</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> of incomplete excision rates of basal cell carcinoma: analysis of 1972 cases from four U.K. regions</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>710-2</pages><number>3</number><contributors><authors><author>Macbeth, A. E.</author><author>Torley, D.</author><author>Casie Chetty, N.</author><author>Hepburn, N.</author><author>Hussain, K.</author><author>Blasdale, C.</author><author>von der Werth, J.</author><author>Garioch, J. J.</author><author>Levell, N. J.</author></authors></contributors><edition>2009/07/03</edition><language>eng</language><added-date format="utc">1572013556</added-date><ref-type name="Journal Article">17</ref-type><rec-number>258</rec-number><last-updated-date format="utc">1572013556</last-updated-date><accession-num>19575756</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09346.x</electronic-resource-num><volume>161</volume></record></Cite></EndNote>22 and GPs the least at between 30-50%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ud2lzdDwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PElE

VGV4dD5SYXRlIG9mIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFz

IGJ5IEdlbmVyYWwgUHJhY3RpdGlvbmVycyB3aXRoIFNwZWNpYWwgSW50ZXJlc3Q8L0lEVGV4dD48

RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij4yMSwgMjM8L3N0eWxlPjwvRGlz

cGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+PC9wdWIt

ZGF0ZXM+PHllYXI+MjAwOTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5v

bWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtl

eXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48

a2V5d29yZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVh

bDwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVj

aWFsaXphdGlvbjwva2V5d29yZD48a2V5d29yZD5XYWxlczwva2V5d29yZD48L2tleXdvcmRzPjx1

cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1l

ZC8xOTQxNjI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lz

Ym4+PHRpdGxlcz48dGl0bGU+UmF0ZSBvZiBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNl

bGwgY2FyY2lub21hcyBieSBHZW5lcmFsIFByYWN0aXRpb25lcnMgd2l0aCBTcGVjaWFsIEludGVy

ZXN0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRs

ZT48L3RpdGxlcz48cGFnZXM+MTg3PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+VHdpc3QsIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJp

YnV0b3JzPjxlZGl0aW9uPjIwMDkvMDMvMjY8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3Vh

Z2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTM3NzI8L2FkZGVkLWRhdGU+PHJlZi10

eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1OTwv

cmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTM3NzI8L2xh

c3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE5NDE2MjUzPC9hY2Nlc3Npb24tbnVtPjxl

bGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDkuMDkxMjkueDwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4xNjE8L3ZvbHVtZT48L3JlY29yZD48L0Np

dGU+PENpdGU+PEF1dGhvcj5TYWxtb248L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxJRFRleHQ+

U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWlu

aW5nPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+PC9w

dWItZGF0ZXM+PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BbWJ1

bGF0b3J5IFN1cmdpY2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29t

cGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9neTwva2V5d29yZD48a2V5d29yZD5G

YW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3Jk

PkxvZ2lzdGljIE1vZGVsczwva2V5d29yZD48a2V5d29yZD5OZXcgWmVhbGFuZDwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTk4MTgwNjg8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTM2NS0yMTMz

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlN1cmdpY2FsIGV4Y2lzaW9uIG9mIHNraW4gY2FuY2VyOiB0

aGUgaW1wb3J0YW5jZSBvZiB0cmFpbmluZzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIERl

cm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjExNy0yMjwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlNhbG1vbiwgUC48

L2F1dGhvcj48YXV0aG9yPk1vcnRpbWVyLCBOLjwvYXV0aG9yPjxhdXRob3I+UmFkZW1ha2VyLCBN

LjwvYXV0aG9yPjxhdXRob3I+QWRhbXMsIEwuPC9hdXRob3I+PGF1dGhvcj5TdGFud2F5LCBBLjwv

YXV0aG9yPjxhdXRob3I+SGlsbCwgUy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAwOS8xMC8xMDwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk0NjEyMjwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk0NjEyMjwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTk4MTgwNjg8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvai4xMzY1LTIxMzMuMjAwOS4wOTU0OC54PC9lbGVjdHJv

bmljLXJlc291cmNlLW51bT48dm9sdW1lPjE2Mjwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0Vu

ZE5vdGU+AG==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ud2lzdDwvQXV0aG9yPjxZZWFyPjIwMDk8L1llYXI+PElE

VGV4dD5SYXRlIG9mIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFz

IGJ5IEdlbmVyYWwgUHJhY3RpdGlvbmVycyB3aXRoIFNwZWNpYWwgSW50ZXJlc3Q8L0lEVGV4dD48

RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij4yMSwgMjM8L3N0eWxlPjwvRGlz

cGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+PC9wdWIt

ZGF0ZXM+PHllYXI+MjAwOTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5v

bWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtl

eXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48

a2V5d29yZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVh

bDwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVj

aWFsaXphdGlvbjwva2V5d29yZD48a2V5d29yZD5XYWxlczwva2V5d29yZD48L2tleXdvcmRzPjx1

cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1l

ZC8xOTQxNjI1MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIxMzM8L2lz

Ym4+PHRpdGxlcz48dGl0bGU+UmF0ZSBvZiBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNl

bGwgY2FyY2lub21hcyBieSBHZW5lcmFsIFByYWN0aXRpb25lcnMgd2l0aCBTcGVjaWFsIEludGVy

ZXN0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEogRGVybWF0b2w8L3NlY29uZGFyeS10aXRs

ZT48L3RpdGxlcz48cGFnZXM+MTg3PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+VHdpc3QsIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJp

YnV0b3JzPjxlZGl0aW9uPjIwMDkvMDMvMjY8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3Vh

Z2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTM3NzI8L2FkZGVkLWRhdGU+PHJlZi10

eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1OTwv

cmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTM3NzI8L2xh

c3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE5NDE2MjUzPC9hY2Nlc3Npb24tbnVtPjxl

bGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDkuMDkxMjkueDwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4xNjE8L3ZvbHVtZT48L3JlY29yZD48L0Np

dGU+PENpdGU+PEF1dGhvcj5TYWxtb248L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxJRFRleHQ+

U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWlu

aW5nPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+PC9w

dWItZGF0ZXM+PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BbWJ1

bGF0b3J5IFN1cmdpY2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29t

cGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5EZXJtYXRvbG9neTwva2V5d29yZD48a2V5d29yZD5G

YW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3Jk

PkxvZ2lzdGljIE1vZGVsczwva2V5d29yZD48a2V5d29yZD5OZXcgWmVhbGFuZDwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTk4MTgwNjg8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTM2NS0yMTMz

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlN1cmdpY2FsIGV4Y2lzaW9uIG9mIHNraW4gY2FuY2VyOiB0

aGUgaW1wb3J0YW5jZSBvZiB0cmFpbmluZzwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIERl

cm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjExNy0yMjwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlNhbG1vbiwgUC48

L2F1dGhvcj48YXV0aG9yPk1vcnRpbWVyLCBOLjwvYXV0aG9yPjxhdXRob3I+UmFkZW1ha2VyLCBN

LjwvYXV0aG9yPjxhdXRob3I+QWRhbXMsIEwuPC9hdXRob3I+PGF1dGhvcj5TdGFud2F5LCBBLjwv

YXV0aG9yPjxhdXRob3I+SGlsbCwgUy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAwOS8xMC8xMDwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk0NjEyMjwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk0NjEyMjwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTk4MTgwNjg8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvai4xMzY1LTIxMzMuMjAwOS4wOTU0OC54PC9lbGVjdHJv

bmljLXJlc291cmNlLW51bT48dm9sdW1lPjE2Mjwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0Vu

ZE5vdGU+AG==

ADDIN EN.CITE.DATA 21, 23. Specific anatomical locations were noted to be higher risk for incomplete excision by multiple studies, all of which are on the head. Specifically the temple PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE1LCAxNiwgMjQsIDI1PC9z

dHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9k

YXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTU8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdv

cmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sg

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NZWRp

Y2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgU3RhZmYsIEhvc3BpdGFsPC9rZXl3

b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5Ob3J0aGVy

biBJcmVsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxrZXl3b3Jk

PlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2Fs

IENlbGwgQ2FyY2lub21hPC9rZXl3b3JkPjxrZXl3b3JkPlJldmFsaWRhdGlvbjwva2V5d29yZD48

a2V5d29yZD5TdXJnaWNhbCBvdXRjb21lczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxh

dGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yNTQ2ODQ1

NzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNTMyLTIxNTc8L2lzYm4+PHRpdGxl

cz48dGl0bGU+SGlzdG9wYXRob2xvZ2ljYWwgdmFyaWF0aW9uIG9mIGluY29tcGxldGVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hJmFwb3M7cyBhbmQgdGhlIHZhcmlhdGlvbiB3aXRoIHRo

ZSBncmFkZSBvZiBzdXJnZW9uIC0gaW1wbGljYXRpb25zIGZvciByZXZhbGlkYXRpb248L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+RXVyIEogU3VyZyBPbmNvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0

bGVzPjxwYWdlcz4xNjUtODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPlJvYmluc29uLCBBLiBKLjwvYXV0aG9yPjxhdXRob3I+V2Fsc2gsIE0u

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBDLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDE0LzExLzA2PC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDE0MjExPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNjM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDE0MjExPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yNTQ2ODQ1NzwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmVqc28uMjAxNC4xMC4wNTk8L2VsZWN0cm9uaWMt

cmVzb3VyY2UtbnVtPjx2b2x1bWU+NDE8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1

dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4dD5SaXNrIGFuZCBvdXRj

b21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC9JRFRl

eHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5EZWM8L2RhdGU+PC9wdWItZGF0ZXM+

PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29y

ZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3

b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DaGVl

azwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVj

ayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Tm9zZSBO

ZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3Jk

PjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRj

b21lPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFkdWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzIwMjI2NzUwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNi

bj48dGl0bGVzPjx0aXRsZT5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2Vj

dXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVy

cmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3Qg

UmVjb25zdHIgQWVzdGhldCBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIw

NTctNjM8L3BhZ2VzPjxudW1iZXI+MTI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxh

dXRob3I+TWFsaWssIFYuPC9hdXRob3I+PGF1dGhvcj5Hb2gsIEsuIFMuPC9hdXRob3I+PGF1dGhv

cj5MZW9uZywgUy48L2F1dGhvcj48YXV0aG9yPlRhbiwgQS48L2F1dGhvcj48YXV0aG9yPkRvd25l

eSwgRC48L2F1dGhvcj48YXV0aG9yPk8mYXBvcztEb25vdmFuLCBELjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEwLzAzLzExPC9lZGl0aW9uPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTkwNDU3PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51

bWJlcj4yNDU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcx

OTkwNDU3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMDIyNjc1MDwvYWNjZXNz

aW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMC4wMS4w

MTY8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjM8L3ZvbHVtZT48L3JlY29yZD48

L0NpdGU+PENpdGU+PEF1dGhvcj5EaWV1PC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48SURUZXh0

PkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBhIHJldHJvc3Bl

Y3RpdmUgYXVkaXQ8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk1hcjwv

ZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAyPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3

b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwg

ODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+QXVzdHJhbGlhPC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+

PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+

TWVkaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5

d29yZD5OZW9wbGFzbSBSZWN1cnJlbmNlLCBMb2NhbDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJh

dGlvbjwva2V5d29yZD48a2V5d29yZD5SZXByb2R1Y2liaWxpdHkgb2YgUmVzdWx0czwva2V5d29y

ZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBO

ZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IEZhaWx1cmU8L2tleXdvcmQ+PC9r

ZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmlo

Lmdvdi9wdWJtZWQvMTIwNzE0NTY8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQ0

NS0xNDMzPC9pc2JuPjx0aXRsZXM+PHRpdGxlPkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzOiBhIHJldHJvc3BlY3RpdmUgYXVkaXQ8L3RpdGxlPjxzZWNvbmRhcnkt

dGl0bGU+QU5aIEogU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMTktMjE8

L3BhZ2VzPjxudW1iZXI+MzwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5E

aWV1LCBULjwvYXV0aG9yPjxhdXRob3I+TWFjbGVvZCwgQS4gTS48L2F1dGhvcj48L2F1dGhvcnM+

PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0

PSJ1dGMiPjE1NzIwMTI4OTU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0

aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0OTwvcmVjLW51bWJlcj48bGFzdC11cGRh

dGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI4OTU8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nl

c3Npb24tbnVtPjEyMDcxNDU2PC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+NzI8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5HcmlmZml0aHM8L0F1dGhvcj48WWVhcj4yMDA3PC9Z

ZWFyPjxJRFRleHQ+QmFzYWwgY2VsbCBjYXJjaW5vbWEgaGlzdG9sb2dpY2FsIGNsZWFyYW5jZSBt

YXJnaW5zOiBhbiBhbmFseXNpcyBvZiAxNTM5IGNvbnZlbnRpb25hbGx5IGV4Y2lzZWQgdHVtb3Vy

cy4gV2lkZXIgc3RpbGwgYW5kIGRlZXBlcj88L0lEVGV4dD48cmVjb3JkPjxrZXl3b3Jkcz48a2V5

d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVj

ayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPlNr

aW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRjb21lPC9rZXl3b3Jk

Pjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxt

Lm5paC5nb3YvcHVibWVkLzE3MTI2MjY1PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2Ju

PjE3NDgtNjgxNTwvaXNibj48dGl0bGVzPjx0aXRsZT5CYXNhbCBjZWxsIGNhcmNpbm9tYSBoaXN0

b2xvZ2ljYWwgY2xlYXJhbmNlIG1hcmdpbnM6IGFuIGFuYWx5c2lzIG9mIDE1MzkgY29udmVudGlv

bmFsbHkgZXhjaXNlZCB0dW1vdXJzLiBXaWRlciBzdGlsbCBhbmQgZGVlcGVyPzwvdGl0bGU+PHNl

Y29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25kYXJ5LXRp

dGxlPjwvdGl0bGVzPjxwYWdlcz40MS03PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJp

YnV0b3JzPjxhdXRob3JzPjxhdXRob3I+R3JpZmZpdGhzLCBSLiBXLjwvYXV0aG9yPjxhdXRob3I+

U3V2YXJuYSwgUy4gSy48L2F1dGhvcj48YXV0aG9yPlN0b25lLCBKLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA2LzA5LzAxPC9lZGl0aW9uPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTk5NjM4PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+

PHllYXI+MjAwNzwveWVhcj48L2RhdGVzPjxyZWMtbnVtYmVyPjI0NjwvcmVjLW51bWJlcj48bGFz

dC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTk2Mzg8L2xhc3QtdXBkYXRlZC1kYXRl

PjxhY2Nlc3Npb24tbnVtPjE3MTI2MjY1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291

cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDA2LjA2LjAwOTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+PHZvbHVtZT42MDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE1LCAxNiwgMjQsIDI1PC9z

dHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9k

YXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTU8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdv

cmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sg

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NZWRp

Y2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgU3RhZmYsIEhvc3BpdGFsPC9rZXl3

b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5Ob3J0aGVy

biBJcmVsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxrZXl3b3Jk

PlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2Fs

IENlbGwgQ2FyY2lub21hPC9rZXl3b3JkPjxrZXl3b3JkPlJldmFsaWRhdGlvbjwva2V5d29yZD48

a2V5d29yZD5TdXJnaWNhbCBvdXRjb21lczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxh

dGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yNTQ2ODQ1

NzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNTMyLTIxNTc8L2lzYm4+PHRpdGxl

cz48dGl0bGU+SGlzdG9wYXRob2xvZ2ljYWwgdmFyaWF0aW9uIG9mIGluY29tcGxldGVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hJmFwb3M7cyBhbmQgdGhlIHZhcmlhdGlvbiB3aXRoIHRo

ZSBncmFkZSBvZiBzdXJnZW9uIC0gaW1wbGljYXRpb25zIGZvciByZXZhbGlkYXRpb248L3RpdGxl

PjxzZWNvbmRhcnktdGl0bGU+RXVyIEogU3VyZyBPbmNvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0

bGVzPjxwYWdlcz4xNjUtODwvcGFnZXM+PG51bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPlJvYmluc29uLCBBLiBKLjwvYXV0aG9yPjxhdXRob3I+V2Fsc2gsIE0u

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBDLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDE0LzExLzA2PC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDE0MjExPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNjM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDE0MjExPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yNTQ2ODQ1NzwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmVqc28uMjAxNC4xMC4wNTk8L2VsZWN0cm9uaWMt

cmVzb3VyY2UtbnVtPjx2b2x1bWU+NDE8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PENpdGU+PEF1

dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4dD5SaXNrIGFuZCBvdXRj

b21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC9JRFRl

eHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5EZWM8L2RhdGU+PC9wdWItZGF0ZXM+

PHllYXI+MjAxMDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29y

ZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3

b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DaGVl

azwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVj

ayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Tm9zZSBO

ZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3Jk

PjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRj

b21lPC9rZXl3b3JkPjxrZXl3b3JkPllvdW5nIEFkdWx0PC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzIwMjI2NzUwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE4NzgtMDUzOTwvaXNi

bj48dGl0bGVzPjx0aXRsZT5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2Vj

dXRpdmVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVy

cmFsIHBsYXN0aWMgc3VyZ2VyeSB1bml0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3Qg

UmVjb25zdHIgQWVzdGhldCBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIw

NTctNjM8L3BhZ2VzPjxudW1iZXI+MTI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxh

dXRob3I+TWFsaWssIFYuPC9hdXRob3I+PGF1dGhvcj5Hb2gsIEsuIFMuPC9hdXRob3I+PGF1dGhv

cj5MZW9uZywgUy48L2F1dGhvcj48YXV0aG9yPlRhbiwgQS48L2F1dGhvcj48YXV0aG9yPkRvd25l

eSwgRC48L2F1dGhvcj48YXV0aG9yPk8mYXBvcztEb25vdmFuLCBELjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEwLzAzLzExPC9lZGl0aW9uPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTkwNDU3PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51

bWJlcj4yNDU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcx

OTkwNDU3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMDIyNjc1MDwvYWNjZXNz

aW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMC4wMS4w

MTY8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjM8L3ZvbHVtZT48L3JlY29yZD48

L0NpdGU+PENpdGU+PEF1dGhvcj5EaWV1PC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48SURUZXh0

PkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBhIHJldHJvc3Bl

Y3RpdmUgYXVkaXQ8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk1hcjwv

ZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAyPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3

b3JkPkFkdWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwg

ODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+QXVzdHJhbGlhPC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+

PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+

TWVkaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5

d29yZD5OZW9wbGFzbSBSZWN1cnJlbmNlLCBMb2NhbDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJh

dGlvbjwva2V5d29yZD48a2V5d29yZD5SZXByb2R1Y2liaWxpdHkgb2YgUmVzdWx0czwva2V5d29y

ZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBO

ZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IEZhaWx1cmU8L2tleXdvcmQ+PC9r

ZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmlo

Lmdvdi9wdWJtZWQvMTIwNzE0NTY8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQ0

NS0xNDMzPC9pc2JuPjx0aXRsZXM+PHRpdGxlPkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzOiBhIHJldHJvc3BlY3RpdmUgYXVkaXQ8L3RpdGxlPjxzZWNvbmRhcnkt

dGl0bGU+QU5aIEogU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMTktMjE8

L3BhZ2VzPjxudW1iZXI+MzwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5E

aWV1LCBULjwvYXV0aG9yPjxhdXRob3I+TWFjbGVvZCwgQS4gTS48L2F1dGhvcj48L2F1dGhvcnM+

PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0

PSJ1dGMiPjE1NzIwMTI4OTU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0

aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0OTwvcmVjLW51bWJlcj48bGFzdC11cGRh

dGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI4OTU8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nl

c3Npb24tbnVtPjEyMDcxNDU2PC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+NzI8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5HcmlmZml0aHM8L0F1dGhvcj48WWVhcj4yMDA3PC9Z

ZWFyPjxJRFRleHQ+QmFzYWwgY2VsbCBjYXJjaW5vbWEgaGlzdG9sb2dpY2FsIGNsZWFyYW5jZSBt

YXJnaW5zOiBhbiBhbmFseXNpcyBvZiAxNTM5IGNvbnZlbnRpb25hbGx5IGV4Y2lzZWQgdHVtb3Vy

cy4gV2lkZXIgc3RpbGwgYW5kIGRlZXBlcj88L0lEVGV4dD48cmVjb3JkPjxrZXl3b3Jkcz48a2V5

d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVj

ayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPlNr

aW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlRyZWF0bWVudCBPdXRjb21lPC9rZXl3b3Jk

Pjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxt

Lm5paC5nb3YvcHVibWVkLzE3MTI2MjY1PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2Ju

PjE3NDgtNjgxNTwvaXNibj48dGl0bGVzPjx0aXRsZT5CYXNhbCBjZWxsIGNhcmNpbm9tYSBoaXN0

b2xvZ2ljYWwgY2xlYXJhbmNlIG1hcmdpbnM6IGFuIGFuYWx5c2lzIG9mIDE1MzkgY29udmVudGlv

bmFsbHkgZXhjaXNlZCB0dW1vdXJzLiBXaWRlciBzdGlsbCBhbmQgZGVlcGVyPzwvdGl0bGU+PHNl

Y29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25kYXJ5LXRp

dGxlPjwvdGl0bGVzPjxwYWdlcz40MS03PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJp

YnV0b3JzPjxhdXRob3JzPjxhdXRob3I+R3JpZmZpdGhzLCBSLiBXLjwvYXV0aG9yPjxhdXRob3I+

U3V2YXJuYSwgUy4gSy48L2F1dGhvcj48YXV0aG9yPlN0b25lLCBKLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA2LzA5LzAxPC9lZGl0aW9uPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTk5NjM4PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+

PHllYXI+MjAwNzwveWVhcj48L2RhdGVzPjxyZWMtbnVtYmVyPjI0NjwvcmVjLW51bWJlcj48bGFz

dC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTk2Mzg8L2xhc3QtdXBkYXRlZC1kYXRl

PjxhY2Nlc3Npb24tbnVtPjE3MTI2MjY1PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291

cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDA2LjA2LjAwOTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1u

dW0+PHZvbHVtZT42MDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 15, 16, 24, 25, medial canthusPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE1LCAyNCwgMjY8L3N0eWxl

PjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxNTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5D

YXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwg

QXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWVkaWNhbCBTdGFmZiwgSG9zcGl0YWw8L2tleXdvcmQ+

PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk5vcnRoZXJuIEly

ZWxhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+UmV0

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3

b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+QmFzYWwgQ2Vs

bCBDYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+UmV2YWxpZGF0aW9uPC9rZXl3b3JkPjxrZXl3

b3JkPlN1cmdpY2FsIG91dGNvbWVzPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQt

dXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzI1NDY4NDU3PC91

cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE1MzItMjE1NzwvaXNibj48dGl0bGVzPjx0

aXRsZT5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lzZWQg

YmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhlIGdy

YWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvdGl0bGU+PHNl

Y29uZGFyeS10aXRsZT5FdXIgSiBTdXJnIE9uY29sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+

PHBhZ2VzPjE2NS04PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+Um9iaW5zb24sIEEuIEouPC9hdXRob3I+PGF1dGhvcj5XYWxzaCwgTS48L2F1

dGhvcj48YXV0aG9yPkhpbGwsIEMuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxl

ZGl0aW9uPjIwMTQvMTEvMDY8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVk

LWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTQyMTE8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9

IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI2MzwvcmVjLW51bWJl

cj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTQyMTE8L2xhc3QtdXBkYXRl

ZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjI1NDY4NDU3PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmlj

LXJlc291cmNlLW51bT4xMC4xMDE2L2ouZWpzby4yMDE0LjEwLjA1OTwvZWxlY3Ryb25pYy1yZXNv

dXJjZS1udW0+PHZvbHVtZT40MTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9y

Pk1hbGlrPC9BdXRob3I+PFllYXI+MjAxMDwvWWVhcj48SURUZXh0PlJpc2sgYW5kIG91dGNvbWUg

YW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5v

bWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L0lEVGV4dD48

cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkRlYzwvZGF0ZT48L3B1Yi1kYXRlcz48eWVh

cj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxr

ZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+

PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoZWVrPC9r

ZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwv

a2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Ob3NlIE5lb3Bs

YXNtczwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtl

eXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IE91dGNvbWU8

L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48

cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjAy

MjY3NTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0

aXRsZXM+PHRpdGxlPlJpc2sgYW5kIG91dGNvbWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2

ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwg

cGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNv

bnN0ciBBZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjA1Ny02

MzwvcGFnZXM+PG51bWJlcj4xMjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5NYWxpaywgVi48L2F1dGhvcj48YXV0aG9yPkdvaCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkxl

b25nLCBTLjwvYXV0aG9yPjxhdXRob3I+VGFuLCBBLjwvYXV0aG9yPjxhdXRob3I+RG93bmV5LCBE

LjwvYXV0aG9yPjxhdXRob3I+TyZhcG9zO0Rvbm92YW4sIEQuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTAvMDMvMTE8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0NTc8L2FkZGVkLWRhdGU+

PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVy

PjI0NTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0

NTc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjIwMjI2NzUwPC9hY2Nlc3Npb24t

bnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDEwLjAxLjAxNjwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42Mzwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPldpbHNvbjwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5T

dXJnaWNhbCBtYW5hZ2VtZW50IG9mIGluY29tcGxldGVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBvZiB0aGUgaGVhZCBhbmQgbmVjazwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+QXVnPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3

b3JkPkNvaG9ydCBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxh

c21zPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwg

UmVzaWR1YWw8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sgRmFjdG9yczwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8xNTIyNTk0ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4wMjY2LTQzNTY8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgbWFuYWdlbWVudCBv

ZiBpbmNvbXBsZXRlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNhcmNpbm9tYXMgb2YgdGhlIGhlYWQg

YW5kIG5lY2s8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBPcmFsIE1heGlsbG9mYWMgU3Vy

Zzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4zMTEtNDwvcGFnZXM+PG51bWJlcj40

PC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPldpbHNvbiwgQS4gVy48L2F1

dGhvcj48YXV0aG9yPkhvd3NhbSwgRy48L2F1dGhvcj48YXV0aG9yPlNhbnRoYW5hbSwgVi48L2F1

dGhvcj48YXV0aG9yPk1hY3BoZXJzb24sIEQuPC9hdXRob3I+PGF1dGhvcj5HcmFudCwgSi48L2F1

dGhvcj48YXV0aG9yPlByYXR0LCBDLiBBLjwvYXV0aG9yPjxhdXRob3I+VG93bmVuZCwgSi4gVi48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTMyNTQ8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1NDwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTMyNTQ8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1MjI1OTQ4PC9hY2Nlc3Npb24tbnVtPjxlbGVj

dHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpvbXMuMjAwNC4wMi4wMzA8L2VsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDI8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmRO

b3RlPn==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE1LCAyNCwgMjY8L3N0eWxl

PjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KYW48L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxNTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5D

YXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQgTmVjayBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwg

QXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TWVkaWNhbCBTdGFmZiwgSG9zcGl0YWw8L2tleXdvcmQ+

PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk5vcnRoZXJuIEly

ZWxhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+UmV0

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3

b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+QmFzYWwgQ2Vs

bCBDYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+UmV2YWxpZGF0aW9uPC9rZXl3b3JkPjxrZXl3

b3JkPlN1cmdpY2FsIG91dGNvbWVzPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQt

dXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzI1NDY4NDU3PC91

cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE1MzItMjE1NzwvaXNibj48dGl0bGVzPjx0

aXRsZT5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lzZWQg

YmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhlIGdy

YWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvdGl0bGU+PHNl

Y29uZGFyeS10aXRsZT5FdXIgSiBTdXJnIE9uY29sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+

PHBhZ2VzPjE2NS04PC9wYWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+Um9iaW5zb24sIEEuIEouPC9hdXRob3I+PGF1dGhvcj5XYWxzaCwgTS48L2F1

dGhvcj48YXV0aG9yPkhpbGwsIEMuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxl

ZGl0aW9uPjIwMTQvMTEvMDY8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVk

LWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTQyMTE8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9

IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI2MzwvcmVjLW51bWJl

cj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTQyMTE8L2xhc3QtdXBkYXRl

ZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjI1NDY4NDU3PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmlj

LXJlc291cmNlLW51bT4xMC4xMDE2L2ouZWpzby4yMDE0LjEwLjA1OTwvZWxlY3Ryb25pYy1yZXNv

dXJjZS1udW0+PHZvbHVtZT40MTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9y

Pk1hbGlrPC9BdXRob3I+PFllYXI+MjAxMDwvWWVhcj48SURUZXh0PlJpc2sgYW5kIG91dGNvbWUg

YW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5v

bWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L0lEVGV4dD48

cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkRlYzwvZGF0ZT48L3B1Yi1kYXRlcz48eWVh

cj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3JkPjxr

ZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+

PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoZWVrPC9r

ZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwv

a2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Ob3NlIE5lb3Bs

YXNtczwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtl

eXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IE91dGNvbWU8

L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48

cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjAy

MjY3NTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0

aXRsZXM+PHRpdGxlPlJpc2sgYW5kIG91dGNvbWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2

ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwg

cGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNv

bnN0ciBBZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjA1Ny02

MzwvcGFnZXM+PG51bWJlcj4xMjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5NYWxpaywgVi48L2F1dGhvcj48YXV0aG9yPkdvaCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkxl

b25nLCBTLjwvYXV0aG9yPjxhdXRob3I+VGFuLCBBLjwvYXV0aG9yPjxhdXRob3I+RG93bmV5LCBE

LjwvYXV0aG9yPjxhdXRob3I+TyZhcG9zO0Rvbm92YW4sIEQuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTAvMDMvMTE8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwv

bGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0NTc8L2FkZGVkLWRhdGU+

PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVy

PjI0NTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0

NTc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjIwMjI2NzUwPC9hY2Nlc3Npb24t

bnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDEwLjAxLjAxNjwv

ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42Mzwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPldpbHNvbjwvQXV0aG9yPjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5T

dXJnaWNhbCBtYW5hZ2VtZW50IG9mIGluY29tcGxldGVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2Fy

Y2lub21hcyBvZiB0aGUgaGVhZCBhbmQgbmVjazwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+QXVnPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3

b3JkPkNvaG9ydCBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxh

c21zPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwg

UmVzaWR1YWw8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sgRmFjdG9yczwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8xNTIyNTk0ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4wMjY2LTQzNTY8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgbWFuYWdlbWVudCBv

ZiBpbmNvbXBsZXRlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNhcmNpbm9tYXMgb2YgdGhlIGhlYWQg

YW5kIG5lY2s8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+QnIgSiBPcmFsIE1heGlsbG9mYWMgU3Vy

Zzwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4zMTEtNDwvcGFnZXM+PG51bWJlcj40

PC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPldpbHNvbiwgQS4gVy48L2F1

dGhvcj48YXV0aG9yPkhvd3NhbSwgRy48L2F1dGhvcj48YXV0aG9yPlNhbnRoYW5hbSwgVi48L2F1

dGhvcj48YXV0aG9yPk1hY3BoZXJzb24sIEQuPC9hdXRob3I+PGF1dGhvcj5HcmFudCwgSi48L2F1

dGhvcj48YXV0aG9yPlByYXR0LCBDLiBBLjwvYXV0aG9yPjxhdXRob3I+VG93bmVuZCwgSi4gVi48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+

PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTMyNTQ8L2FkZGVkLWRhdGU+PHJlZi10eXBl

IG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1NDwvcmVj

LW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTMyNTQ8L2xhc3Qt

dXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1MjI1OTQ4PC9hY2Nlc3Npb24tbnVtPjxlbGVj

dHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpvbXMuMjAwNC4wMi4wMzA8L2VsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDI8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9FbmRO

b3RlPn==

ADDIN EN.CITE.DATA 15, 24, 26, nosePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDI1LTI4PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0

ZXM+PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48

a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48

a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJh

c2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3

b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRs

ZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3Vu

ZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRw

czovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11

cmxzPjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQg

b3V0Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxs

IGNhcmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwv

dGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9u

dW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxh

dXRob3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhv

cj5UYW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFw

b3M7RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+

MjAxMC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5h

bCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0

LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+

PGFjY2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3Vy

Y2UtbnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RGlldTwv

QXV0aG9yPjxZZWFyPjIwMDI8L1llYXI+PElEVGV4dD5JbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJh

c2FsIGNlbGwgY2FyY2lub21hczogYSByZXRyb3NwZWN0aXZlIGF1ZGl0PC9JRFRleHQ+PHJlY29y

ZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5NYXI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAw

MjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29y

ZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3

b3JkPkF1c3RyYWxpYTwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tl

eXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48

a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtl

eXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5jZSwg

TG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+UmVw

cm9kdWNpYmlsaXR5IG9mIFJlc3VsdHM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlRyZWF0bWVudCBGYWlsdXJlPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJs

cz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzEyMDcxNDU2PC91cmw+

PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE0NDUtMTQzMzwvaXNibj48dGl0bGVzPjx0aXRs

ZT5JbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczogYSByZXRyb3Nw

ZWN0aXZlIGF1ZGl0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFOWiBKIFN1cmc8L3NlY29uZGFy

eS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjE5LTIxPC9wYWdlcz48bnVtYmVyPjM8L251bWJlcj48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+RGlldSwgVC48L2F1dGhvcj48YXV0aG9yPk1h

Y2xlb2QsIEEuIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyODk1PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51

bWJlcj4yNDk8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcy

MDEyODk1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMjA3MTQ1NjwvYWNjZXNz

aW9uLW51bT48dm9sdW1lPjcyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+

VGFsYm90PC9BdXRob3I+PFllYXI+MjAwNDwvWWVhcj48SURUZXh0PkluY29tcGxldGUgcHJpbWFy

eSBleGNpc2lvbiBvZiBjdXRhbmVvdXMgYmFzYWwgYW5kIHNxdWFtb3VzIGNlbGwgY2FyY2lub21h

cyBpbiB0aGUgQmF5IG9mIFBsZW50eTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+QXByPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENl

bGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkVkdWNhdGlv

bmFsIFN0YXR1czwva2V5d29yZD48a2V5d29yZD5GYW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtl

eXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgU3VyZ2VyeTwva2V5d29yZD48

a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8

L2tleXdvcmQ+PGtleXdvcmQ+SW5jaWRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdv

cmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lk

dWFsPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJv

c3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48

a2V5d29yZD5Ta2luPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwv

a2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5p

aC5nb3YvcHVibWVkLzE1MTA3ODcwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEx

NzUtODcxNjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24g

b2YgY3V0YW5lb3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJh

eSBvZiBQbGVudHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+TiBaIE1lZCBKPC9zZWNvbmRhcnkt

dGl0bGU+PC90aXRsZXM+PHBhZ2VzPlU4NDg8L3BhZ2VzPjxudW1iZXI+MTE5MjwvbnVtYmVyPjxj

b250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5UYWxib3QsIFMuPC9hdXRob3I+PGF1dGhvcj5I

aXRjaGNvY2ssIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIw

MDQvMDQvMjM8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0NDwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjE1MTA3ODcwPC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+MTE3PC92b2x1bWU+

PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNreTwvQXV0aG9y

PjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhj

aXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzPC9JRFRleHQ+PHJlY29yZD48a2V5d29yZHM+

PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tl

eXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+

Q3Jvc3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmFjaWFsIE5lb3BsYXNt

czwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+

PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+Umlz

ayBGYWN0b3JzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzE1MDQwNDc3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDEt

NTU1NTwvaXNibj48dGl0bGVzPjx0aXRsZT5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhj

aXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFj

dGEgRGVybSBWZW5lcmVvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40NC03PC9w

YWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Qm9n

ZGFub3YtQmVyZXpvdnNreSwgQS48L2F1dGhvcj48YXV0aG9yPkNvaGVuLCBBLiBELjwvYXV0aG9y

PjxhdXRob3I+R2xlc2luZ2VyLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FnbmFubywgRS48L2F1dGhv

cj48YXV0aG9yPktyaWVnZXIsIFkuPC9hdXRob3I+PGF1dGhvcj5Sb3NlbmJlcmcsIEwuPC9hdXRo

b3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRl

ZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEzMTA3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1l

PSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNDwveWVhcj48

L2RhdGVzPjxyZWMtbnVtYmVyPjI1MjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzIwMTMxMDc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1

MDQwNDc3PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDgwLzAw

MDE1NTUwMzEwMDIwNTg1PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjg0PC92b2x1

bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+V2lsc29uPC9BdXRob3I+PFllYXI+MjAw

NDwvWWVhcj48SURUZXh0PlN1cmdpY2FsIG1hbmFnZW1lbnQgb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIG9mIHRoZSBoZWFkIGFuZCBuZWNrPC9JRFRleHQ+PHJl

Y29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5BdWc8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+

MjAwNDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENl

bGw8L2tleXdvcmQ+PGtleXdvcmQ+Q29ob3J0IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SGVh

ZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxr

ZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJhdGlvbjwv

a2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+

UmlzayBGYWN0b3JzPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE1MjI1OTQ4PC91cmw+PC9yZWxh

dGVkLXVybHM+PC91cmxzPjxpc2JuPjAyNjYtNDM1NjwvaXNibj48dGl0bGVzPjx0aXRsZT5TdXJn

aWNhbCBtYW5hZ2VtZW50IG9mIGluY29tcGxldGVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2FyY2lu

b21hcyBvZiB0aGUgaGVhZCBhbmQgbmVjazwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIE9y

YWwgTWF4aWxsb2ZhYyBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjMxMS00

PC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+

V2lsc29uLCBBLiBXLjwvYXV0aG9yPjxhdXRob3I+SG93c2FtLCBHLjwvYXV0aG9yPjxhdXRob3I+

U2FudGhhbmFtLCBWLjwvYXV0aG9yPjxhdXRob3I+TWFjcGhlcnNvbiwgRC48L2F1dGhvcj48YXV0

aG9yPkdyYW50LCBKLjwvYXV0aG9yPjxhdXRob3I+UHJhdHQsIEMuIEEuPC9hdXRob3I+PGF1dGhv

cj5Ub3duZW5kLCBKLiBWLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3Vh

Z2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMzI1NDwvYWRk

ZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJl

Yy1udW1iZXI+MjU0PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+

MTU3MjAxMzI1NDwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTUyMjU5NDg8L2Fj

Y2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYvai5iam9tcy4yMDA0

LjAyLjAzMDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40Mjwvdm9sdW1lPjwvcmVj

b3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDI1LTI4PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0

ZXM+PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48

a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48

a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJh

c2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3

b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRs

ZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwv

a2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3Vu

ZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRw

czovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11

cmxzPjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQg

b3V0Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxs

IGNhcmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwv

dGl0bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vj

b25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9u

dW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxh

dXRob3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhv

cj5UYW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFw

b3M7RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+

MjAxMC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5h

bCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0

LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+

PGFjY2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3Vy

Y2UtbnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+RGlldTwv

QXV0aG9yPjxZZWFyPjIwMDI8L1llYXI+PElEVGV4dD5JbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJh

c2FsIGNlbGwgY2FyY2lub21hczogYSByZXRyb3NwZWN0aXZlIGF1ZGl0PC9JRFRleHQ+PHJlY29y

ZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5NYXI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAw

MjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29y

ZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3

b3JkPkF1c3RyYWxpYTwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tl

eXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48

a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtl

eXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5jZSwg

TG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UmVvcGVyYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+UmVw

cm9kdWNpYmlsaXR5IG9mIFJlc3VsdHM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlRyZWF0bWVudCBGYWlsdXJlPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJs

cz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzEyMDcxNDU2PC91cmw+

PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjE0NDUtMTQzMzwvaXNibj48dGl0bGVzPjx0aXRs

ZT5JbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczogYSByZXRyb3Nw

ZWN0aXZlIGF1ZGl0PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFOWiBKIFN1cmc8L3NlY29uZGFy

eS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjE5LTIxPC9wYWdlcz48bnVtYmVyPjM8L251bWJlcj48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+RGlldSwgVC48L2F1dGhvcj48YXV0aG9yPk1h

Y2xlb2QsIEEuIE0uPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5l

bmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyODk1PC9hZGRlZC1k

YXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51

bWJlcj4yNDk8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcy

MDEyODk1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMjA3MTQ1NjwvYWNjZXNz

aW9uLW51bT48dm9sdW1lPjcyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+

VGFsYm90PC9BdXRob3I+PFllYXI+MjAwNDwvWWVhcj48SURUZXh0PkluY29tcGxldGUgcHJpbWFy

eSBleGNpc2lvbiBvZiBjdXRhbmVvdXMgYmFzYWwgYW5kIHNxdWFtb3VzIGNlbGwgY2FyY2lub21h

cyBpbiB0aGUgQmF5IG9mIFBsZW50eTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+QXByPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENl

bGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkVkdWNhdGlv

bmFsIFN0YXR1czwva2V5d29yZD48a2V5d29yZD5GYW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtl

eXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgU3VyZ2VyeTwva2V5d29yZD48

a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8

L2tleXdvcmQ+PGtleXdvcmQ+SW5jaWRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdv

cmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lk

dWFsPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJv

c3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48

a2V5d29yZD5Ta2luPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwv

a2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5p

aC5nb3YvcHVibWVkLzE1MTA3ODcwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEx

NzUtODcxNjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24g

b2YgY3V0YW5lb3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJh

eSBvZiBQbGVudHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+TiBaIE1lZCBKPC9zZWNvbmRhcnkt

dGl0bGU+PC90aXRsZXM+PHBhZ2VzPlU4NDg8L3BhZ2VzPjxudW1iZXI+MTE5MjwvbnVtYmVyPjxj

b250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5UYWxib3QsIFMuPC9hdXRob3I+PGF1dGhvcj5I

aXRjaGNvY2ssIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIw

MDQvMDQvMjM8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0NDwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjE1MTA3ODcwPC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+MTE3PC92b2x1bWU+

PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNreTwvQXV0aG9y

PjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhj

aXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzPC9JRFRleHQ+PHJlY29yZD48a2V5d29yZHM+

PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tl

eXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+

Q3Jvc3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmFjaWFsIE5lb3BsYXNt

czwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3

b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+

PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+Umlz

ayBGYWN0b3JzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzE1MDQwNDc3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDEt

NTU1NTwvaXNibj48dGl0bGVzPjx0aXRsZT5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhj

aXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFj

dGEgRGVybSBWZW5lcmVvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40NC03PC9w

YWdlcz48bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Qm9n

ZGFub3YtQmVyZXpvdnNreSwgQS48L2F1dGhvcj48YXV0aG9yPkNvaGVuLCBBLiBELjwvYXV0aG9y

PjxhdXRob3I+R2xlc2luZ2VyLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FnbmFubywgRS48L2F1dGhv

cj48YXV0aG9yPktyaWVnZXIsIFkuPC9hdXRob3I+PGF1dGhvcj5Sb3NlbmJlcmcsIEwuPC9hdXRo

b3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRl

ZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEzMTA3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1l

PSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNDwveWVhcj48

L2RhdGVzPjxyZWMtbnVtYmVyPjI1MjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzIwMTMxMDc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1

MDQwNDc3PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDgwLzAw

MDE1NTUwMzEwMDIwNTg1PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjg0PC92b2x1

bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+V2lsc29uPC9BdXRob3I+PFllYXI+MjAw

NDwvWWVhcj48SURUZXh0PlN1cmdpY2FsIG1hbmFnZW1lbnQgb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIG9mIHRoZSBoZWFkIGFuZCBuZWNrPC9JRFRleHQ+PHJl

Y29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5BdWc8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+

MjAwNDwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENl

bGw8L2tleXdvcmQ+PGtleXdvcmQ+Q29ob3J0IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+SGVh

ZCBhbmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxr

ZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJhdGlvbjwv

a2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+

UmlzayBGYWN0b3JzPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJs

Pmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE1MjI1OTQ4PC91cmw+PC9yZWxh

dGVkLXVybHM+PC91cmxzPjxpc2JuPjAyNjYtNDM1NjwvaXNibj48dGl0bGVzPjx0aXRsZT5TdXJn

aWNhbCBtYW5hZ2VtZW50IG9mIGluY29tcGxldGVseSBleGNpc2VkIGJhc2FsIGNlbGwgY2FyY2lu

b21hcyBvZiB0aGUgaGVhZCBhbmQgbmVjazwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIE9y

YWwgTWF4aWxsb2ZhYyBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjMxMS00

PC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+

V2lsc29uLCBBLiBXLjwvYXV0aG9yPjxhdXRob3I+SG93c2FtLCBHLjwvYXV0aG9yPjxhdXRob3I+

U2FudGhhbmFtLCBWLjwvYXV0aG9yPjxhdXRob3I+TWFjcGhlcnNvbiwgRC48L2F1dGhvcj48YXV0

aG9yPkdyYW50LCBKLjwvYXV0aG9yPjxhdXRob3I+UHJhdHQsIEMuIEEuPC9hdXRob3I+PGF1dGhv

cj5Ub3duZW5kLCBKLiBWLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3Vh

Z2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMzI1NDwvYWRk

ZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJl

Yy1udW1iZXI+MjU0PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+

MTU3MjAxMzI1NDwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTUyMjU5NDg8L2Fj

Y2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYvai5iam9tcy4yMDA0

LjAyLjAzMDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40Mjwvdm9sdW1lPjwvcmVj

b3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 15, 25-28 and earsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EaWV1PC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48SURU

ZXh0PkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBhIHJldHJv

c3BlY3RpdmUgYXVkaXQ8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2Ny

aXB0Ij4yNSwgMjcsIDI4PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+TWFyPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29y

ZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5BdXN0cmFsaWE8

L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3Jk

PkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwv

a2V5d29yZD48a2V5d29yZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVuY2UsIExvY2FsPC9rZXl3b3Jk

PjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlJlcHJvZHVjaWJpbGl0eSBv

ZiBSZXN1bHRzPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29y

ZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgRmFp

bHVyZTwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xMjA3MTQ1NjwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xNDQ1LTE0MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+SW5jb21wbGV0ZSBl

eGNpc2lvbiBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYXM6IGEgcmV0cm9zcGVjdGl2ZSBhdWRpdDwv

dGl0bGU+PHNlY29uZGFyeS10aXRsZT5BTlogSiBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRs

ZXM+PHBhZ2VzPjIxOS0yMTwvcGFnZXM+PG51bWJlcj4zPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPkRpZXUsIFQuPC9hdXRob3I+PGF1dGhvcj5NYWNsZW9kLCBBLiBNLjwv

YXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48

YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjg5NTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUg

bmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ5PC9yZWMt

bnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjg5NTwvbGFzdC11

cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTIwNzE0NTY8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT43Mjwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlRhbGJvdDwvQXV0aG9y

PjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24gb2Yg

Y3V0YW5lb3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJheSBv

ZiBQbGVudHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkFwcjwvZGF0

ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDA0PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3Jk

PkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgQmFzb3NxdWFtb3VzPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9t

YSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FZHVjYXRpb25hbCBTdGF0dXM8L2tl

eXdvcmQ+PGtleXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwv

a2V5d29yZD48a2V5d29yZD5HZW5lcmFsIFN1cmdlcnk8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBh

bmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPkluY2lkZW5jZTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1p

ZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48

a2V5d29yZD5OZXcgWmVhbGFuZDwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRp

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2V4IEZhY3RvcnM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbjwv

a2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxz

PjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8x

NTEwNzg3MDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMTc1LTg3MTY8L2lzYm4+

PHRpdGxlcz48dGl0bGU+SW5jb21wbGV0ZSBwcmltYXJ5IGV4Y2lzaW9uIG9mIGN1dGFuZW91cyBi

YXNhbCBhbmQgc3F1YW1vdXMgY2VsbCBjYXJjaW5vbWFzIGluIHRoZSBCYXkgb2YgUGxlbnR5PC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPk4gWiBNZWQgSjwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwYWdlcz5VODQ4PC9wYWdlcz48bnVtYmVyPjExOTI8L251bWJlcj48Y29udHJpYnV0b3JzPjxh

dXRob3JzPjxhdXRob3I+VGFsYm90LCBTLjwvYXV0aG9yPjxhdXRob3I+SGl0Y2hjb2NrLCBCLjwv

YXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA0LzA0LzIzPC9lZGl0

aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcx

OTQ2MzI0PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9y

ZWYtdHlwZT48cmVjLW51bWJlcj4yNDQ8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZv

cm1hdD0idXRjIj4xNTcxOTQ2MzI0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4x

NTEwNzg3MDwvYWNjZXNzaW9uLW51bT48dm9sdW1lPjExNzwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPkJvZ2Rhbm92LUJlcmV6b3Zza3k8L0F1dGhvcj48WWVhcj4yMDA0PC9Z

ZWFyPjxJRFRleHQ+UmlzayBmYWN0b3JzIGZvciBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2Fs

IGNlbGwgY2FyY2lub21hczwvSURUZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8

L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmNpbm9tYSwgQmFzb3NxdWFtb3VzPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25h

bCBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZhY2lhbCBOZW9wbGFzbXM8L2tleXdvcmQ+PGtl

eXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5N

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3Bs

YXNtIFJlY3VycmVuY2UsIExvY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sgRmFjdG9yczwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xNTA0

MDQ3NzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4wMDAxLTU1NTU8L2lzYm4+PHRp

dGxlcz48dGl0bGU+UmlzayBmYWN0b3JzIGZvciBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2Fs

IGNlbGwgY2FyY2lub21hczwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5BY3RhIERlcm0gVmVuZXJl

b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+NDQtNzwvcGFnZXM+PG51bWJlcj4x

PC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkJvZ2Rhbm92LUJlcmV6b3Zz

a3ksIEEuPC9hdXRob3I+PGF1dGhvcj5Db2hlbiwgQS4gRC48L2F1dGhvcj48YXV0aG9yPkdsZXNp

bmdlciwgUi48L2F1dGhvcj48YXV0aG9yPkNhZ25hbm8sIEUuPC9hdXRob3I+PGF1dGhvcj5Lcmll

Z2VyLCBZLjwvYXV0aG9yPjxhdXRob3I+Um9zZW5iZXJnLCBMLjwvYXV0aG9yPjwvYXV0aG9ycz48

L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9

InV0YyI+MTU3MjAxMzEwNzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRp

Y2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48cmVjLW51

bWJlcj4yNTI8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcy

MDEzMTA3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xNTA0MDQ3NzwvYWNjZXNz

aW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA4MC8wMDAxNTU1MDMxMDAyMDU4

NTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT44NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EaWV1PC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48SURU

ZXh0PkluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwgY2VsbCBjYXJjaW5vbWFzOiBhIHJldHJv

c3BlY3RpdmUgYXVkaXQ8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2Ny

aXB0Ij4yNSwgMjcsIDI4PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWIt

ZGF0ZXM+PGRhdGU+TWFyPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRl

cz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29y

ZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5BdXN0cmFsaWE8

L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3Jk

PkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwv

a2V5d29yZD48a2V5d29yZD5NZWRpY2FsIEF1ZGl0PC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFJlY3VycmVuY2UsIExvY2FsPC9rZXl3b3Jk

PjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlJlcHJvZHVjaWJpbGl0eSBv

ZiBSZXN1bHRzPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29y

ZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5UcmVhdG1lbnQgRmFp

bHVyZTwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xMjA3MTQ1NjwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xNDQ1LTE0MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+SW5jb21wbGV0ZSBl

eGNpc2lvbiBvZiBiYXNhbCBjZWxsIGNhcmNpbm9tYXM6IGEgcmV0cm9zcGVjdGl2ZSBhdWRpdDwv

dGl0bGU+PHNlY29uZGFyeS10aXRsZT5BTlogSiBTdXJnPC9zZWNvbmRhcnktdGl0bGU+PC90aXRs

ZXM+PHBhZ2VzPjIxOS0yMTwvcGFnZXM+PG51bWJlcj4zPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48

YXV0aG9ycz48YXV0aG9yPkRpZXUsIFQuPC9hdXRob3I+PGF1dGhvcj5NYWNsZW9kLCBBLiBNLjwv

YXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48

YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjg5NTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUg

bmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ5PC9yZWMt

bnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjg5NTwvbGFzdC11

cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTIwNzE0NTY8L2FjY2Vzc2lvbi1udW0+PHZvbHVt

ZT43Mjwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0aG9yPlRhbGJvdDwvQXV0aG9y

PjxZZWFyPjIwMDQ8L1llYXI+PElEVGV4dD5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24gb2Yg

Y3V0YW5lb3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJheSBv

ZiBQbGVudHk8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkFwcjwvZGF0

ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDA0PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3Jk

PkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgQmFzb3NxdWFtb3VzPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9t

YSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FZHVjYXRpb25hbCBTdGF0dXM8L2tl

eXdvcmQ+PGtleXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwv

a2V5d29yZD48a2V5d29yZD5HZW5lcmFsIFN1cmdlcnk8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBh

bmQgTmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPkluY2lkZW5jZTwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1p

ZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48

a2V5d29yZD5OZXcgWmVhbGFuZDwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRp

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2V4IEZhY3RvcnM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbjwv

a2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxz

PjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8x

NTEwNzg3MDwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMTc1LTg3MTY8L2lzYm4+

PHRpdGxlcz48dGl0bGU+SW5jb21wbGV0ZSBwcmltYXJ5IGV4Y2lzaW9uIG9mIGN1dGFuZW91cyBi

YXNhbCBhbmQgc3F1YW1vdXMgY2VsbCBjYXJjaW5vbWFzIGluIHRoZSBCYXkgb2YgUGxlbnR5PC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPk4gWiBNZWQgSjwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVz

PjxwYWdlcz5VODQ4PC9wYWdlcz48bnVtYmVyPjExOTI8L251bWJlcj48Y29udHJpYnV0b3JzPjxh

dXRob3JzPjxhdXRob3I+VGFsYm90LCBTLjwvYXV0aG9yPjxhdXRob3I+SGl0Y2hjb2NrLCBCLjwv

YXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDA0LzA0LzIzPC9lZGl0

aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcx

OTQ2MzI0PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9y

ZWYtdHlwZT48cmVjLW51bWJlcj4yNDQ8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZv

cm1hdD0idXRjIj4xNTcxOTQ2MzI0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4x

NTEwNzg3MDwvYWNjZXNzaW9uLW51bT48dm9sdW1lPjExNzwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0

ZT48Q2l0ZT48QXV0aG9yPkJvZ2Rhbm92LUJlcmV6b3Zza3k8L0F1dGhvcj48WWVhcj4yMDA0PC9Z

ZWFyPjxJRFRleHQ+UmlzayBmYWN0b3JzIGZvciBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2Fs

IGNlbGwgY2FyY2lub21hczwvSURUZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8

L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3Jk

PkNhcmNpbm9tYSwgQmFzb3NxdWFtb3VzPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25h

bCBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZhY2lhbCBOZW9wbGFzbXM8L2tleXdvcmQ+PGtl

eXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5N

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3Bs

YXNtIFJlY3VycmVuY2UsIExvY2FsPC9rZXl3b3JkPjxrZXl3b3JkPlJpc2sgRmFjdG9yczwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxy

ZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8xNTA0

MDQ3NzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4wMDAxLTU1NTU8L2lzYm4+PHRp

dGxlcz48dGl0bGU+UmlzayBmYWN0b3JzIGZvciBpbmNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2Fs

IGNlbGwgY2FyY2lub21hczwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5BY3RhIERlcm0gVmVuZXJl

b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+NDQtNzwvcGFnZXM+PG51bWJlcj4x

PC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkJvZ2Rhbm92LUJlcmV6b3Zz

a3ksIEEuPC9hdXRob3I+PGF1dGhvcj5Db2hlbiwgQS4gRC48L2F1dGhvcj48YXV0aG9yPkdsZXNp

bmdlciwgUi48L2F1dGhvcj48YXV0aG9yPkNhZ25hbm8sIEUuPC9hdXRob3I+PGF1dGhvcj5Lcmll

Z2VyLCBZLjwvYXV0aG9yPjxhdXRob3I+Um9zZW5iZXJnLCBMLjwvYXV0aG9yPjwvYXV0aG9ycz48

L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9

InV0YyI+MTU3MjAxMzEwNzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRp

Y2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48cmVjLW51

bWJlcj4yNTI8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcy

MDEzMTA3PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xNTA0MDQ3NzwvYWNjZXNz

aW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA4MC8wMDAxNTU1MDMxMDAyMDU4

NTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT44NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 25, 27, 28.The size of the lesions affects the incomplete excision rate. One study on scalp BCC showed larger tumours were more often higher grade and more commonly had perineural invasion ADDIN EN.CITE <EndNote><Cite><Author>Cho</Author><Year>2016</Year><IDText>Scalp Basal Cell Carcinoma: Review of 2,202 Cases</IDText><DisplayText><style face="superscript">29</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2016</year></dates><keywords><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Invasiveness</keyword><keyword>Neoplasm, Residual</keyword><keyword>Retrospective Studies</keyword><keyword>Scalp</keyword><keyword>Sex Factors</keyword><keyword>Skin Neoplasms</keyword><keyword>South Australia</keyword></keywords><urls><related-urls><url> Basal Cell Carcinoma: Review of 2,202 Cases</title><secondary-title>Dermatol Surg</secondary-title></titles><pages>834-41</pages><number>7</number><contributors><authors><author>Cho, M.</author><author>Lee, J.</author><author>James, C. L.</author><author>Marshman, G.</author><author>Huilgol, S. C.</author></authors></contributors><language>eng</language><added-date format="utc">1572014245</added-date><ref-type name="Journal Article">17</ref-type><rec-number>264</rec-number><last-updated-date format="utc">1572014245</last-updated-date><accession-num>27243131</accession-num><electronic-resource-num>10.1097/DSS.0000000000000783</electronic-resource-num><volume>42</volume></record></Cite></EndNote>29. These factors increased their incomplete excision rate to 26% from 16% ADDIN EN.CITE <EndNote><Cite><Author>Cho</Author><Year>2016</Year><IDText>Scalp Basal Cell Carcinoma: Review of 2,202 Cases</IDText><DisplayText><style face="superscript">29</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2016</year></dates><keywords><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Invasiveness</keyword><keyword>Neoplasm, Residual</keyword><keyword>Retrospective Studies</keyword><keyword>Scalp</keyword><keyword>Sex Factors</keyword><keyword>Skin Neoplasms</keyword><keyword>South Australia</keyword></keywords><urls><related-urls><url> Basal Cell Carcinoma: Review of 2,202 Cases</title><secondary-title>Dermatol Surg</secondary-title></titles><pages>834-41</pages><number>7</number><contributors><authors><author>Cho, M.</author><author>Lee, J.</author><author>James, C. L.</author><author>Marshman, G.</author><author>Huilgol, S. C.</author></authors></contributors><language>eng</language><added-date format="utc">1572014245</added-date><ref-type name="Journal Article">17</ref-type><rec-number>264</rec-number><last-updated-date format="utc">1572014245</last-updated-date><accession-num>27243131</accession-num><electronic-resource-num>10.1097/DSS.0000000000000783</electronic-resource-num><volume>42</volume></record></Cite></EndNote>29. Larger tumours were more likely to be incompletely excised in another study ADDIN EN.CITE <EndNote><Cite><Author>Stolle</Author><Year>2013</Year><IDText>A single center retrospective study on 959 excisions of non-melanoma skin cancer in 2011</IDText><DisplayText><style face="superscript">19</style></DisplayText><record><dates><pub-dates><date>Nov</date></pub-dates><year>2013</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Extremities</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm, Residual</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Retrospective Studies</keyword><keyword>Scalp</keyword><keyword>Skin Neoplasms</keyword><keyword>Torso</keyword><keyword>Tumor Burden</keyword><keyword>Young Adult</keyword></keywords><urls><related-urls><url> single center retrospective study on 959 excisions of non-melanoma skin cancer in 2011</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>1630-2</pages><number>11</number><contributors><authors><author>Stolle, L. B.</author><author>Kjerkegaard, U. K.</author></authors></contributors><edition>2013/06/14</edition><language>eng</language><added-date format="utc">1571257915</added-date><ref-type name="Journal Article">17</ref-type><rec-number>231</rec-number><last-updated-date format="utc">1571257915</last-updated-date><accession-num>23751973</accession-num><electronic-resource-num>10.1016/j.bjps.2013.05.021</electronic-resource-num><volume>66</volume></record></Cite></EndNote>19 however not correlated in two othersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyODwvc3R5bGU+PC9EaXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVz

PjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtl

eXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBD

ZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdv

cmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5P

ZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdv

cmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4g

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAt

OTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBw

aHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBt

YXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5z

dGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkog

QW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8

L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5G

bGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxh

dXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1

dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxh

dXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+

PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhv

cj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+

TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5n

PC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0

ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1i

ZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAx

MjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lv

bi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjxDaXRlPjxBdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNreTwvQXV0aG9yPjxZZWFyPjIwMDQ8L1ll

YXI+PElEVGV4dD5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzPC9JRFRleHQ+PHJlY29yZD48a2V5d29yZHM+PGtleXdvcmQ+QWdlZDwv

a2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+

Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+Q3Jvc3MtU2VjdGlvbmFs

IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmFjaWFsIE5lb3BsYXNtczwva2V5d29yZD48a2V5

d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxh

c20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UmlzayBGYWN0b3JzPC9rZXl3

b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE1MDQw

NDc3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDEtNTU1NTwvaXNibj48dGl0

bGVzPjx0aXRsZT5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFjdGEgRGVybSBWZW5lcmVv

bDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40NC03PC9wYWdlcz48bnVtYmVyPjE8

L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNr

eSwgQS48L2F1dGhvcj48YXV0aG9yPkNvaGVuLCBBLiBELjwvYXV0aG9yPjxhdXRob3I+R2xlc2lu

Z2VyLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FnbmFubywgRS48L2F1dGhvcj48YXV0aG9yPktyaWVn

ZXIsIFkuPC9hdXRob3I+PGF1dGhvcj5Sb3NlbmJlcmcsIEwuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0i

dXRjIj4xNTcyMDEzMTA3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGlj

bGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNDwveWVhcj48L2RhdGVzPjxyZWMtbnVt

YmVyPjI1MjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIw

MTMxMDc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1MDQwNDc3PC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDgwLzAwMDE1NTUwMzEwMDIwNTg1

PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjg0PC92b2x1bWU+PC9yZWNvcmQ+PC9D

aXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyODwvc3R5bGU+PC9EaXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVz

PjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtl

eXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBD

ZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdv

cmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxl

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29yZD48a2V5d29yZD5P

ZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2YgSGVhbHRoIENhcmU8L2tleXdv

cmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4g

TmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9rZXl3b3JkPjwva2V5

d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5n

b3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAxOTAt

OTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3BlY2lhbHR5IG9mIHRoZSB0cmVhdGluZyBw

aHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBvZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBt

YXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTogcmVzdWx0cyBmcm9tIGEgbXVsdGktaW5z

dGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkog

QW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8

L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5G

bGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5GZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxh

dXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRob3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1

dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxh

dXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhvcj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+

PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkthdHosIEEuIFMuPC9hdXRob3I+PGF1dGhv

cj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktuYXBwLCBULjwvYXV0aG9yPjxhdXRob3I+

TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5n

PC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0

ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1i

ZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAx

MjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTExNzQzNzk8L2FjY2Vzc2lv

bi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9l

bGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjxDaXRlPjxBdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNreTwvQXV0aG9yPjxZZWFyPjIwMDQ8L1ll

YXI+PElEVGV4dD5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzPC9JRFRleHQ+PHJlY29yZD48a2V5d29yZHM+PGtleXdvcmQ+QWdlZDwv

a2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+

Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+Q3Jvc3MtU2VjdGlvbmFs

IFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RmFjaWFsIE5lb3BsYXNtczwva2V5d29yZD48a2V5

d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1h

bGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxh

c20gUmVjdXJyZW5jZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+UmlzayBGYWN0b3JzPC9rZXl3

b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJl

bGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzE1MDQw

NDc3PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDEtNTU1NTwvaXNibj48dGl0

bGVzPjx0aXRsZT5SaXNrIGZhY3RvcnMgZm9yIGluY29tcGxldGUgZXhjaXNpb24gb2YgYmFzYWwg

Y2VsbCBjYXJjaW5vbWFzPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkFjdGEgRGVybSBWZW5lcmVv

bDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40NC03PC9wYWdlcz48bnVtYmVyPjE8

L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+Qm9nZGFub3YtQmVyZXpvdnNr

eSwgQS48L2F1dGhvcj48YXV0aG9yPkNvaGVuLCBBLiBELjwvYXV0aG9yPjxhdXRob3I+R2xlc2lu

Z2VyLCBSLjwvYXV0aG9yPjxhdXRob3I+Q2FnbmFubywgRS48L2F1dGhvcj48YXV0aG9yPktyaWVn

ZXIsIFkuPC9hdXRob3I+PGF1dGhvcj5Sb3NlbmJlcmcsIEwuPC9hdXRob3I+PC9hdXRob3JzPjwv

Y29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0i

dXRjIj4xNTcyMDEzMTA3PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGlj

bGUiPjE3PC9yZWYtdHlwZT48ZGF0ZXM+PHllYXI+MjAwNDwveWVhcj48L2RhdGVzPjxyZWMtbnVt

YmVyPjI1MjwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIw

MTMxMDc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE1MDQwNDc3PC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDgwLzAwMDE1NTUwMzEwMDIwNTg1

PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjg0PC92b2x1bWU+PC9yZWNvcmQ+PC9D

aXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE.DATA 20, 28. Larger tumours required more complex reconstructions (mean diameter 10.2mm in direct closure compared to 17mm with skin grafts and 12.5mm with flaps ADDIN EN.CITE <EndNote><Cite><Author>Stathopoulos</Author><Year>2017</Year><IDText>Head and neck nonmelanoma cutaneous malignancy treatment in a skin cancer referral center</IDText><DisplayText><style face="superscript">30</style></DisplayText><record><dates><pub-dates><date>Feb</date></pub-dates><year>2017</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Biopsy</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Diagnosis, Differential</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Metastasis</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Predictive Value of Tests</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword></keywords><urls><related-urls><url> and neck nonmelanoma cutaneous malignancy treatment in a skin cancer referral center</title><secondary-title>Oral Surg Oral Med Oral Pathol Oral Radiol</secondary-title></titles><pages>183-187</pages><number>2</number><contributors><authors><author>Stathopoulos, P.</author><author>Igoumenakis, D.</author><author>Shuttleworth, J.</author><author>Frawley, T.</author><author>Ennis, C.</author><author>Battista, E.</author><author>Ameerally, P.</author></authors></contributors><edition>2016/10/13</edition><language>eng</language><added-date format="utc">1572014320</added-date><ref-type name="Journal Article">17</ref-type><rec-number>265</rec-number><last-updated-date format="utc">1572014320</last-updated-date><accession-num>27989709</accession-num><electronic-resource-num>10.1016/j.oooo.2016.10.004</electronic-resource-num><volume>123</volume></record></Cite></EndNote>30). Dermatologists excised the largest tumours in one study ADDIN EN.CITE <EndNote><Cite><Author>Salmon</Author><Year>2010</Year><IDText>Surgical excision of skin cancer: the importance of training</IDText><DisplayText><style face="superscript">21</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2010</year></dates><keywords><keyword>Ambulatory Surgical Procedures</keyword><keyword>Clinical Competence</keyword><keyword>Dermatology</keyword><keyword>Family Practice</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>New Zealand</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Specialization</keyword></keywords><urls><related-urls><url> excision of skin cancer: the importance of training</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>117-22</pages><number>1</number><contributors><authors><author>Salmon, P.</author><author>Mortimer, N.</author><author>Rademaker, M.</author><author>Adams, L.</author><author>Stanway, A.</author><author>Hill, S.</author></authors></contributors><edition>2009/10/10</edition><language>eng</language><added-date format="utc">1571946122</added-date><ref-type name="Journal Article">17</ref-type><rec-number>243</rec-number><last-updated-date format="utc">1571946122</last-updated-date><accession-num>19818068</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09548.x</electronic-resource-num><volume>162</volume></record></Cite></EndNote>21 and Plastic Surgeons excised the largest in anotherPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE.DATA 20.Conflicting results were found in terms of whether surgeon experience was correlated with incomplete excisions. Three studies found no correlationPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UaW1tb25zPC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48

SURUZXh0PkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE4LCAyMCwgMzE8L3N0eWxl

PjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdW48L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5D

YXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxr

ZXl3b3JkPk1lZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5j

ZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PC9rZXl3

b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdv

di9wdWJtZWQvMTIxNjA1NDg8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAwNy0x

MjI2PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwg

Y2FyY2lub21hczwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MzYyPC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+VGltbW9ucywgTS4gSi48L2F1dGhvcj48YXV0

aG9yPkhlc3NlbCwgSy4gQy48L2F1dGhvcj48YXV0aG9yPktyYW5pZGhpb3RpcywgTi4gTS48L2F1

dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFk

ZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI5MzM8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5h

bWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1MDwvcmVjLW51

bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI5MzM8L2xhc3QtdXBk

YXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjEyMTYwNTQ4PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJv

bmljLXJlc291cmNlLW51bT4xMC4xMDU0L2JqcHMuMjAwMi4zODQ5PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjU1PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+

RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkg

b2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9y

LWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRz

IGZyb20gYSBtdWx0aS1pbnN0aXR1dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48

cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVh

cj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENv

bXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFu

czwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3

b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNp

ZHVhbDwva2V5d29yZD48a2V5d29yZD5PZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxp

dHkgb2YgSGVhbHRoIENhcmU8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNp

YWxpemF0aW9uPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0

dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjxpc2JuPjAxOTAtOTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3Bl

Y2lhbHR5IG9mIHRoZSB0cmVhdGluZyBwaHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBv

ZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBtYXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTog

cmVzdWx0cyBmcm9tIGEgbXVsdGktaW5zdGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogQW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmli

dXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5GbGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5G

ZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxhdXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRo

b3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+

Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxhdXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhv

cj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkth

dHosIEEuIFMuPC9hdXRob3I+PGF1dGhvcj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktu

YXBwLCBULjwvYXV0aG9yPjxhdXRob3I+TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0

YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xl

Ij4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQt

ZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lv

bi1udW0+MTExNzQzNzk8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEw

LjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S3VtYXI8L0F1dGhvcj48WWVh

cj4yMDAwPC9ZZWFyPjxJRFRleHQ+SW5jaWRlbmNlIG9mIGluY29tcGxldGUgZXhjaXNpb24gaW4g

c3VyZ2ljYWxseSB0cmVhdGVkIGJhc2FsIGNlbGwgY2FyY2lub21hOiBhIHJldHJvc3BlY3RpdmUg

Y2xpbmljYWwgYXVkaXQ8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk9j

dDwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxr

ZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdv

cmQ+QWdlIERpc3RyaWJ1dGlvbjwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3

b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwg

Q2VsbDwva2V5d29yZD48a2V5d29yZD5DaGlsZDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1h

bnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIEF1ZGl0

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgU3RhZmYsIEhvc3BpdGFsPC9rZXl3b3JkPjxrZXl3

b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRGlzdHJp

YnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29y

ZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3Yv

cHVibWVkLzExMDAwMDcxPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIy

NjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNpZGVuY2Ugb2YgaW5jb21wbGV0ZSBleGNpc2lvbiBp

biBzdXJnaWNhbGx5IHRyZWF0ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IGEgcmV0cm9zcGVjdGl2

ZSBjbGluaWNhbCBhdWRpdDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8

L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+NTYzLTY8L3BhZ2VzPjxudW1iZXI+Nzwv

bnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5LdW1hciwgUC48L2F1dGhvcj48

YXV0aG9yPk9ydG9uLCBDLiBJLjwvYXV0aG9yPjxhdXRob3I+TWNXaWxsaWFtLCBMLiBKLjwvYXV0

aG9yPjxhdXRob3I+V2F0c29uLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48

bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI1NzE5

MTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5

cGU+PHJlYy1udW1iZXI+MjMwPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9

InV0YyI+MTU3MTI1NzE5MTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTEwMDAw

NzE8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNTQvYmpwcy4y

MDAwLjMzOTQ8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NTM8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PC9FbmROb3RlPn==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UaW1tb25zPC9BdXRob3I+PFllYXI+MjAwMjwvWWVhcj48

SURUZXh0PkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwgY2FyY2lub21hczwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE4LCAyMCwgMzE8L3N0eWxl

PjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdW48L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAwMjwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5D

YXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxr

ZXl3b3JkPk1lZGljYWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20gUmVjdXJyZW5j

ZSwgTG9jYWw8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PC9rZXl3

b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdv

di9wdWJtZWQvMTIxNjA1NDg8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDAwNy0x

MjI2PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkNvbXBsZXRlIGV4Y2lzaW9uIG9mIGJhc2FsIGNlbGwg

Y2FyY2lub21hczwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8L3NlY29u

ZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MzYyPC9wYWdlcz48bnVtYmVyPjQ8L251bWJlcj48

Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+VGltbW9ucywgTS4gSi48L2F1dGhvcj48YXV0

aG9yPkhlc3NlbCwgSy4gQy48L2F1dGhvcj48YXV0aG9yPktyYW5pZGhpb3RpcywgTi4gTS48L2F1

dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFk

ZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI5MzM8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5h

bWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI1MDwvcmVjLW51

bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI5MzM8L2xhc3QtdXBk

YXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjEyMTYwNTQ4PC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJv

bmljLXJlc291cmNlLW51bT4xMC4xMDU0L2JqcHMuMjAwMi4zODQ5PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjU1PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+

RmxlaXNjaGVyPC9BdXRob3I+PFllYXI+MjAwMTwvWWVhcj48SURUZXh0PlRoZSBzcGVjaWFsdHkg

b2YgdGhlIHRyZWF0aW5nIHBoeXNpY2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9y

LWZyZWUgcmVzZWN0aW9uIG1hcmdpbnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRz

IGZyb20gYSBtdWx0aS1pbnN0aXR1dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L0lEVGV4dD48

cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkZlYjwvZGF0ZT48L3B1Yi1kYXRlcz48eWVh

cj4yMDAxPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtl

eXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENv

bXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFu

czwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljaW5lPC9rZXl3

b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNp

ZHVhbDwva2V5d29yZD48a2V5d29yZD5PZGRzIFJhdGlvPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxp

dHkgb2YgSGVhbHRoIENhcmU8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNp

YWxpemF0aW9uPC9rZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0

dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVkLzExMTc0Mzc5PC91cmw+PC9yZWxhdGVk

LXVybHM+PC91cmxzPjxpc2JuPjAxOTAtOTYyMjwvaXNibj48dGl0bGVzPjx0aXRsZT5UaGUgc3Bl

Y2lhbHR5IG9mIHRoZSB0cmVhdGluZyBwaHlzaWNpYW4gYWZmZWN0cyB0aGUgbGlrZWxpaG9vZCBv

ZiB0dW1vci1mcmVlIHJlc2VjdGlvbiBtYXJnaW5zIGZvciBiYXNhbCBjZWxsIGNhcmNpbm9tYTog

cmVzdWx0cyBmcm9tIGEgbXVsdGktaW5zdGl0dXRpb25hbCByZXRyb3NwZWN0aXZlIHN0dWR5PC90

aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogQW0gQWNhZCBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwYWdlcz4yMjQtMzA8L3BhZ2VzPjxudW1iZXI+MjwvbnVtYmVyPjxjb250cmli

dXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5GbGVpc2NoZXIsIEEuIEIuPC9hdXRob3I+PGF1dGhvcj5G

ZWxkbWFuLCBTLiBSLjwvYXV0aG9yPjxhdXRob3I+QmFybG93LCBKLiBPLjwvYXV0aG9yPjxhdXRo

b3I+WmhlbmcsIEIuPC9hdXRob3I+PGF1dGhvcj5IYWhuLCBILiBCLjwvYXV0aG9yPjxhdXRob3I+

Q2h1YW5nLCBULiBZLjwvYXV0aG9yPjxhdXRob3I+RHJhZnQsIEsuIFMuPC9hdXRob3I+PGF1dGhv

cj5Hb2xpdHosIEwuIEUuPC9hdXRob3I+PGF1dGhvcj5XdSwgRS48L2F1dGhvcj48YXV0aG9yPkth

dHosIEEuIFMuPC9hdXRob3I+PGF1dGhvcj5NYWl6ZSwgSi4gQy48L2F1dGhvcj48YXV0aG9yPktu

YXBwLCBULjwvYXV0aG9yPjxhdXRob3I+TGVzaGluLCBCLjwvYXV0aG9yPjwvYXV0aG9ycz48L2Nv

bnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0

YyI+MTU3MjAxMjczNjwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xl

Ij4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ3PC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQt

ZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxMjczNjwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lv

bi1udW0+MTExNzQzNzk8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEw

LjEwNjcvbWpkLjIwMDEuMTEwMzk2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQ0

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S3VtYXI8L0F1dGhvcj48WWVh

cj4yMDAwPC9ZZWFyPjxJRFRleHQ+SW5jaWRlbmNlIG9mIGluY29tcGxldGUgZXhjaXNpb24gaW4g

c3VyZ2ljYWxseSB0cmVhdGVkIGJhc2FsIGNlbGwgY2FyY2lub21hOiBhIHJldHJvc3BlY3RpdmUg

Y2xpbmljYWwgYXVkaXQ8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk9j

dDwvZGF0ZT48L3B1Yi1kYXRlcz48eWVhcj4yMDAwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxr

ZXl3b3JkPkFkb2xlc2NlbnQ8L2tleXdvcmQ+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdv

cmQ+QWdlIERpc3RyaWJ1dGlvbjwva2V5d29yZD48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3

b3JkPkFnZWQsIDgwIGFuZCBvdmVyPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwg

Q2VsbDwva2V5d29yZD48a2V5d29yZD5DaGlsZDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1h

bnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIEF1ZGl0

PC9rZXl3b3JkPjxrZXl3b3JkPk1lZGljYWwgU3RhZmYsIEhvc3BpdGFsPC9rZXl3b3JkPjxrZXl3

b3JkPk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPlJlb3BlcmF0aW9uPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRGlzdHJp

YnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29y

ZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3Yv

cHVibWVkLzExMDAwMDcxPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjAwMDctMTIy

NjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNpZGVuY2Ugb2YgaW5jb21wbGV0ZSBleGNpc2lvbiBp

biBzdXJnaWNhbGx5IHRyZWF0ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IGEgcmV0cm9zcGVjdGl2

ZSBjbGluaWNhbCBhdWRpdDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIFBsYXN0IFN1cmc8

L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+NTYzLTY8L3BhZ2VzPjxudW1iZXI+Nzwv

bnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5LdW1hciwgUC48L2F1dGhvcj48

YXV0aG9yPk9ydG9uLCBDLiBJLjwvYXV0aG9yPjxhdXRob3I+TWNXaWxsaWFtLCBMLiBKLjwvYXV0

aG9yPjxhdXRob3I+V2F0c29uLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48

bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI1NzE5

MTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5

cGU+PHJlYy1udW1iZXI+MjMwPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9

InV0YyI+MTU3MTI1NzE5MTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MTEwMDAw

NzE8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwNTQvYmpwcy4y

MDAwLjMzOTQ8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NTM8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PC9FbmROb3RlPn==

ADDIN EN.CITE.DATA 18, 20, 31, two studies found junior surgeons had more incomplete excisionPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjI0LCAzMjwvc3R5bGU+PC9E

aXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48L3B1

Yi1kYXRlcz48eWVhcj4yMDE1PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkNhcmNp

bm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNt

czwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWVkaWNhbCBBdWRp

dDwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIFN0YWZmLCBIb3NwaXRhbDwva2V5d29yZD48a2V5

d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdvcmQ+Tm9ydGhlcm4gSXJlbGFu

ZDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJhdGlvbjwva2V5d29yZD48a2V5d29yZD5SZXRyb3Nw

ZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+

PGtleXdvcmQ+U3VyZ2VyeSwgUGxhc3RpYzwva2V5d29yZD48a2V5d29yZD5CYXNhbCBDZWxsIENh

cmNpbm9tYTwva2V5d29yZD48a2V5d29yZD5SZXZhbGlkYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

U3VyZ2ljYWwgb3V0Y29tZXM8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxz

Pjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjU0Njg0NTc8L3VybD48

L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTUzMi0yMTU3PC9pc2JuPjx0aXRsZXM+PHRpdGxl

Pkhpc3RvcGF0aG9sb2dpY2FsIHZhcmlhdGlvbiBvZiBpbmNvbXBsZXRlbHkgZXhjaXNlZCBiYXNh

bCBjZWxsIGNhcmNpbm9tYSZhcG9zO3MgYW5kIHRoZSB2YXJpYXRpb24gd2l0aCB0aGUgZ3JhZGUg

b2Ygc3VyZ2VvbiAtIGltcGxpY2F0aW9ucyBmb3IgcmV2YWxpZGF0aW9uPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkV1ciBKIFN1cmcgT25jb2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFn

ZXM+MTY1LTg8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+

PGF1dGhvcj5Sb2JpbnNvbiwgQS4gSi48L2F1dGhvcj48YXV0aG9yPldhbHNoLCBNLjwvYXV0aG9y

PjxhdXRob3I+SGlsbCwgQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRp

b24+MjAxNC8xMS8wNjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0

ZSBmb3JtYXQ9InV0YyI+MTU3MjAxNDIxMTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjYzPC9yZWMtbnVtYmVyPjxs

YXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxNDIxMTwvbGFzdC11cGRhdGVkLWRh

dGU+PGFjY2Vzc2lvbi1udW0+MjU0Njg0NTc8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjEwLjEwMTYvai5lanNvLjIwMTQuMTAuMDU5PC9lbGVjdHJvbmljLXJlc291cmNl

LW51bT48dm9sdW1lPjQxPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S3Vt

YXI8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJRFRleHQ+SW5jb21wbGV0ZSBleGNpc2lvbiBv

ZiBiYXNhbCBjZWxsIGNhcmNpbm9tYTogYSBwcm9zcGVjdGl2ZSBtdWx0aWNlbnRyZSBhdWRpdDwv

SURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRh

dGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWRvbGVzY2Vu

dDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2UgRGlzdHJpYnV0

aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+Q29uZm91bmRpbmcg

RmFjdG9ycyAoRXBpZGVtaW9sb2d5KTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+

PGtleXdvcmQ+TWVkaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIFN0YWZmLCBI

b3NwaXRhbDwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Q

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJlY29uc3RydWN0aXZlIFN1cmdp

Y2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmVjdXJyZW5jZTwva2V5d29yZD48a2V5

d29yZD5TZXggRGlzdHJpYnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9r

ZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5j

YmkubmxtLm5paC5nb3YvcHVibWVkLzEyNTUwMTEzPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxz

Pjxpc2JuPjAwMDctMTIyNjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIGV4Y2lzaW9u

IG9mIGJhc2FsIGNlbGwgY2FyY2lub21hOiBhIHByb3NwZWN0aXZlIG11bHRpY2VudHJlIGF1ZGl0

PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEogUGxhc3QgU3VyZzwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwYWdlcz42MTYtMjI8L3BhZ2VzPjxudW1iZXI+ODwvbnVtYmVyPjxjb250cmli

dXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5LdW1hciwgUC48L2F1dGhvcj48YXV0aG9yPldhdHNvbiwg

Uy48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLiBOLjwvYXV0aG9yPjxhdXRob3I+RGF2ZW5wb3J0

LCBQLiBKLjwvYXV0aG9yPjxhdXRob3I+TWNXaWxsaWFtLCBMLiBKLjwvYXV0aG9yPjxhdXRob3I+

QmFuZXJqZWUsIFMuIFMuPC9hdXRob3I+PGF1dGhvcj5CaXNzZXQsIEQuIEwuPC9hdXRob3I+PC9h

dXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRl

IGZvcm1hdD0idXRjIj4xNTcxMjU1NzU1PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3Vy

bmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjU8L3JlYy1udW1iZXI+PGxh

c3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU1NzU1PC9sYXN0LXVwZGF0ZWQtZGF0

ZT48YWNjZXNzaW9uLW51bT4xMjU1MDExMzwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNv

dXJjZS1udW0+MTAuMTA1NC9ianBzLjIwMDIuMzk0ODwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

PHZvbHVtZT41NTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AG==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Sb2JpbnNvbjwvQXV0aG9yPjxZZWFyPjIwMTU8L1llYXI+

PElEVGV4dD5IaXN0b3BhdGhvbG9naWNhbCB2YXJpYXRpb24gb2YgaW5jb21wbGV0ZWx5IGV4Y2lz

ZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWEmYXBvcztzIGFuZCB0aGUgdmFyaWF0aW9uIHdpdGggdGhl

IGdyYWRlIG9mIHN1cmdlb24gLSBpbXBsaWNhdGlvbnMgZm9yIHJldmFsaWRhdGlvbjwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjI0LCAzMjwvc3R5bGU+PC9E

aXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48L3B1

Yi1kYXRlcz48eWVhcj4yMDE1PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkNhcmNp

bm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNt

czwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWVkaWNhbCBBdWRp

dDwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIFN0YWZmLCBIb3NwaXRhbDwva2V5d29yZD48a2V5

d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdvcmQ+Tm9ydGhlcm4gSXJlbGFu

ZDwva2V5d29yZD48a2V5d29yZD5SZW9wZXJhdGlvbjwva2V5d29yZD48a2V5d29yZD5SZXRyb3Nw

ZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+

PGtleXdvcmQ+U3VyZ2VyeSwgUGxhc3RpYzwva2V5d29yZD48a2V5d29yZD5CYXNhbCBDZWxsIENh

cmNpbm9tYTwva2V5d29yZD48a2V5d29yZD5SZXZhbGlkYXRpb248L2tleXdvcmQ+PGtleXdvcmQ+

U3VyZ2ljYWwgb3V0Y29tZXM8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxz

Pjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjU0Njg0NTc8L3VybD48

L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTUzMi0yMTU3PC9pc2JuPjx0aXRsZXM+PHRpdGxl

Pkhpc3RvcGF0aG9sb2dpY2FsIHZhcmlhdGlvbiBvZiBpbmNvbXBsZXRlbHkgZXhjaXNlZCBiYXNh

bCBjZWxsIGNhcmNpbm9tYSZhcG9zO3MgYW5kIHRoZSB2YXJpYXRpb24gd2l0aCB0aGUgZ3JhZGUg

b2Ygc3VyZ2VvbiAtIGltcGxpY2F0aW9ucyBmb3IgcmV2YWxpZGF0aW9uPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkV1ciBKIFN1cmcgT25jb2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFn

ZXM+MTY1LTg8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+

PGF1dGhvcj5Sb2JpbnNvbiwgQS4gSi48L2F1dGhvcj48YXV0aG9yPldhbHNoLCBNLjwvYXV0aG9y

PjxhdXRob3I+SGlsbCwgQy48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRp

b24+MjAxNC8xMS8wNjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0

ZSBmb3JtYXQ9InV0YyI+MTU3MjAxNDIxMTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjYzPC9yZWMtbnVtYmVyPjxs

YXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MjAxNDIxMTwvbGFzdC11cGRhdGVkLWRh

dGU+PGFjY2Vzc2lvbi1udW0+MjU0Njg0NTc8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjEwLjEwMTYvai5lanNvLjIwMTQuMTAuMDU5PC9lbGVjdHJvbmljLXJlc291cmNl

LW51bT48dm9sdW1lPjQxPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S3Vt

YXI8L0F1dGhvcj48WWVhcj4yMDAyPC9ZZWFyPjxJRFRleHQ+SW5jb21wbGV0ZSBleGNpc2lvbiBv

ZiBiYXNhbCBjZWxsIGNhcmNpbm9tYTogYSBwcm9zcGVjdGl2ZSBtdWx0aWNlbnRyZSBhdWRpdDwv

SURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRh

dGVzPjx5ZWFyPjIwMDI8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWRvbGVzY2Vu

dDwva2V5d29yZD48a2V5d29yZD5BZHVsdDwva2V5d29yZD48a2V5d29yZD5BZ2UgRGlzdHJpYnV0

aW9uPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+Q29uZm91bmRpbmcg

RmFjdG9ycyAoRXBpZGVtaW9sb2d5KTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+

PGtleXdvcmQ+TWVkaWNhbCBBdWRpdDwva2V5d29yZD48a2V5d29yZD5NZWRpY2FsIFN0YWZmLCBI

b3NwaXRhbDwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Q

cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPlJlY29uc3RydWN0aXZlIFN1cmdp

Y2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmVjdXJyZW5jZTwva2V5d29yZD48a2V5

d29yZD5TZXggRGlzdHJpYnV0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9r

ZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5j

YmkubmxtLm5paC5nb3YvcHVibWVkLzEyNTUwMTEzPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxz

Pjxpc2JuPjAwMDctMTIyNjwvaXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIGV4Y2lzaW9u

IG9mIGJhc2FsIGNlbGwgY2FyY2lub21hOiBhIHByb3NwZWN0aXZlIG11bHRpY2VudHJlIGF1ZGl0

PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEogUGxhc3QgU3VyZzwvc2Vjb25kYXJ5LXRpdGxl

PjwvdGl0bGVzPjxwYWdlcz42MTYtMjI8L3BhZ2VzPjxudW1iZXI+ODwvbnVtYmVyPjxjb250cmli

dXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5LdW1hciwgUC48L2F1dGhvcj48YXV0aG9yPldhdHNvbiwg

Uy48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLiBOLjwvYXV0aG9yPjxhdXRob3I+RGF2ZW5wb3J0

LCBQLiBKLjwvYXV0aG9yPjxhdXRob3I+TWNXaWxsaWFtLCBMLiBKLjwvYXV0aG9yPjxhdXRob3I+

QmFuZXJqZWUsIFMuIFMuPC9hdXRob3I+PGF1dGhvcj5CaXNzZXQsIEQuIEwuPC9hdXRob3I+PC9h

dXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRl

IGZvcm1hdD0idXRjIj4xNTcxMjU1NzU1PC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3Vy

bmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yMjU8L3JlYy1udW1iZXI+PGxh

c3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU1NzU1PC9sYXN0LXVwZGF0ZWQtZGF0

ZT48YWNjZXNzaW9uLW51bT4xMjU1MDExMzwvYWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNv

dXJjZS1udW0+MTAuMTA1NC9ianBzLjIwMDIuMzk0ODwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

PHZvbHVtZT41NTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AG==

ADDIN EN.CITE.DATA 24, 32 and two studies found consultant surgeons had more incomplete excisionsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDI3PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+VGFsYm90PC9B

dXRob3I+PFllYXI+MjAwNDwvWWVhcj48SURUZXh0PkluY29tcGxldGUgcHJpbWFyeSBleGNpc2lv

biBvZiBjdXRhbmVvdXMgYmFzYWwgYW5kIHNxdWFtb3VzIGNlbGwgY2FyY2lub21hcyBpbiB0aGUg

QmF5IG9mIFBsZW50eTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+QXBy

PC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtl

eXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdv

cmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkVkdWNhdGlvbmFsIFN0YXR1

czwva2V5d29yZD48a2V5d29yZD5GYW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVt

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgU3VyZ2VyeTwva2V5d29yZD48a2V5d29yZD5I

ZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+

PGtleXdvcmQ+SW5jaWRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdv

cmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3

b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUg

U3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5T

a2luPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzE1MTA3ODcwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjExNzUtODcxNjwv

aXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24gb2YgY3V0YW5l

b3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJheSBvZiBQbGVu

dHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+TiBaIE1lZCBKPC9zZWNvbmRhcnktdGl0bGU+PC90

aXRsZXM+PHBhZ2VzPlU4NDg8L3BhZ2VzPjxudW1iZXI+MTE5MjwvbnVtYmVyPjxjb250cmlidXRv

cnM+PGF1dGhvcnM+PGF1dGhvcj5UYWxib3QsIFMuPC9hdXRob3I+PGF1dGhvcj5IaXRjaGNvY2ss

IEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMDQvMDQvMjM8

L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMi

PjE1NzE5NDYzMjQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+

MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0NDwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRh

dGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24t

bnVtPjE1MTA3ODcwPC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+MTE3PC92b2x1bWU+PC9yZWNvcmQ+

PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDI3PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+VGFsYm90PC9B

dXRob3I+PFllYXI+MjAwNDwvWWVhcj48SURUZXh0PkluY29tcGxldGUgcHJpbWFyeSBleGNpc2lv

biBvZiBjdXRhbmVvdXMgYmFzYWwgYW5kIHNxdWFtb3VzIGNlbGwgY2FyY2lub21hcyBpbiB0aGUg

QmF5IG9mIFBsZW50eTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+QXBy

PC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDQ8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtl

eXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdv

cmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNvc3F1YW1vdXM8L2tleXdvcmQ+PGtleXdvcmQ+Q2Fy

Y2lub21hLCBTcXVhbW91cyBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkVkdWNhdGlvbmFsIFN0YXR1

czwva2V5d29yZD48a2V5d29yZD5GYW1pbHkgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+RmVt

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgU3VyZ2VyeTwva2V5d29yZD48a2V5d29yZD5I

ZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+

PGtleXdvcmQ+SW5jaWRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdv

cmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3

b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUg

U3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TZXggRmFjdG9yczwva2V5d29yZD48a2V5d29yZD5T

a2luPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+

PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVi

bWVkLzE1MTA3ODcwPC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjExNzUtODcxNjwv

aXNibj48dGl0bGVzPjx0aXRsZT5JbmNvbXBsZXRlIHByaW1hcnkgZXhjaXNpb24gb2YgY3V0YW5l

b3VzIGJhc2FsIGFuZCBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYXMgaW4gdGhlIEJheSBvZiBQbGVu

dHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+TiBaIE1lZCBKPC9zZWNvbmRhcnktdGl0bGU+PC90

aXRsZXM+PHBhZ2VzPlU4NDg8L3BhZ2VzPjxudW1iZXI+MTE5MjwvbnVtYmVyPjxjb250cmlidXRv

cnM+PGF1dGhvcnM+PGF1dGhvcj5UYWxib3QsIFMuPC9hdXRob3I+PGF1dGhvcj5IaXRjaGNvY2ss

IEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMDQvMDQvMjM8

L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMi

PjE1NzE5NDYzMjQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+

MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjI0NDwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRh

dGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYzMjQ8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24t

bnVtPjE1MTA3ODcwPC9hY2Nlc3Npb24tbnVtPjx2b2x1bWU+MTE3PC92b2x1bWU+PC9yZWNvcmQ+

PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE.DATA 15, 27. All three observations can simultaneously be true if the case mix is sufficiently different, with units where juniors are excising incompletely more may be working on cases beyond their capabilities and in units where the rate is lower may be because they are not being challenged or trusted enough with cases they are well capable of. Specific histological types of BCC (infiltrative and morphoeic) are known to be higher risk for incomplete excisionPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UZWxmZXI8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxJ

RFRleHQ+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5v

bWE8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij44LCAxNSwg

MzM8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5K

dWw8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwODwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48

a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q3J5b3N1cmdl

cnk8L2tleXdvcmQ+PGtleXdvcmQ+Q3VyZXR0YWdlPC9rZXl3b3JkPjxrZXl3b3JkPkV2aWRlbmNl

LUJhc2VkIE1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPkd1aWRlbGluZSBBZGhlcmVuY2U8L2tl

eXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPlBob3RvY2hlbW90aGVyYXB5

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzE4NTkzMzg1PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEzNjUtMjEzMzwvaXNi

bj48dGl0bGVzPjx0aXRsZT5HdWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiBiYXNhbCBj

ZWxsIGNhcmNpbm9tYTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIERlcm1hdG9sPC9zZWNv

bmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjM1LTQ4PC9wYWdlcz48bnVtYmVyPjE8L251bWJl

cj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+VGVsZmVyLCBOLiBSLjwvYXV0aG9yPjxh

dXRob3I+Q29sdmVyLCBHLiBCLjwvYXV0aG9yPjxhdXRob3I+TW9ydG9uLCBDLiBBLjwvYXV0aG9y

PjxhdXRob3I+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0czwvYXV0aG9yPjwv

YXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0

ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjgxOTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQwPC9yZWMtbnVtYmVyPjxs

YXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjgxOTwvbGFzdC11cGRhdGVkLWRh

dGU+PGFjY2Vzc2lvbi1udW0+MTg1OTMzODU8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjEwLjExMTEvai4xMzY1LTIxMzMuMjAwOC4wODY2Ni54PC9lbGVjdHJvbmljLXJl

c291cmNlLW51bT48dm9sdW1lPjE1OTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0

aG9yPk1hbGlrPC9BdXRob3I+PFllYXI+MjAxMDwvWWVhcj48SURUZXh0PlJpc2sgYW5kIG91dGNv

bWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJj

aW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L0lEVGV4

dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkRlYzwvZGF0ZT48L3B1Yi1kYXRlcz48

eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3Jk

PjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdv

cmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoZWVr

PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNr

IE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFs

ZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Ob3NlIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+

PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IE91dGNv

bWU8L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJs

cz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQv

MjAyMjY3NTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2Ju

Pjx0aXRsZXM+PHRpdGxlPlJpc2sgYW5kIG91dGNvbWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1

dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJy

YWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBS

ZWNvbnN0ciBBZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjA1

Ny02MzwvcGFnZXM+PG51bWJlcj4xMjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5NYWxpaywgVi48L2F1dGhvcj48YXV0aG9yPkdvaCwgSy4gUy48L2F1dGhvcj48YXV0aG9y

Pkxlb25nLCBTLjwvYXV0aG9yPjxhdXRob3I+VGFuLCBBLjwvYXV0aG9yPjxhdXRob3I+RG93bmV5

LCBELjwvYXV0aG9yPjxhdXRob3I+TyZhcG9zO0Rvbm92YW4sIEQuPC9hdXRob3I+PC9hdXRob3Jz

PjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTAvMDMvMTE8L2VkaXRpb24+PGxhbmd1YWdlPmVu

ZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0NTc8L2FkZGVkLWRh

dGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVt

YmVyPjI0NTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5

OTA0NTc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjIwMjI2NzUwPC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDEwLjAxLjAx

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42Mzwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPktpZWx5PC9BdXRob3I+PFllYXI+MjAxOTwvWWVhcj48SURUZXh0

PkEgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvZiA2OTQgQmFzYWwgQ2VsbCBDYXJjaW5vbWEgZXhjaXNp

b25zIHRvIHF1YW50aWZ5IGRlZXAgbWFyZ2luIGRvY3VtZW50YXRpb24gYW5kIGNsZWFyYW5jZSBj

b21wYXJlZCB0byBoaXN0b2xvZ2ljYWwgdHlwZSBhbmQgc3VyZ2ljYWwgbWFyZ2luPC9JRFRleHQ+

PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdW48L2RhdGU+PC9wdWItZGF0ZXM+PHll

YXI+MjAxOTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5CQ0M8L2tleXdvcmQ+PGtl

eXdvcmQ+U2tpbiBiaW9wc3k8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBjYW5jZXI8L2tleXdvcmQ+

PGtleXdvcmQ+U3VyZ2ljYWwgZXhjaXNpb248L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVs

YXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzEzMzE3

MjI8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRs

ZXM+PHRpdGxlPkEgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvZiA2OTQgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgZXhjaXNpb25zIHRvIHF1YW50aWZ5IGRlZXAgbWFyZ2luIGRvY3VtZW50YXRpb24gYW5kIGNs

ZWFyYW5jZSBjb21wYXJlZCB0byBoaXN0b2xvZ2ljYWwgdHlwZSBhbmQgc3VyZ2ljYWwgbWFyZ2lu

PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25zdHIgQWVzdGhldCBTdXJnPC9z

ZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktp

ZWx5LCBKLiBSLjwvYXV0aG9yPjxhdXRob3I+UGF0ZWwsIEEuIEouIEsuPC9hdXRob3I+PC9hdXRo

b3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTkvMDYvMjc8L2VkaXRpb24+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTkwMjI8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjIzMzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzEyNTkwMjI8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjMxMzMxNzIyPC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDE5LjA2

LjAwMjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5UZWxmZXI8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxJ

RFRleHQ+R3VpZGVsaW5lcyBmb3IgdGhlIG1hbmFnZW1lbnQgb2YgYmFzYWwgY2VsbCBjYXJjaW5v

bWE8L0lEVGV4dD48RGlzcGxheVRleHQ+PHN0eWxlIGZhY2U9InN1cGVyc2NyaXB0Ij44LCAxNSwg

MzM8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5K

dWw8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwODwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48

a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q3J5b3N1cmdl

cnk8L2tleXdvcmQ+PGtleXdvcmQ+Q3VyZXR0YWdlPC9rZXl3b3JkPjxrZXl3b3JkPkV2aWRlbmNl

LUJhc2VkIE1lZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPkd1aWRlbGluZSBBZGhlcmVuY2U8L2tl

eXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPlBob3RvY2hlbW90aGVyYXB5

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjwva2V5d29yZHM+PHVy

bHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5jYmkubmxtLm5paC5nb3YvcHVibWVk

LzE4NTkzMzg1PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxzPjxpc2JuPjEzNjUtMjEzMzwvaXNi

bj48dGl0bGVzPjx0aXRsZT5HdWlkZWxpbmVzIGZvciB0aGUgbWFuYWdlbWVudCBvZiBiYXNhbCBj

ZWxsIGNhcmNpbm9tYTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5CciBKIERlcm1hdG9sPC9zZWNv

bmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjM1LTQ4PC9wYWdlcz48bnVtYmVyPjE8L251bWJl

cj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+VGVsZmVyLCBOLiBSLjwvYXV0aG9yPjxh

dXRob3I+Q29sdmVyLCBHLiBCLjwvYXV0aG9yPjxhdXRob3I+TW9ydG9uLCBDLiBBLjwvYXV0aG9y

PjxhdXRob3I+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0czwvYXV0aG9yPjwv

YXV0aG9ycz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0

ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjgxOTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91

cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQwPC9yZWMtbnVtYmVyPjxs

YXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYyNjgxOTwvbGFzdC11cGRhdGVkLWRh

dGU+PGFjY2Vzc2lvbi1udW0+MTg1OTMzODU8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVz

b3VyY2UtbnVtPjEwLjExMTEvai4xMzY1LTIxMzMuMjAwOC4wODY2Ni54PC9lbGVjdHJvbmljLXJl

c291cmNlLW51bT48dm9sdW1lPjE1OTwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48Q2l0ZT48QXV0

aG9yPk1hbGlrPC9BdXRob3I+PFllYXI+MjAxMDwvWWVhcj48SURUZXh0PlJpc2sgYW5kIG91dGNv

bWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJj

aW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJyYWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L0lEVGV4

dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkRlYzwvZGF0ZT48L3B1Yi1kYXRlcz48

eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFkdWx0PC9rZXl3b3Jk

PjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5kIG92ZXI8L2tleXdv

cmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxrZXl3b3JkPkNoZWVr

PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNr

IE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFs

ZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUgQWdlZDwva2V5d29yZD48a2V5d29yZD5Ob3NlIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+

PGtleXdvcmQ+U2tpbiBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+VHJlYXRtZW50IE91dGNv

bWU8L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJs

cz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQv

MjAyMjY3NTA8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2Ju

Pjx0aXRsZXM+PHRpdGxlPlJpc2sgYW5kIG91dGNvbWUgYW5hbHlzaXMgb2YgMTgzMiBjb25zZWN1

dGl2ZWx5IGV4Y2lzZWQgYmFzYWwgY2VsbCBjYXJjaW5vbWFzIGluIGEgdGVydGlhcnkgcmVmZXJy

YWwgcGxhc3RpYyBzdXJnZXJ5IHVuaXQ8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBS

ZWNvbnN0ciBBZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjA1

Ny02MzwvcGFnZXM+PG51bWJlcj4xMjwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5NYWxpaywgVi48L2F1dGhvcj48YXV0aG9yPkdvaCwgSy4gUy48L2F1dGhvcj48YXV0aG9y

Pkxlb25nLCBTLjwvYXV0aG9yPjxhdXRob3I+VGFuLCBBLjwvYXV0aG9yPjxhdXRob3I+RG93bmV5

LCBELjwvYXV0aG9yPjxhdXRob3I+TyZhcG9zO0Rvbm92YW4sIEQuPC9hdXRob3I+PC9hdXRob3Jz

PjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTAvMDMvMTE8L2VkaXRpb24+PGxhbmd1YWdlPmVu

ZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5OTA0NTc8L2FkZGVkLWRh

dGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVt

YmVyPjI0NTwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5

OTA0NTc8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjIwMjI2NzUwPC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDEwLjAxLjAx

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT42Mzwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPktpZWx5PC9BdXRob3I+PFllYXI+MjAxOTwvWWVhcj48SURUZXh0

PkEgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvZiA2OTQgQmFzYWwgQ2VsbCBDYXJjaW5vbWEgZXhjaXNp

b25zIHRvIHF1YW50aWZ5IGRlZXAgbWFyZ2luIGRvY3VtZW50YXRpb24gYW5kIGNsZWFyYW5jZSBj

b21wYXJlZCB0byBoaXN0b2xvZ2ljYWwgdHlwZSBhbmQgc3VyZ2ljYWwgbWFyZ2luPC9JRFRleHQ+

PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdW48L2RhdGU+PC9wdWItZGF0ZXM+PHll

YXI+MjAxOTwveWVhcj48L2RhdGVzPjxrZXl3b3Jkcz48a2V5d29yZD5CQ0M8L2tleXdvcmQ+PGtl

eXdvcmQ+U2tpbiBiaW9wc3k8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBjYW5jZXI8L2tleXdvcmQ+

PGtleXdvcmQ+U3VyZ2ljYWwgZXhjaXNpb248L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVs

YXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzEzMzE3

MjI8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRs

ZXM+PHRpdGxlPkEgcmV0cm9zcGVjdGl2ZSBzdHVkeSBvZiA2OTQgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgZXhjaXNpb25zIHRvIHF1YW50aWZ5IGRlZXAgbWFyZ2luIGRvY3VtZW50YXRpb24gYW5kIGNs

ZWFyYW5jZSBjb21wYXJlZCB0byBoaXN0b2xvZ2ljYWwgdHlwZSBhbmQgc3VyZ2ljYWwgbWFyZ2lu

PC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkogUGxhc3QgUmVjb25zdHIgQWVzdGhldCBTdXJnPC9z

ZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktp

ZWx5LCBKLiBSLjwvYXV0aG9yPjxhdXRob3I+UGF0ZWwsIEEuIEouIEsuPC9hdXRob3I+PC9hdXRo

b3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTkvMDYvMjc8L2VkaXRpb24+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTkwMjI8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjIzMzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzEyNTkwMjI8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjMxMzMxNzIyPC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDE2L2ouYmpwcy4yMDE5LjA2

LjAwMjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PC9yZWNvcmQ+PC9DaXRlPjwvRW5kTm90ZT4A

ADDIN EN.CITE.DATA 8, 15, 33. Data from the UK and abroad showed between 26-31% of the BCC excised in Plastic Surgery units had a high-risk histological elementPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWVseTwvQXV0aG9yPjxZZWFyPjIwMTk8L1llYXI+PElE

VGV4dD5BIHJldHJvc3BlY3RpdmUgc3R1ZHkgb2YgNjk0IEJhc2FsIENlbGwgQ2FyY2lub21hIGV4

Y2lzaW9ucyB0byBxdWFudGlmeSBkZWVwIG1hcmdpbiBkb2N1bWVudGF0aW9uIGFuZCBjbGVhcmFu

Y2UgY29tcGFyZWQgdG8gaGlzdG9sb2dpY2FsIHR5cGUgYW5kIHN1cmdpY2FsIG1hcmdpbjwvSURU

ZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE5LCAzMzwvc3R5bGU+

PC9EaXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkp1bjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDE5PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkJD

Qzwva2V5d29yZD48a2V5d29yZD5Ta2luIGJpb3BzeTwva2V5d29yZD48a2V5d29yZD5Ta2luIGNh

bmNlcjwva2V5d29yZD48a2V5d29yZD5TdXJnaWNhbCBleGNpc2lvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8zMTMzMTcyMjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xODc4LTA1

Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+QSByZXRyb3NwZWN0aXZlIHN0dWR5IG9mIDY5NCBCYXNh

bCBDZWxsIENhcmNpbm9tYSBleGNpc2lvbnMgdG8gcXVhbnRpZnkgZGVlcCBtYXJnaW4gZG9jdW1l

bnRhdGlvbiBhbmQgY2xlYXJhbmNlIGNvbXBhcmVkIHRvIGhpc3RvbG9naWNhbCB0eXBlIGFuZCBz

dXJnaWNhbCBtYXJnaW48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+S2llbHksIEouIFIuPC9hdXRob3I+PGF1dGhvcj5QYXRlbCwgQS4gSi4gSy48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAxOS8wNi8yNzwvZWRp

dGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3

MTYyODEyOTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwv

cmVmLXR5cGU+PHJlYy1udW1iZXI+MjQyPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTYyODEyOTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+

MzEzMzE3MjI8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYv

ai5ianBzLjIwMTkuMDYuMDAyPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48L3JlY29yZD48L0Np

dGU+PENpdGU+PEF1dGhvcj5TdG9sbGU8L0F1dGhvcj48WWVhcj4yMDEzPC9ZZWFyPjxJRFRleHQ+

QSBzaW5nbGUgY2VudGVyIHJldHJvc3BlY3RpdmUgc3R1ZHkgb24gOTU5IGV4Y2lzaW9ucyBvZiBu

b24tbWVsYW5vbWEgc2tpbiBjYW5jZXIgaW4gMjAxMTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxw

dWItZGF0ZXM+PGRhdGU+Tm92PC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTM8L3llYXI+PC9k

YXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5

d29yZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5v

bWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxs

PC9rZXl3b3JkPjxrZXl3b3JkPkV4dHJlbWl0aWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwv

a2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29y

ZD5Ib3NwaXRhbGl6YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+

TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPlJlY29uc3RydWN0aXZlIFN1cmdp

Y2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9r

ZXl3b3JkPjxrZXl3b3JkPlNjYWxwPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9r

ZXl3b3JkPjxrZXl3b3JkPlRvcnNvPC9rZXl3b3JkPjxrZXl3b3JkPlR1bW9yIEJ1cmRlbjwva2V5

d29yZD48a2V5d29yZD5Zb3VuZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxh

dGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMzc1MTk3

MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxl

cz48dGl0bGU+QSBzaW5nbGUgY2VudGVyIHJldHJvc3BlY3RpdmUgc3R1ZHkgb24gOTU5IGV4Y2lz

aW9ucyBvZiBub24tbWVsYW5vbWEgc2tpbiBjYW5jZXIgaW4gMjAxMTwvdGl0bGU+PHNlY29uZGFy

eS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwv

dGl0bGVzPjxwYWdlcz4xNjMwLTI8L3BhZ2VzPjxudW1iZXI+MTE8L251bWJlcj48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+U3RvbGxlLCBMLiBCLjwvYXV0aG9yPjxhdXRob3I+S2plcmtl

Z2FhcmQsIFUuIEsuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIw

MTMvMDYvMTQ8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzEyNTc5MTU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIzMTwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTc5MTU8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjIzNzUxOTczPC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNl

LW51bT4xMC4xMDE2L2ouYmpwcy4yMDEzLjA1LjAyMTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

PHZvbHVtZT42Njwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AG==

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LaWVseTwvQXV0aG9yPjxZZWFyPjIwMTk8L1llYXI+PElE

VGV4dD5BIHJldHJvc3BlY3RpdmUgc3R1ZHkgb2YgNjk0IEJhc2FsIENlbGwgQ2FyY2lub21hIGV4

Y2lzaW9ucyB0byBxdWFudGlmeSBkZWVwIG1hcmdpbiBkb2N1bWVudGF0aW9uIGFuZCBjbGVhcmFu

Y2UgY29tcGFyZWQgdG8gaGlzdG9sb2dpY2FsIHR5cGUgYW5kIHN1cmdpY2FsIG1hcmdpbjwvSURU

ZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjE5LCAzMzwvc3R5bGU+

PC9EaXNwbGF5VGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkp1bjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDE5PC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkJD

Qzwva2V5d29yZD48a2V5d29yZD5Ta2luIGJpb3BzeTwva2V5d29yZD48a2V5d29yZD5Ta2luIGNh

bmNlcjwva2V5d29yZD48a2V5d29yZD5TdXJnaWNhbCBleGNpc2lvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8zMTMzMTcyMjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xODc4LTA1

Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+QSByZXRyb3NwZWN0aXZlIHN0dWR5IG9mIDY5NCBCYXNh

bCBDZWxsIENhcmNpbm9tYSBleGNpc2lvbnMgdG8gcXVhbnRpZnkgZGVlcCBtYXJnaW4gZG9jdW1l

bnRhdGlvbiBhbmQgY2xlYXJhbmNlIGNvbXBhcmVkIHRvIGhpc3RvbG9naWNhbCB0eXBlIGFuZCBz

dXJnaWNhbCBtYXJnaW48L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48Y29udHJpYnV0b3JzPjxhdXRo

b3JzPjxhdXRob3I+S2llbHksIEouIFIuPC9hdXRob3I+PGF1dGhvcj5QYXRlbCwgQS4gSi4gSy48

L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAxOS8wNi8yNzwvZWRp

dGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3

MTYyODEyOTwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwv

cmVmLXR5cGU+PHJlYy1udW1iZXI+MjQyPC9yZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTYyODEyOTwvbGFzdC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+

MzEzMzE3MjI8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjEwMTYv

ai5ianBzLjIwMTkuMDYuMDAyPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48L3JlY29yZD48L0Np

dGU+PENpdGU+PEF1dGhvcj5TdG9sbGU8L0F1dGhvcj48WWVhcj4yMDEzPC9ZZWFyPjxJRFRleHQ+

QSBzaW5nbGUgY2VudGVyIHJldHJvc3BlY3RpdmUgc3R1ZHkgb24gOTU5IGV4Y2lzaW9ucyBvZiBu

b24tbWVsYW5vbWEgc2tpbiBjYW5jZXIgaW4gMjAxMTwvSURUZXh0PjxyZWNvcmQ+PGRhdGVzPjxw

dWItZGF0ZXM+PGRhdGU+Tm92PC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTM8L3llYXI+PC9k

YXRlcz48a2V5d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5

d29yZD48a2V5d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5v

bWEsIEJhc2FsIENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBTcXVhbW91cyBDZWxs

PC9rZXl3b3JkPjxrZXl3b3JkPkV4dHJlbWl0aWVzPC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwv

a2V5d29yZD48a2V5d29yZD5IZWFkIGFuZCBOZWNrIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29y

ZD5Ib3NwaXRhbGl6YXRpb248L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+

TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPlJlY29uc3RydWN0aXZlIFN1cmdp

Y2FsIFByb2NlZHVyZXM8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9r

ZXl3b3JkPjxrZXl3b3JkPlNjYWxwPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9r

ZXl3b3JkPjxrZXl3b3JkPlRvcnNvPC9rZXl3b3JkPjxrZXl3b3JkPlR1bW9yIEJ1cmRlbjwva2V5

d29yZD48a2V5d29yZD5Zb3VuZyBBZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxh

dGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMzc1MTk3

MzwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxl

cz48dGl0bGU+QSBzaW5nbGUgY2VudGVyIHJldHJvc3BlY3RpdmUgc3R1ZHkgb24gOTU5IGV4Y2lz

aW9ucyBvZiBub24tbWVsYW5vbWEgc2tpbiBjYW5jZXIgaW4gMjAxMTwvdGl0bGU+PHNlY29uZGFy

eS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25kYXJ5LXRpdGxlPjwv

dGl0bGVzPjxwYWdlcz4xNjMwLTI8L3BhZ2VzPjxudW1iZXI+MTE8L251bWJlcj48Y29udHJpYnV0

b3JzPjxhdXRob3JzPjxhdXRob3I+U3RvbGxlLCBMLiBCLjwvYXV0aG9yPjxhdXRob3I+S2plcmtl

Z2FhcmQsIFUuIEsuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIw

MTMvMDYvMTQ8L2VkaXRpb24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9y

bWF0PSJ1dGMiPjE1NzEyNTc5MTU8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwg

QXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVtYmVyPjIzMTwvcmVjLW51bWJlcj48bGFzdC11

cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzEyNTc5MTU8L2xhc3QtdXBkYXRlZC1kYXRlPjxh

Y2Nlc3Npb24tbnVtPjIzNzUxOTczPC9hY2Nlc3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNl

LW51bT4xMC4xMDE2L2ouYmpwcy4yMDEzLjA1LjAyMTwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+

PHZvbHVtZT42Njwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+AG==

ADDIN EN.CITE.DATA 19, 33. This was not reported in any of the studies by Dermatologists. Plastic Surgeons would be expected to be performing more skin grafts and flaps than Dermatologists who have a more medical background. In Plastic Surgery units skin grafts were used in 19-34%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDE5PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+U3RvbGxlPC9B

dXRob3I+PFllYXI+MjAxMzwvWWVhcj48SURUZXh0PkEgc2luZ2xlIGNlbnRlciByZXRyb3NwZWN0

aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4gY2FuY2VyIGlu

IDIwMTE8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk5vdjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEzPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFk

dWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FeHRyZW1p

dGllczwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQg

TmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SG9zcGl0YWxpemF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

Pk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29y

ZD48a2V5d29yZD5SZWNvbnN0cnVjdGl2ZSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TY2FscDwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5Ub3Jzbzwva2V5

d29yZD48a2V5d29yZD5UdW1vciBCdXJkZW48L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8

L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cu

bmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjM3NTE5NzM8L3VybD48L3JlbGF0ZWQtdXJscz48L3Vy

bHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkEgc2luZ2xlIGNlbnRlciBy

ZXRyb3NwZWN0aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4g

Y2FuY2VyIGluIDIwMTE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTYzMC0yPC9wYWdl

cz48bnVtYmVyPjExPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlN0b2xs

ZSwgTC4gQi48L2F1dGhvcj48YXV0aG9yPktqZXJrZWdhYXJkLCBVLiBLLjwvYXV0aG9yPjwvYXV0

aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEzLzA2LzE0PC9lZGl0aW9uPjxsYW5ndWFn

ZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU3OTE1PC9hZGRl

ZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVj

LW51bWJlcj4yMzE8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxMjU3OTE1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMzc1MTk3MzwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMy4w

NS4wMjE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjY8L3ZvbHVtZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDE5PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+U3RvbGxlPC9B

dXRob3I+PFllYXI+MjAxMzwvWWVhcj48SURUZXh0PkEgc2luZ2xlIGNlbnRlciByZXRyb3NwZWN0

aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4gY2FuY2VyIGlu

IDIwMTE8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk5vdjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEzPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFk

dWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FeHRyZW1p

dGllczwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQg

TmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SG9zcGl0YWxpemF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

Pk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29y

ZD48a2V5d29yZD5SZWNvbnN0cnVjdGl2ZSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TY2FscDwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5Ub3Jzbzwva2V5

d29yZD48a2V5d29yZD5UdW1vciBCdXJkZW48L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8

L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cu

bmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjM3NTE5NzM8L3VybD48L3JlbGF0ZWQtdXJscz48L3Vy

bHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkEgc2luZ2xlIGNlbnRlciBy

ZXRyb3NwZWN0aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4g

Y2FuY2VyIGluIDIwMTE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTYzMC0yPC9wYWdl

cz48bnVtYmVyPjExPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlN0b2xs

ZSwgTC4gQi48L2F1dGhvcj48YXV0aG9yPktqZXJrZWdhYXJkLCBVLiBLLjwvYXV0aG9yPjwvYXV0

aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEzLzA2LzE0PC9lZGl0aW9uPjxsYW5ndWFn

ZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU3OTE1PC9hZGRl

ZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVj

LW51bWJlcj4yMzE8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxMjU3OTE1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMzc1MTk3MzwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMy4w

NS4wMjE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjY8L3ZvbHVtZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 15, 19 and flaps in 12-13.2%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDE5PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+U3RvbGxlPC9B

dXRob3I+PFllYXI+MjAxMzwvWWVhcj48SURUZXh0PkEgc2luZ2xlIGNlbnRlciByZXRyb3NwZWN0

aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4gY2FuY2VyIGlu

IDIwMTE8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk5vdjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEzPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFk

dWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FeHRyZW1p

dGllczwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQg

TmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SG9zcGl0YWxpemF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

Pk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29y

ZD48a2V5d29yZD5SZWNvbnN0cnVjdGl2ZSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TY2FscDwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5Ub3Jzbzwva2V5

d29yZD48a2V5d29yZD5UdW1vciBCdXJkZW48L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8

L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cu

bmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjM3NTE5NzM8L3VybD48L3JlbGF0ZWQtdXJscz48L3Vy

bHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkEgc2luZ2xlIGNlbnRlciBy

ZXRyb3NwZWN0aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4g

Y2FuY2VyIGluIDIwMTE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTYzMC0yPC9wYWdl

cz48bnVtYmVyPjExPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlN0b2xs

ZSwgTC4gQi48L2F1dGhvcj48YXV0aG9yPktqZXJrZWdhYXJkLCBVLiBLLjwvYXV0aG9yPjwvYXV0

aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEzLzA2LzE0PC9lZGl0aW9uPjxsYW5ndWFn

ZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU3OTE1PC9hZGRl

ZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVj

LW51bWJlcj4yMzE8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxMjU3OTE1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMzc1MTk3MzwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMy4w

NS4wMjE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjY8L3ZvbHVtZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxpazwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElE

VGV4dD5SaXNrIGFuZCBvdXRjb21lIGFuYWx5c2lzIG9mIDE4MzIgY29uc2VjdXRpdmVseSBleGNp

c2VkIGJhc2FsIGNlbGwgY2FyY2lub21hcyBpbiBhIHRlcnRpYXJ5IHJlZmVycmFsIHBsYXN0aWMg

c3VyZ2VyeSB1bml0PC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlw

dCI+MTUsIDE5PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+

PGRhdGU+RGVjPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5

d29yZHM+PGtleXdvcmQ+QWR1bHQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5

d29yZD5BZ2VkLCA4MCBhbmQgb3Zlcjwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2Fs

IENlbGw8L2tleXdvcmQ+PGtleXdvcmQ+Q2hlZWs8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkhlYWQgYW5kIE5lY2sgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

Pkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBB

Z2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5vc2UgTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlJl

dHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5

d29yZD48a2V5d29yZD5UcmVhdG1lbnQgT3V0Y29tZTwva2V5d29yZD48a2V5d29yZD5Zb3VuZyBB

ZHVsdDwva2V5d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczov

L3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yMDIyNjc1MDwvdXJsPjwvcmVsYXRlZC11cmxz

PjwvdXJscz48aXNibj4xODc4LTA1Mzk8L2lzYm4+PHRpdGxlcz48dGl0bGU+UmlzayBhbmQgb3V0

Y29tZSBhbmFseXNpcyBvZiAxODMyIGNvbnNlY3V0aXZlbHkgZXhjaXNlZCBiYXNhbCBjZWxsIGNh

cmNpbm9tYXMgaW4gYSB0ZXJ0aWFyeSByZWZlcnJhbCBwbGFzdGljIHN1cmdlcnkgdW5pdDwvdGl0

bGU+PHNlY29uZGFyeS10aXRsZT5KIFBsYXN0IFJlY29uc3RyIEFlc3RoZXQgU3VyZzwvc2Vjb25k

YXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4yMDU3LTYzPC9wYWdlcz48bnVtYmVyPjEyPC9udW1i

ZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPk1hbGlrLCBWLjwvYXV0aG9yPjxhdXRo

b3I+R29oLCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+TGVvbmcsIFMuPC9hdXRob3I+PGF1dGhvcj5U

YW4sIEEuPC9hdXRob3I+PGF1dGhvcj5Eb3duZXksIEQuPC9hdXRob3I+PGF1dGhvcj5PJmFwb3M7

RG9ub3ZhbiwgRC48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

MC8wMy8xMTwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTk5MDQ1NzwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjQ1PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTk5MDQ1NzwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjAyMjY3NTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjEwMTYvai5ianBzLjIwMTAuMDEuMDE2PC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48

dm9sdW1lPjYzPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+U3RvbGxlPC9B

dXRob3I+PFllYXI+MjAxMzwvWWVhcj48SURUZXh0PkEgc2luZ2xlIGNlbnRlciByZXRyb3NwZWN0

aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4gY2FuY2VyIGlu

IDIwMTE8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPk5vdjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEzPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFk

dWx0PC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdlZCwgODAgYW5k

IG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9rZXl3b3JkPjxr

ZXl3b3JkPkNhcmNpbm9tYSwgU3F1YW1vdXMgQ2VsbDwva2V5d29yZD48a2V5d29yZD5FeHRyZW1p

dGllczwva2V5d29yZD48a2V5d29yZD5GZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SGVhZCBhbmQg

TmVjayBOZW9wbGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+SG9zcGl0YWxpemF0aW9uPC9rZXl3b3Jk

PjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3Jk

Pk1pZGRsZSBBZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtLCBSZXNpZHVhbDwva2V5d29y

ZD48a2V5d29yZD5SZWNvbnN0cnVjdGl2ZSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5TY2FscDwva2V5

d29yZD48a2V5d29yZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5Ub3Jzbzwva2V5

d29yZD48a2V5d29yZD5UdW1vciBCdXJkZW48L2tleXdvcmQ+PGtleXdvcmQ+WW91bmcgQWR1bHQ8

L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cu

bmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjM3NTE5NzM8L3VybD48L3JlbGF0ZWQtdXJscz48L3Vy

bHM+PGlzYm4+MTg3OC0wNTM5PC9pc2JuPjx0aXRsZXM+PHRpdGxlPkEgc2luZ2xlIGNlbnRlciBy

ZXRyb3NwZWN0aXZlIHN0dWR5IG9uIDk1OSBleGNpc2lvbnMgb2Ygbm9uLW1lbGFub21hIHNraW4g

Y2FuY2VyIGluIDIwMTE8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBQbGFzdCBSZWNvbnN0ciBB

ZXN0aGV0IFN1cmc8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTYzMC0yPC9wYWdl

cz48bnVtYmVyPjExPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPlN0b2xs

ZSwgTC4gQi48L2F1dGhvcj48YXV0aG9yPktqZXJrZWdhYXJkLCBVLiBLLjwvYXV0aG9yPjwvYXV0

aG9ycz48L2NvbnRyaWJ1dG9ycz48ZWRpdGlvbj4yMDEzLzA2LzE0PC9lZGl0aW9uPjxsYW5ndWFn

ZT5lbmc8L2xhbmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxMjU3OTE1PC9hZGRl

ZC1kYXRlPjxyZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVj

LW51bWJlcj4yMzE8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxMjU3OTE1PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4yMzc1MTk3MzwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTAxNi9qLmJqcHMuMjAxMy4w

NS4wMjE8L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NjY8L3ZvbHVtZT48L3JlY29y

ZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 15, 19. In contrast UK Dermatologists used skin grafts 2.5-4.2%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 13, 14 and flaps in 6-6.8%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 13, 14. The complication rates were rarely reported, however was 4.4% ADDIN EN.CITE <EndNote><Cite><Author>Malik</Author><Year>2010</Year><IDText>Risk and outcome analysis of 1832 consecutively excised basal cell carcinomas in a tertiary referral plastic surgery unit</IDText><DisplayText><style face="superscript">15</style></DisplayText><record><dates><pub-dates><date>Dec</date></pub-dates><year>2010</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Cheek</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Nose Neoplasms</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword><keyword>Young Adult</keyword></keywords><urls><related-urls><url> and outcome analysis of 1832 consecutively excised basal cell carcinomas in a tertiary referral plastic surgery unit</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>2057-63</pages><number>12</number><contributors><authors><author>Malik, V.</author><author>Goh, K. S.</author><author>Leong, S.</author><author>Tan, A.</author><author>Downey, D.</author><author>O&apos;Donovan, D.</author></authors></contributors><edition>2010/03/11</edition><language>eng</language><added-date format="utc">1571990457</added-date><ref-type name="Journal Article">17</ref-type><rec-number>245</rec-number><last-updated-date format="utc">1571990457</last-updated-date><accession-num>20226750</accession-num><electronic-resource-num>10.1016/j.bjps.2010.01.016</electronic-resource-num><volume>63</volume></record></Cite></EndNote>15 in one Plastic Surgery unit and 3.0-3.4%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 13, 14 in UK Dermatologists. Finally, three studies have directly compared incomplete excision rates between different practitioners who excised skin cancer. These all reported Dermatology (0-14.2%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyMSwgMzQ8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1k

YXRlcz48ZGF0ZT5GZWI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48L2RhdGVz

PjxrZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUg

QWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdv

cmQ+T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIEhlYWx0aCBDYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48

L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5u

aWguZ292L3B1Ym1lZC8xMTE3NDM3OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4w

MTkwLTk2MjI8L2lzYm4+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRp

bmcgcGh5c2ljaWFuIGFmZmVjdHMgdGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rp

b24gbWFyZ2lucyBmb3IgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRp

LWluc3RpdHV0aW9uYWwgcmV0cm9zcGVjdGl2ZSBzdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRs

ZT5KIEFtIEFjYWQgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjI0

LTMwPC9wYWdlcz48bnVtYmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+RmxlaXNjaGVyLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+RmVsZG1hbiwgUy4gUi48L2F1dGhv

cj48YXV0aG9yPkJhcmxvdywgSi4gTy48L2F1dGhvcj48YXV0aG9yPlpoZW5nLCBCLjwvYXV0aG9y

PjxhdXRob3I+SGFobiwgSC4gQi48L2F1dGhvcj48YXV0aG9yPkNodWFuZywgVC4gWS48L2F1dGhv

cj48YXV0aG9yPkRyYWZ0LCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+R29saXR6LCBMLiBFLjwvYXV0

aG9yPjxhdXRob3I+V3UsIEUuPC9hdXRob3I+PGF1dGhvcj5LYXR6LCBBLiBTLjwvYXV0aG9yPjxh

dXRob3I+TWFpemUsIEouIEMuPC9hdXRob3I+PGF1dGhvcj5LbmFwcCwgVC48L2F1dGhvcj48YXV0

aG9yPkxlc2hpbiwgQi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI3MzY8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjI0NzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzIwMTI3MzY8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjExMTc0Mzc5PC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDY3L21qZC4yMDAxLjExMDM5

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4

dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJh

aW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFt

YnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdv

cmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIx

MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6

IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEog

RGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTE3LTIyPC9wYWdlcz48

bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+U2FsbW9uLCBQ

LjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRob3I+PGF1dGhvcj5SYWRlbWFrZXIs

IE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhvcj48YXV0aG9yPlN0YW53YXksIEEu

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEzMy4yMDA5LjA5NTQ4Lng8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxD

aXRlPjxBdXRob3I+UmFtZGFzPC9BdXRob3I+PFllYXI+MjAxODwvWWVhcj48SURUZXh0PkRpZmZl

cmVuY2VzIGluIFJhdGUgb2YgQ29tcGxldGUgRXhjaXNpb24gb2YgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgYnkgRGVybWF0b2xvZ2lzdHMsIFBsYXN0aWMgU3VyZ2VvbnMgYW5kIEdlbmVyYWwgUHJhY3Rp

dGlvbmVyczogQSBMYXJnZSBDcm9zcy1TZWN0aW9uYWwgU3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVy

PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29y

ZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25hbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5H

ZW5lcmFsIFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48

a2V5d29yZD5NYXJnaW5zIG9mIEV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29y

ZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TdXJnZW9uczwva2V5d29yZD48a2V5

d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2FsIGNlbGwgY2FyY2lu

b21hPC9rZXl3b3JkPjxrZXl3b3JkPkNvbXBhcmF0aXZlIHN0dWR5PC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgcHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5NYXJnaW5zIG9mIGV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPlBoeXNpY2lhbnM8L2tleXdvcmQ+PGtleXdvcmQ+UGxh

c3RpYyBzdXJnZW9uczwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIGhlYWx0aCBjYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnk8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRl

ZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzAwODY1NDE8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQyMS05ODMyPC9pc2JuPjxjdXN0b20y

PlBNQzYxNzI3OTY8L2N1c3RvbTI+PHRpdGxlcz48dGl0bGU+RGlmZmVyZW5jZXMgaW4gUmF0ZSBv

ZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9n

aXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdl

IENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5EZXJtYXRvbG9n

eTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz44Ni05MTwvcGFnZXM+PG51bWJlcj4z

LTQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UmFtZGFzLCBLLjwvYXV0

aG9yPjxhdXRob3I+dmFuIExlZSwgQy48L2F1dGhvcj48YXV0aG9yPkJlY2ssIFMuPC9hdXRob3I+

PGF1dGhvcj5CaW5kZWxzLCBQLjwvYXV0aG9yPjxhdXRob3I+Tm9vcmRob2VrIEhlZ3QsIFYuPC9h

dXRob3I+PGF1dGhvcj5QYXJkbywgTC48L2F1dGhvcj48YXV0aG9yPlZlcnNuZWwsIFMuPC9hdXRo

b3I+PGF1dGhvcj5OaWpzdGVuLCBULjwvYXV0aG9yPjxhdXRob3I+dmFuIGRlbiBCb3MsIFIuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTgvMDgvMDc8L2VkaXRp

b24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MTIzMzQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxkYXRlcz48eWVhcj4yMDE4PC95ZWFyPjwvZGF0ZXM+PHJlYy1udW1iZXI+MjM1PC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzAwODY1NDE8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExNTkvMDAwNDkwMzQ0PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjIzNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyMSwgMzQ8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1k

YXRlcz48ZGF0ZT5GZWI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48L2RhdGVz

PjxrZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUg

QWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdv

cmQ+T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIEhlYWx0aCBDYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48

L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5u

aWguZ292L3B1Ym1lZC8xMTE3NDM3OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4w

MTkwLTk2MjI8L2lzYm4+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRp

bmcgcGh5c2ljaWFuIGFmZmVjdHMgdGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rp

b24gbWFyZ2lucyBmb3IgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRp

LWluc3RpdHV0aW9uYWwgcmV0cm9zcGVjdGl2ZSBzdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRs

ZT5KIEFtIEFjYWQgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjI0

LTMwPC9wYWdlcz48bnVtYmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+RmxlaXNjaGVyLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+RmVsZG1hbiwgUy4gUi48L2F1dGhv

cj48YXV0aG9yPkJhcmxvdywgSi4gTy48L2F1dGhvcj48YXV0aG9yPlpoZW5nLCBCLjwvYXV0aG9y

PjxhdXRob3I+SGFobiwgSC4gQi48L2F1dGhvcj48YXV0aG9yPkNodWFuZywgVC4gWS48L2F1dGhv

cj48YXV0aG9yPkRyYWZ0LCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+R29saXR6LCBMLiBFLjwvYXV0

aG9yPjxhdXRob3I+V3UsIEUuPC9hdXRob3I+PGF1dGhvcj5LYXR6LCBBLiBTLjwvYXV0aG9yPjxh

dXRob3I+TWFpemUsIEouIEMuPC9hdXRob3I+PGF1dGhvcj5LbmFwcCwgVC48L2F1dGhvcj48YXV0

aG9yPkxlc2hpbiwgQi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI3MzY8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjI0NzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzIwMTI3MzY8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjExMTc0Mzc5PC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDY3L21qZC4yMDAxLjExMDM5

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4

dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJh

aW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFt

YnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdv

cmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIx

MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6

IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEog

RGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTE3LTIyPC9wYWdlcz48

bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+U2FsbW9uLCBQ

LjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRob3I+PGF1dGhvcj5SYWRlbWFrZXIs

IE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhvcj48YXV0aG9yPlN0YW53YXksIEEu

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEzMy4yMDA5LjA5NTQ4Lng8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxD

aXRlPjxBdXRob3I+UmFtZGFzPC9BdXRob3I+PFllYXI+MjAxODwvWWVhcj48SURUZXh0PkRpZmZl

cmVuY2VzIGluIFJhdGUgb2YgQ29tcGxldGUgRXhjaXNpb24gb2YgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgYnkgRGVybWF0b2xvZ2lzdHMsIFBsYXN0aWMgU3VyZ2VvbnMgYW5kIEdlbmVyYWwgUHJhY3Rp

dGlvbmVyczogQSBMYXJnZSBDcm9zcy1TZWN0aW9uYWwgU3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVy

PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29y

ZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25hbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5H

ZW5lcmFsIFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48

a2V5d29yZD5NYXJnaW5zIG9mIEV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29y

ZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TdXJnZW9uczwva2V5d29yZD48a2V5

d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2FsIGNlbGwgY2FyY2lu

b21hPC9rZXl3b3JkPjxrZXl3b3JkPkNvbXBhcmF0aXZlIHN0dWR5PC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgcHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5NYXJnaW5zIG9mIGV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPlBoeXNpY2lhbnM8L2tleXdvcmQ+PGtleXdvcmQ+UGxh

c3RpYyBzdXJnZW9uczwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIGhlYWx0aCBjYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnk8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRl

ZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzAwODY1NDE8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQyMS05ODMyPC9pc2JuPjxjdXN0b20y

PlBNQzYxNzI3OTY8L2N1c3RvbTI+PHRpdGxlcz48dGl0bGU+RGlmZmVyZW5jZXMgaW4gUmF0ZSBv

ZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9n

aXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdl

IENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5EZXJtYXRvbG9n

eTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz44Ni05MTwvcGFnZXM+PG51bWJlcj4z

LTQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UmFtZGFzLCBLLjwvYXV0

aG9yPjxhdXRob3I+dmFuIExlZSwgQy48L2F1dGhvcj48YXV0aG9yPkJlY2ssIFMuPC9hdXRob3I+

PGF1dGhvcj5CaW5kZWxzLCBQLjwvYXV0aG9yPjxhdXRob3I+Tm9vcmRob2VrIEhlZ3QsIFYuPC9h

dXRob3I+PGF1dGhvcj5QYXJkbywgTC48L2F1dGhvcj48YXV0aG9yPlZlcnNuZWwsIFMuPC9hdXRo

b3I+PGF1dGhvcj5OaWpzdGVuLCBULjwvYXV0aG9yPjxhdXRob3I+dmFuIGRlbiBCb3MsIFIuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTgvMDgvMDc8L2VkaXRp

b24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MTIzMzQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxkYXRlcz48eWVhcj4yMDE4PC95ZWFyPjwvZGF0ZXM+PHJlYy1udW1iZXI+MjM1PC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzAwODY1NDE8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExNTkvMDAwNDkwMzQ0PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjIzNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 20, 21, 34) had the lowest rate compared to Plastic Surgeons (17-27.6%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyMSwgMzQ8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1k

YXRlcz48ZGF0ZT5GZWI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48L2RhdGVz

PjxrZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUg

QWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdv

cmQ+T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIEhlYWx0aCBDYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48

L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5u

aWguZ292L3B1Ym1lZC8xMTE3NDM3OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4w

MTkwLTk2MjI8L2lzYm4+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRp

bmcgcGh5c2ljaWFuIGFmZmVjdHMgdGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rp

b24gbWFyZ2lucyBmb3IgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRp

LWluc3RpdHV0aW9uYWwgcmV0cm9zcGVjdGl2ZSBzdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRs

ZT5KIEFtIEFjYWQgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjI0

LTMwPC9wYWdlcz48bnVtYmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+RmxlaXNjaGVyLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+RmVsZG1hbiwgUy4gUi48L2F1dGhv

cj48YXV0aG9yPkJhcmxvdywgSi4gTy48L2F1dGhvcj48YXV0aG9yPlpoZW5nLCBCLjwvYXV0aG9y

PjxhdXRob3I+SGFobiwgSC4gQi48L2F1dGhvcj48YXV0aG9yPkNodWFuZywgVC4gWS48L2F1dGhv

cj48YXV0aG9yPkRyYWZ0LCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+R29saXR6LCBMLiBFLjwvYXV0

aG9yPjxhdXRob3I+V3UsIEUuPC9hdXRob3I+PGF1dGhvcj5LYXR6LCBBLiBTLjwvYXV0aG9yPjxh

dXRob3I+TWFpemUsIEouIEMuPC9hdXRob3I+PGF1dGhvcj5LbmFwcCwgVC48L2F1dGhvcj48YXV0

aG9yPkxlc2hpbiwgQi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI3MzY8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjI0NzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzIwMTI3MzY8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjExMTc0Mzc5PC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDY3L21qZC4yMDAxLjExMDM5

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4

dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJh

aW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFt

YnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdv

cmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIx

MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6

IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEog

RGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTE3LTIyPC9wYWdlcz48

bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+U2FsbW9uLCBQ

LjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRob3I+PGF1dGhvcj5SYWRlbWFrZXIs

IE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhvcj48YXV0aG9yPlN0YW53YXksIEEu

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEzMy4yMDA5LjA5NTQ4Lng8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxD

aXRlPjxBdXRob3I+UmFtZGFzPC9BdXRob3I+PFllYXI+MjAxODwvWWVhcj48SURUZXh0PkRpZmZl

cmVuY2VzIGluIFJhdGUgb2YgQ29tcGxldGUgRXhjaXNpb24gb2YgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgYnkgRGVybWF0b2xvZ2lzdHMsIFBsYXN0aWMgU3VyZ2VvbnMgYW5kIEdlbmVyYWwgUHJhY3Rp

dGlvbmVyczogQSBMYXJnZSBDcm9zcy1TZWN0aW9uYWwgU3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVy

PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29y

ZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25hbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5H

ZW5lcmFsIFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48

a2V5d29yZD5NYXJnaW5zIG9mIEV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29y

ZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TdXJnZW9uczwva2V5d29yZD48a2V5

d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2FsIGNlbGwgY2FyY2lu

b21hPC9rZXl3b3JkPjxrZXl3b3JkPkNvbXBhcmF0aXZlIHN0dWR5PC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgcHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5NYXJnaW5zIG9mIGV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPlBoeXNpY2lhbnM8L2tleXdvcmQ+PGtleXdvcmQ+UGxh

c3RpYyBzdXJnZW9uczwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIGhlYWx0aCBjYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnk8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRl

ZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzAwODY1NDE8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQyMS05ODMyPC9pc2JuPjxjdXN0b20y

PlBNQzYxNzI3OTY8L2N1c3RvbTI+PHRpdGxlcz48dGl0bGU+RGlmZmVyZW5jZXMgaW4gUmF0ZSBv

ZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9n

aXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdl

IENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5EZXJtYXRvbG9n

eTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz44Ni05MTwvcGFnZXM+PG51bWJlcj4z

LTQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UmFtZGFzLCBLLjwvYXV0

aG9yPjxhdXRob3I+dmFuIExlZSwgQy48L2F1dGhvcj48YXV0aG9yPkJlY2ssIFMuPC9hdXRob3I+

PGF1dGhvcj5CaW5kZWxzLCBQLjwvYXV0aG9yPjxhdXRob3I+Tm9vcmRob2VrIEhlZ3QsIFYuPC9h

dXRob3I+PGF1dGhvcj5QYXJkbywgTC48L2F1dGhvcj48YXV0aG9yPlZlcnNuZWwsIFMuPC9hdXRo

b3I+PGF1dGhvcj5OaWpzdGVuLCBULjwvYXV0aG9yPjxhdXRob3I+dmFuIGRlbiBCb3MsIFIuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTgvMDgvMDc8L2VkaXRp

b24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MTIzMzQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxkYXRlcz48eWVhcj4yMDE4PC95ZWFyPjwvZGF0ZXM+PHJlYy1udW1iZXI+MjM1PC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzAwODY1NDE8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExNTkvMDAwNDkwMzQ0PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjIzNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwLCAyMSwgMzQ8L3N0eWxlPjwvRGlzcGxheVRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1k

YXRlcz48ZGF0ZT5GZWI8L2RhdGU+PC9wdWItZGF0ZXM+PHllYXI+MjAwMTwveWVhcj48L2RhdGVz

PjxrZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFz

YWwgQ2VsbDwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxr

ZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+

TWFsZTwva2V5d29yZD48a2V5d29yZD5NZWRpY2luZTwva2V5d29yZD48a2V5d29yZD5NaWRkbGUg

QWdlZDwva2V5d29yZD48a2V5d29yZD5OZW9wbGFzbSwgUmVzaWR1YWw8L2tleXdvcmQ+PGtleXdv

cmQ+T2RkcyBSYXRpbzwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIEhlYWx0aCBDYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5T

a2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48

L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5u

aWguZ292L3B1Ym1lZC8xMTE3NDM3OTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4w

MTkwLTk2MjI8L2lzYm4+PHRpdGxlcz48dGl0bGU+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRp

bmcgcGh5c2ljaWFuIGFmZmVjdHMgdGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rp

b24gbWFyZ2lucyBmb3IgYmFzYWwgY2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRp

LWluc3RpdHV0aW9uYWwgcmV0cm9zcGVjdGl2ZSBzdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRs

ZT5KIEFtIEFjYWQgRGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MjI0

LTMwPC9wYWdlcz48bnVtYmVyPjI8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRo

b3I+RmxlaXNjaGVyLCBBLiBCLjwvYXV0aG9yPjxhdXRob3I+RmVsZG1hbiwgUy4gUi48L2F1dGhv

cj48YXV0aG9yPkJhcmxvdywgSi4gTy48L2F1dGhvcj48YXV0aG9yPlpoZW5nLCBCLjwvYXV0aG9y

PjxhdXRob3I+SGFobiwgSC4gQi48L2F1dGhvcj48YXV0aG9yPkNodWFuZywgVC4gWS48L2F1dGhv

cj48YXV0aG9yPkRyYWZ0LCBLLiBTLjwvYXV0aG9yPjxhdXRob3I+R29saXR6LCBMLiBFLjwvYXV0

aG9yPjxhdXRob3I+V3UsIEUuPC9hdXRob3I+PGF1dGhvcj5LYXR6LCBBLiBTLjwvYXV0aG9yPjxh

dXRob3I+TWFpemUsIEouIEMuPC9hdXRob3I+PGF1dGhvcj5LbmFwcCwgVC48L2F1dGhvcj48YXV0

aG9yPkxlc2hpbiwgQi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGxhbmd1YWdl

PmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzIwMTI3MzY8L2FkZGVk

LWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMt

bnVtYmVyPjI0NzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1

NzIwMTI3MzY8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjExMTc0Mzc5PC9hY2Nl

c3Npb24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMDY3L21qZC4yMDAxLjExMDM5

NjwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT40NDwvdm9sdW1lPjwvcmVjb3JkPjwv

Q2l0ZT48Q2l0ZT48QXV0aG9yPlNhbG1vbjwvQXV0aG9yPjxZZWFyPjIwMTA8L1llYXI+PElEVGV4

dD5TdXJnaWNhbCBleGNpc2lvbiBvZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJh

aW5pbmc8L0lEVGV4dD48cmVjb3JkPjxkYXRlcz48cHViLWRhdGVzPjxkYXRlPkphbjwvZGF0ZT48

L3B1Yi1kYXRlcz48eWVhcj4yMDEwPC95ZWFyPjwvZGF0ZXM+PGtleXdvcmRzPjxrZXl3b3JkPkFt

YnVsYXRvcnkgU3VyZ2ljYWwgUHJvY2VkdXJlczwva2V5d29yZD48a2V5d29yZD5DbGluaWNhbCBD

b21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3Jk

PkZhbWlseSBQcmFjdGljZTwva2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdv

cmQ+TG9naXN0aWMgTW9kZWxzPC9rZXl3b3JkPjxrZXl3b3JkPk5ldyBaZWFsYW5kPC9rZXl3b3Jk

PjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29yZD5Ta2luIE5l

b3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TcGVjaWFsaXphdGlvbjwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8xOTgxODA2ODwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIx

MzM8L2lzYm4+PHRpdGxlcz48dGl0bGU+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6

IHRoZSBpbXBvcnRhbmNlIG9mIHRyYWluaW5nPC90aXRsZT48c2Vjb25kYXJ5LXRpdGxlPkJyIEog

RGVybWF0b2w8L3NlY29uZGFyeS10aXRsZT48L3RpdGxlcz48cGFnZXM+MTE3LTIyPC9wYWdlcz48

bnVtYmVyPjE8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+U2FsbW9uLCBQ

LjwvYXV0aG9yPjxhdXRob3I+TW9ydGltZXIsIE4uPC9hdXRob3I+PGF1dGhvcj5SYWRlbWFrZXIs

IE0uPC9hdXRob3I+PGF1dGhvcj5BZGFtcywgTC48L2F1dGhvcj48YXV0aG9yPlN0YW53YXksIEEu

PC9hdXRob3I+PGF1dGhvcj5IaWxsLCBTLjwvYXV0aG9yPjwvYXV0aG9ycz48L2NvbnRyaWJ1dG9y

cz48ZWRpdGlvbj4yMDA5LzEwLzEwPC9lZGl0aW9uPjxsYW5ndWFnZT5lbmc8L2xhbmd1YWdlPjxh

ZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9hZGRlZC1kYXRlPjxyZWYtdHlwZSBu

YW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4yNDM8L3JlYy1u

dW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcxOTQ2MTIyPC9sYXN0LXVw

ZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xOTgxODA2ODwvYWNjZXNzaW9uLW51bT48ZWxlY3Ry

b25pYy1yZXNvdXJjZS1udW0+MTAuMTExMS9qLjEzNjUtMjEzMy4yMDA5LjA5NTQ4Lng8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MTYyPC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxD

aXRlPjxBdXRob3I+UmFtZGFzPC9BdXRob3I+PFllYXI+MjAxODwvWWVhcj48SURUZXh0PkRpZmZl

cmVuY2VzIGluIFJhdGUgb2YgQ29tcGxldGUgRXhjaXNpb24gb2YgQmFzYWwgQ2VsbCBDYXJjaW5v

bWEgYnkgRGVybWF0b2xvZ2lzdHMsIFBsYXN0aWMgU3VyZ2VvbnMgYW5kIEdlbmVyYWwgUHJhY3Rp

dGlvbmVyczogQSBMYXJnZSBDcm9zcy1TZWN0aW9uYWwgU3R1ZHk8L0lEVGV4dD48cmVjb3JkPjxr

ZXl3b3Jkcz48a2V5d29yZD5BZ2VkPC9rZXl3b3JkPjxrZXl3b3JkPkFnZWQsIDgwIGFuZCBvdmVy

PC9rZXl3b3JkPjxrZXl3b3JkPkNhcmNpbm9tYSwgQmFzYWwgQ2VsbDwva2V5d29yZD48a2V5d29y

ZD5DbGluaWNhbCBDb21wZXRlbmNlPC9rZXl3b3JkPjxrZXl3b3JkPkNyb3NzLVNlY3Rpb25hbCBT

dHVkaWVzPC9rZXl3b3JkPjxrZXl3b3JkPkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2d5PC9rZXl3b3JkPjxrZXl3b3JkPkZlbWFsZTwva2V5d29yZD48a2V5d29yZD5H

ZW5lcmFsIFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5IdW1hbnM8L2tleXdvcmQ+PGtleXdvcmQ+TWFsZTwva2V5d29yZD48

a2V5d29yZD5NYXJnaW5zIG9mIEV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1pZGRsZSBBZ2Vk

PC9rZXl3b3JkPjxrZXl3b3JkPlJldHJvc3BlY3RpdmUgU3R1ZGllczwva2V5d29yZD48a2V5d29y

ZD5Ta2luIE5lb3BsYXNtczwva2V5d29yZD48a2V5d29yZD5TdXJnZW9uczwva2V5d29yZD48a2V5

d29yZD5TdXJnZXJ5LCBQbGFzdGljPC9rZXl3b3JkPjxrZXl3b3JkPkJhc2FsIGNlbGwgY2FyY2lu

b21hPC9rZXl3b3JkPjxrZXl3b3JkPkNvbXBhcmF0aXZlIHN0dWR5PC9rZXl3b3JkPjxrZXl3b3Jk

PkRlcm1hdG9sb2dpc3RzPC9rZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgcHJhY3RpdGlvbmVyczwv

a2V5d29yZD48a2V5d29yZD5NYXJnaW5zIG9mIGV4Y2lzaW9uPC9rZXl3b3JkPjxrZXl3b3JkPk1l

ZGljaW5lPC9rZXl3b3JkPjxrZXl3b3JkPlBoeXNpY2lhbnM8L2tleXdvcmQ+PGtleXdvcmQ+UGxh

c3RpYyBzdXJnZW9uczwva2V5d29yZD48a2V5d29yZD5RdWFsaXR5IG9mIGhlYWx0aCBjYXJlPC9r

ZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnk8L2tleXdvcmQ+PC9rZXl3b3Jkcz48dXJscz48cmVsYXRl

ZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMzAwODY1NDE8

L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MTQyMS05ODMyPC9pc2JuPjxjdXN0b20y

PlBNQzYxNzI3OTY8L2N1c3RvbTI+PHRpdGxlcz48dGl0bGU+RGlmZmVyZW5jZXMgaW4gUmF0ZSBv

ZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9n

aXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdl

IENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5EZXJtYXRvbG9n

eTwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz44Ni05MTwvcGFnZXM+PG51bWJlcj4z

LTQ8L251bWJlcj48Y29udHJpYnV0b3JzPjxhdXRob3JzPjxhdXRob3I+UmFtZGFzLCBLLjwvYXV0

aG9yPjxhdXRob3I+dmFuIExlZSwgQy48L2F1dGhvcj48YXV0aG9yPkJlY2ssIFMuPC9hdXRob3I+

PGF1dGhvcj5CaW5kZWxzLCBQLjwvYXV0aG9yPjxhdXRob3I+Tm9vcmRob2VrIEhlZ3QsIFYuPC9h

dXRob3I+PGF1dGhvcj5QYXJkbywgTC48L2F1dGhvcj48YXV0aG9yPlZlcnNuZWwsIFMuPC9hdXRo

b3I+PGF1dGhvcj5OaWpzdGVuLCBULjwvYXV0aG9yPjxhdXRob3I+dmFuIGRlbiBCb3MsIFIuPC9h

dXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMTgvMDgvMDc8L2VkaXRp

b24+PGxhbmd1YWdlPmVuZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE2

MTIzMzQ8L2FkZGVkLWRhdGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3Jl

Zi10eXBlPjxkYXRlcz48eWVhcj4yMDE4PC95ZWFyPjwvZGF0ZXM+PHJlYy1udW1iZXI+MjM1PC9y

ZWMtbnVtYmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvbGFz

dC11cGRhdGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzAwODY1NDE8L2FjY2Vzc2lvbi1udW0+PGVs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjEwLjExNTkvMDAwNDkwMzQ0PC9lbGVjdHJvbmljLXJlc291

cmNlLW51bT48dm9sdW1lPjIzNDwvdm9sdW1lPjwvcmVjb3JkPjwvQ2l0ZT48L0VuZE5vdGU+

ADDIN EN.CITE.DATA 20, 21, 34) and GPs (23-30%PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TYWxtb248L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxJ

RFRleHQ+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9m

IHRyYWluaW5nPC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+

MjEsIDM0PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QW1idWxhdG9yeSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxrZXl3

b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tl

eXdvcmQ+PGtleXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwv

a2V5d29yZD48a2V5d29yZD5Mb2dpc3RpYyBNb2RlbHM8L2tleXdvcmQ+PGtleXdvcmQ+TmV3IFpl

YWxhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9r

ZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5j

YmkubmxtLm5paC5nb3YvcHVibWVkLzE5ODE4MDY4PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxz

Pjxpc2JuPjEzNjUtMjEzMzwvaXNibj48dGl0bGVzPjx0aXRsZT5TdXJnaWNhbCBleGNpc2lvbiBv

ZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJhaW5pbmc8L3RpdGxlPjxzZWNvbmRh

cnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4x

MTctMjI8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5TYWxtb24sIFAuPC9hdXRob3I+PGF1dGhvcj5Nb3J0aW1lciwgTi48L2F1dGhvcj48YXV0

aG9yPlJhZGVtYWtlciwgTS48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBMLjwvYXV0aG9yPjxhdXRo

b3I+U3RhbndheSwgQS48L2F1dGhvcj48YXV0aG9yPkhpbGwsIFMuPC9hdXRob3I+PC9hdXRob3Jz

PjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMDkvMTAvMTA8L2VkaXRpb24+PGxhbmd1YWdlPmVu

ZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYxMjI8L2FkZGVkLWRh

dGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVt

YmVyPjI0MzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5

NDYxMjI8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE5ODE4MDY4PC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDku

MDk1NDgueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4xNjI8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5SYW1kYXM8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFy

PjxJRFRleHQ+RGlmZmVyZW5jZXMgaW4gUmF0ZSBvZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNh

bCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9naXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQg

R2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdlIENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvSURU

ZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdl

ZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9r

ZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+Q3Jv

c3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tl

eXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3

b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJhbCBQ

cmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5N

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgRXhjaXNpb248L2tleXdvcmQ+PGtleXdv

cmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9r

ZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlb25z

PC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+QmFz

YWwgY2VsbCBjYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+Q29tcGFyYXRpdmUgc3R1ZHk8L2tl

eXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJhbCBw

cmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgZXhjaXNpb248L2tleXdv

cmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+UGh5c2ljaWFuczwva2V5d29y

ZD48a2V5d29yZD5QbGFzdGljIHN1cmdlb25zPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2Yg

aGVhbHRoIGNhcmU8L2tleXdvcmQ+PGtleXdvcmQ+U3VyZ2VyeTwva2V5d29yZD48L2tleXdvcmRz

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1

Ym1lZC8zMDA4NjU0MTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNDIxLTk4MzI8

L2lzYm4+PGN1c3RvbTI+UE1DNjE3Mjc5NjwvY3VzdG9tMj48dGl0bGVzPjx0aXRsZT5EaWZmZXJl

bmNlcyBpbiBSYXRlIG9mIENvbXBsZXRlIEV4Y2lzaW9uIG9mIEJhc2FsIENlbGwgQ2FyY2lub21h

IGJ5IERlcm1hdG9sb2dpc3RzLCBQbGFzdGljIFN1cmdlb25zIGFuZCBHZW5lcmFsIFByYWN0aXRp

b25lcnM6IEEgTGFyZ2UgQ3Jvc3MtU2VjdGlvbmFsIFN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRp

dGxlPkRlcm1hdG9sb2d5PC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjg2LTkxPC9w

YWdlcz48bnVtYmVyPjMtNDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5S

YW1kYXMsIEsuPC9hdXRob3I+PGF1dGhvcj52YW4gTGVlLCBDLjwvYXV0aG9yPjxhdXRob3I+QmVj

aywgUy48L2F1dGhvcj48YXV0aG9yPkJpbmRlbHMsIFAuPC9hdXRob3I+PGF1dGhvcj5Ob29yZGhv

ZWsgSGVndCwgVi48L2F1dGhvcj48YXV0aG9yPlBhcmRvLCBMLjwvYXV0aG9yPjxhdXRob3I+VmVy

c25lbCwgUy48L2F1dGhvcj48YXV0aG9yPk5panN0ZW4sIFQuPC9hdXRob3I+PGF1dGhvcj52YW4g

ZGVuIEJvcywgUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

OC8wOC8wNzwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTYxMjMzNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMTg8L3llYXI+PC9kYXRlcz48cmVj

LW51bWJlcj4yMzU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxNjEyMzM0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMDA4NjU0MTwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTE1OS8wMDA0OTAzNDQ8L2Vs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MjM0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjwvRW5kTm90ZT4A

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TYWxtb248L0F1dGhvcj48WWVhcj4yMDEwPC9ZZWFyPjxJ

RFRleHQ+U3VyZ2ljYWwgZXhjaXNpb24gb2Ygc2tpbiBjYW5jZXI6IHRoZSBpbXBvcnRhbmNlIG9m

IHRyYWluaW5nPC9JRFRleHQ+PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+

MjEsIDM0PC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+SmFuPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMTA8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QW1idWxhdG9yeSBTdXJnaWNhbCBQcm9jZWR1cmVzPC9rZXl3b3JkPjxrZXl3

b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tl

eXdvcmQ+PGtleXdvcmQ+RmFtaWx5IFByYWN0aWNlPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwv

a2V5d29yZD48a2V5d29yZD5Mb2dpc3RpYyBNb2RlbHM8L2tleXdvcmQ+PGtleXdvcmQ+TmV3IFpl

YWxhbmQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9rZXl3b3JkPjxr

ZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlNwZWNpYWxpemF0aW9uPC9r

ZXl3b3JkPjwva2V5d29yZHM+PHVybHM+PHJlbGF0ZWQtdXJscz48dXJsPmh0dHBzOi8vd3d3Lm5j

YmkubmxtLm5paC5nb3YvcHVibWVkLzE5ODE4MDY4PC91cmw+PC9yZWxhdGVkLXVybHM+PC91cmxz

Pjxpc2JuPjEzNjUtMjEzMzwvaXNibj48dGl0bGVzPjx0aXRsZT5TdXJnaWNhbCBleGNpc2lvbiBv

ZiBza2luIGNhbmNlcjogdGhlIGltcG9ydGFuY2Ugb2YgdHJhaW5pbmc8L3RpdGxlPjxzZWNvbmRh

cnktdGl0bGU+QnIgSiBEZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz4x

MTctMjI8L3BhZ2VzPjxudW1iZXI+MTwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1

dGhvcj5TYWxtb24sIFAuPC9hdXRob3I+PGF1dGhvcj5Nb3J0aW1lciwgTi48L2F1dGhvcj48YXV0

aG9yPlJhZGVtYWtlciwgTS48L2F1dGhvcj48YXV0aG9yPkFkYW1zLCBMLjwvYXV0aG9yPjxhdXRo

b3I+U3RhbndheSwgQS48L2F1dGhvcj48YXV0aG9yPkhpbGwsIFMuPC9hdXRob3I+PC9hdXRob3Jz

PjwvY29udHJpYnV0b3JzPjxlZGl0aW9uPjIwMDkvMTAvMTA8L2VkaXRpb24+PGxhbmd1YWdlPmVu

ZzwvbGFuZ3VhZ2U+PGFkZGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5NDYxMjI8L2FkZGVkLWRh

dGU+PHJlZi10eXBlIG5hbWU9IkpvdXJuYWwgQXJ0aWNsZSI+MTc8L3JlZi10eXBlPjxyZWMtbnVt

YmVyPjI0MzwvcmVjLW51bWJlcj48bGFzdC11cGRhdGVkLWRhdGUgZm9ybWF0PSJ1dGMiPjE1NzE5

NDYxMjI8L2xhc3QtdXBkYXRlZC1kYXRlPjxhY2Nlc3Npb24tbnVtPjE5ODE4MDY4PC9hY2Nlc3Np

b24tbnVtPjxlbGVjdHJvbmljLXJlc291cmNlLW51bT4xMC4xMTExL2ouMTM2NS0yMTMzLjIwMDku

MDk1NDgueDwvZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+PHZvbHVtZT4xNjI8L3ZvbHVtZT48L3Jl

Y29yZD48L0NpdGU+PENpdGU+PEF1dGhvcj5SYW1kYXM8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFy

PjxJRFRleHQ+RGlmZmVyZW5jZXMgaW4gUmF0ZSBvZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNh

bCBDZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9naXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQg

R2VuZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdlIENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvSURU

ZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+QWdl

ZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxsPC9r

ZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+Q3Jv

c3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tl

eXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9rZXl3

b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJhbCBQ

cmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29yZD5N

YWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgRXhjaXNpb248L2tleXdvcmQ+PGtleXdv

cmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVzPC9r

ZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlb25z

PC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+QmFz

YWwgY2VsbCBjYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+Q29tcGFyYXRpdmUgc3R1ZHk8L2tl

eXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJhbCBw

cmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgZXhjaXNpb248L2tleXdv

cmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+UGh5c2ljaWFuczwva2V5d29y

ZD48a2V5d29yZD5QbGFzdGljIHN1cmdlb25zPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkgb2Yg

aGVhbHRoIGNhcmU8L2tleXdvcmQ+PGtleXdvcmQ+U3VyZ2VyeTwva2V5d29yZD48L2tleXdvcmRz

Pjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1

Ym1lZC8zMDA4NjU0MTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNDIxLTk4MzI8

L2lzYm4+PGN1c3RvbTI+UE1DNjE3Mjc5NjwvY3VzdG9tMj48dGl0bGVzPjx0aXRsZT5EaWZmZXJl

bmNlcyBpbiBSYXRlIG9mIENvbXBsZXRlIEV4Y2lzaW9uIG9mIEJhc2FsIENlbGwgQ2FyY2lub21h

IGJ5IERlcm1hdG9sb2dpc3RzLCBQbGFzdGljIFN1cmdlb25zIGFuZCBHZW5lcmFsIFByYWN0aXRp

b25lcnM6IEEgTGFyZ2UgQ3Jvc3MtU2VjdGlvbmFsIFN0dWR5PC90aXRsZT48c2Vjb25kYXJ5LXRp

dGxlPkRlcm1hdG9sb2d5PC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjg2LTkxPC9w

YWdlcz48bnVtYmVyPjMtNDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhvcj5S

YW1kYXMsIEsuPC9hdXRob3I+PGF1dGhvcj52YW4gTGVlLCBDLjwvYXV0aG9yPjxhdXRob3I+QmVj

aywgUy48L2F1dGhvcj48YXV0aG9yPkJpbmRlbHMsIFAuPC9hdXRob3I+PGF1dGhvcj5Ob29yZGhv

ZWsgSGVndCwgVi48L2F1dGhvcj48YXV0aG9yPlBhcmRvLCBMLjwvYXV0aG9yPjxhdXRob3I+VmVy

c25lbCwgUy48L2F1dGhvcj48YXV0aG9yPk5panN0ZW4sIFQuPC9hdXRob3I+PGF1dGhvcj52YW4g

ZGVuIEJvcywgUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+MjAx

OC8wOC8wNzwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTYxMjMzNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMTg8L3llYXI+PC9kYXRlcz48cmVj

LW51bWJlcj4yMzU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4x

NTcxNjEyMzM0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMDA4NjU0MTwvYWNj

ZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTE1OS8wMDA0OTAzNDQ8L2Vs

ZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MjM0PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRl

PjwvRW5kTm90ZT4A

ADDIN EN.CITE.DATA 21, 34). Studies often concluded this difference was due to increased amount of training time of Dermatologists spend on skin cancer. Pre-operative selection may play a role in reducing Dermatologists incomplete margin rate. They generally have the greatest access to Moh’s micrographic surgery, removing the most challenging and highest risk tumours from their caseload. Indeed in one study where Moh’s micrographic surgery was being used by dermatology, they unsurprisingly reported a 0% incomplete margin ADDIN EN.CITE <EndNote><Cite><Author>Salmon</Author><Year>2010</Year><IDText>Surgical excision of skin cancer: the importance of training</IDText><DisplayText><style face="superscript">21</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2010</year></dates><keywords><keyword>Ambulatory Surgical Procedures</keyword><keyword>Clinical Competence</keyword><keyword>Dermatology</keyword><keyword>Family Practice</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>New Zealand</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Specialization</keyword></keywords><urls><related-urls><url> excision of skin cancer: the importance of training</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>117-22</pages><number>1</number><contributors><authors><author>Salmon, P.</author><author>Mortimer, N.</author><author>Rademaker, M.</author><author>Adams, L.</author><author>Stanway, A.</author><author>Hill, S.</author></authors></contributors><edition>2009/10/10</edition><language>eng</language><added-date format="utc">1571946122</added-date><ref-type name="Journal Article">17</ref-type><rec-number>243</rec-number><last-updated-date format="utc">1571946122</last-updated-date><accession-num>19818068</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09548.x</electronic-resource-num><volume>162</volume></record></Cite></EndNote>21. There is a potential for a conflict of interest in terms of reporting one’s own incomplete excision rate which may affect funding from national bodies or cause patients to seek a different specialist in a private system. While there is nothing to doubt the integrity of the above published data, there may be a publication or selection bias, where authors consciously or subconsciously wish to publish data which places their own unit in the best light and are less forthcoming on a ‘bad’ audit cycle. Role of antibiotics in ulcerated lesionsLittle is known about the use of prophylactic antibiotics in the surgical excision of non-melanoma skin cancer. Certain lesion characteristics, such as ulceration, have previously been reported as independent risk factors for post-operative wound infection ADDIN EN.CITE <EndNote><Cite><Author>Penington</Author><Year>2010</Year><IDText>Ulceration and antihypertensive use are risk factors for infection after skin lesion excision</IDText><DisplayText><style face="superscript">35</style></DisplayText><record><dates><pub-dates><date>Sep</date></pub-dates><year>2010</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Antihypertensive Agents</keyword><keyword>Australia</keyword><keyword>Follow-Up Studies</keyword><keyword>Humans</keyword><keyword>Hypertension</keyword><keyword>Incidence</keyword><keyword>Middle Aged</keyword><keyword>Prospective Studies</keyword><keyword>Risk Factors</keyword><keyword>Skin Neoplasms</keyword><keyword>Skin Ulcer</keyword><keyword>Surgical Wound Infection</keyword></keywords><urls><related-urls><url> and antihypertensive use are risk factors for infection after skin lesion excision</title><secondary-title>ANZ J Surg</secondary-title></titles><pages>642-5</pages><number>9</number><contributors><authors><author>Penington, A.</author></authors></contributors><language>eng</language><added-date format="utc">1574351559</added-date><ref-type name="Journal Article">17</ref-type><rec-number>2667</rec-number><last-updated-date format="utc">1574351559</last-updated-date><accession-num>20840409</accession-num><electronic-resource-num>10.1111/j.1445-2197.2010.05344.x</electronic-resource-num><volume>80</volume></record></Cite></EndNote>35. Despite this, a recent review of 4 RCTs on the use of prophylactic antibiotics in ulcerated BCC/SCC found a lack of high-quality evidence for their benefit ADDIN EN.CITE <EndNote><Cite><Author>Chan</Author><Year>2018</Year><IDText>Do perioperative antibiotics reduce the risk of surgical-site infections following excision of ulcerated skin cancers? A Critically Appraised Topic</IDText><DisplayText><style face="superscript">36</style></DisplayText><record><dates><pub-dates><date>02</date></pub-dates><year>2018</year></dates><keywords><keyword>Administration, Oral</keyword><keyword>Administration, Topical</keyword><keyword>Anti-Bacterial Agents</keyword><keyword>Antibiotic Prophylaxis</keyword><keyword>Humans</keyword><keyword>Injections, Intralesional</keyword><keyword>Intraoperative Care</keyword><keyword>Randomized Controlled Trials as Topic</keyword><keyword>Risk Factors</keyword><keyword>Skin Neoplasms</keyword><keyword>Skin Ulcer</keyword><keyword>Surgical Wound Infection</keyword></keywords><urls><related-urls><url> perioperative antibiotics reduce the risk of surgical-site infections following excision of ulcerated skin cancers? A Critically Appraised Topic</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>394-399</pages><number>2</number><contributors><authors><author>Chan, S. A.</author><author>Wernham, A. G. H.</author><author>Stembridge, N.</author><author>Harper, N.</author><author>Verykiou, S.</author><author>Fremlin, G. A.</author><author>Abbott, R. A.</author><author>Matin, R. N.</author></authors></contributors><edition>2018/01/18</edition><language>eng</language><added-date format="utc">1574351395</added-date><ref-type name="Journal Article">17</ref-type><rec-number>2666</rec-number><last-updated-date format="utc">1574351395</last-updated-date><accession-num>29193009</accession-num><electronic-resource-num>10.1111/bjd.16157</electronic-resource-num><volume>178</volume></record></Cite></EndNote>36. Author,Year,CountryType of study,Years of data collectionOperatorsNumber of lesionsIncomplete excision rate (%)Kumar et al. 2000, UK ADDIN EN.CITE <EndNote><Cite><Author>Kumar</Author><Year>2000</Year><IDText>Incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit</IDText><DisplayText><style face="superscript">31</style></DisplayText><record><dates><pub-dates><date>Oct</date></pub-dates><year>2000</year></dates><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Age Distribution</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Child</keyword><keyword>Clinical Competence</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Medical Audit</keyword><keyword>Medical Staff, Hospital</keyword><keyword>Middle Aged</keyword><keyword>Reoperation</keyword><keyword>Retrospective Studies</keyword><keyword>Sex Distribution</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit</title><secondary-title>Br J Plast Surg</secondary-title></titles><pages>563-6</pages><number>7</number><contributors><authors><author>Kumar, P.</author><author>Orton, C. I.</author><author>McWilliam, L. J.</author><author>Watson, S.</author></authors></contributors><language>eng</language><added-date format="utc">1571257191</added-date><ref-type name="Journal Article">17</ref-type><rec-number>230</rec-number><last-updated-date format="utc">1571257191</last-updated-date><accession-num>11000071</accession-num><electronic-resource-num>10.1054/bjps.2000.3394</electronic-resource-num><volume>53</volume></record></Cite></EndNote>31Single centre2 yearsPlastics879 BCC4.7%Fleischer et al. 2001, USAPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE.DATA 20Multi centreBetween 1 year and 5.5 years depending on centrePlastics1 459 BCC27.6%ENT46.9%Dermatology14.2%General surgery 17.9%Hallock et al. 2001, USA ADDIN EN.CITE <EndNote><Cite><Author>Hallock</Author><Year>2001</Year><IDText>A prospective study of the accuracy of the surgeon&apos;s diagnosis and significance of positive margins in nonmelanoma skin cancers</IDText><DisplayText><style face="superscript">37</style></DisplayText><record><dates><pub-dates><date>Apr</date></pub-dates><year>2001</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Dermatologic Surgical Procedures</keyword><keyword>Diagnosis, Differential</keyword><keyword>Facial Neoplasms</keyword><keyword>Follow-Up Studies</keyword><keyword>Humans</keyword><keyword>Neoplasm Invasiveness</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Neoplasm Staging</keyword><keyword>Neoplasm, Residual</keyword><keyword>Precancerous Conditions</keyword><keyword>Prospective Studies</keyword><keyword>Reoperation</keyword><keyword>Skin</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> prospective study of the accuracy of the surgeon&apos;s diagnosis and significance of positive margins in nonmelanoma skin cancers</title><secondary-title>Plast Reconstr Surg</secondary-title></titles><pages>942-7</pages><number>4</number><contributors><authors><author>Hallock, G. G.</author><author>Lutz, D. A.</author></authors></contributors><language>eng</language><added-date format="utc">1572012837</added-date><ref-type name="Journal Article">17</ref-type><rec-number>248</rec-number><last-updated-date format="utc">1572012837</last-updated-date><accession-num>11252086</accession-num><electronic-resource-num>10.1097/00006534-200104010-00006</electronic-resource-num><volume>107</volume></record></Cite></EndNote>37Single centre7.5 yearsPlastics309 BCC16.2%106 SCC14.2%Dieu et al. 2002, Australia ADDIN EN.CITE <EndNote><Cite><Author>Dieu</Author><Year>2002</Year><IDText>Incomplete excision of basal cell carcinomas: a retrospective audit</IDText><DisplayText><style face="superscript">25</style></DisplayText><record><dates><pub-dates><date>Mar</date></pub-dates><year>2002</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Australia</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Medical Audit</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Reoperation</keyword><keyword>Reproducibility of Results</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Failure</keyword></keywords><urls><related-urls><url> excision of basal cell carcinomas: a retrospective audit</title><secondary-title>ANZ J Surg</secondary-title></titles><pages>219-21</pages><number>3</number><contributors><authors><author>Dieu, T.</author><author>Macleod, A. M.</author></authors></contributors><language>eng</language><added-date format="utc">1572012895</added-date><ref-type name="Journal Article">17</ref-type><rec-number>249</rec-number><last-updated-date format="utc">1572012895</last-updated-date><accession-num>12071456</accession-num><volume>72</volume></record></Cite></EndNote>25Single centre3.5 yearsPlastics3 558 BCC6.3%Kumar et al. 2002, UK ADDIN EN.CITE <EndNote><Cite><Author>Kumar</Author><Year>2002</Year><IDText>Incomplete excision of basal cell carcinoma: a prospective multicentre audit</IDText><DisplayText><style face="superscript">32</style></DisplayText><record><dates><pub-dates><date>Dec</date></pub-dates><year>2002</year></dates><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Age Distribution</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Clinical Competence</keyword><keyword>Confounding Factors (Epidemiology)</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Medical Staff, Hospital</keyword><keyword>Middle Aged</keyword><keyword>Prospective Studies</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Recurrence</keyword><keyword>Sex Distribution</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> excision of basal cell carcinoma: a prospective multicentre audit</title><secondary-title>Br J Plast Surg</secondary-title></titles><pages>616-22</pages><number>8</number><contributors><authors><author>Kumar, P.</author><author>Watson, S.</author><author>Brain, A. N.</author><author>Davenport, P. J.</author><author>McWilliam, L. J.</author><author>Banerjee, S. S.</author><author>Bisset, D. L.</author></authors></contributors><language>eng</language><added-date format="utc">1571255755</added-date><ref-type name="Journal Article">17</ref-type><rec-number>225</rec-number><last-updated-date format="utc">1571255755</last-updated-date><accession-num>12550113</accession-num><electronic-resource-num>10.1054/bjps.2002.3948</electronic-resource-num><volume>55</volume></record></Cite></EndNote>32Regional 1 yearPlastics757 BCC4.5%Timmons et al.2002, UK ADDIN EN.CITE <EndNote><Cite><Author>Timmons</Author><Year>2002</Year><IDText>Complete excision of basal cell carcinomas</IDText><DisplayText><style face="superscript">18</style></DisplayText><record><dates><pub-dates><date>Jun</date></pub-dates><year>2002</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> excision of basal cell carcinomas</title><secondary-title>Br J Plast Surg</secondary-title></titles><pages>362</pages><number>4</number><contributors><authors><author>Timmons, M. J.</author><author>Hessel, K. C.</author><author>Kranidhiotis, N. M.</author></authors></contributors><language>eng</language><added-date format="utc">1572012933</added-date><ref-type name="Journal Article">17</ref-type><rec-number>250</rec-number><last-updated-date format="utc">1572012933</last-updated-date><accession-num>12160548</accession-num><electronic-resource-num>10.1054/bjps.2002.3849</electronic-resource-num><volume>55</volume></record></Cite></EndNote>18Single centre1 yearPlastics557 BCC3.8%Hussain et al. 2003, Ireland ADDIN EN.CITE <EndNote><Cite><Author>Hussain</Author><Year>2003</Year><IDText>The incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit</IDText><DisplayText><style face="superscript">38</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2003</year></dates><keywords><keyword>Adult</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Ireland</keyword><keyword>Male</keyword><keyword>Medical Audit</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Time Factors</keyword></keywords><urls><related-urls><url> incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit</title><secondary-title>Ir Med J</secondary-title></titles><pages>18-20</pages><number>1</number><contributors><authors><author>Hussain, M.</author><author>Earley, M. J.</author></authors></contributors><language>eng</language><added-date format="utc">1572012977</added-date><ref-type name="Journal Article">17</ref-type><rec-number>251</rec-number><last-updated-date format="utc">1572012977</last-updated-date><accession-num>12617437</accession-num><volume>96</volume></record></Cite></EndNote>38Single centre1 yearPlastics126 BCC7.9%Bogdanov-Berzovsky et al. 2004, Israel ADDIN EN.CITE <EndNote><Cite><Author>Bogdanov-Berezovsky</Author><Year>2004</Year><IDText>Risk factors for incomplete excision of basal cell carcinomas</IDText><DisplayText><style face="superscript">28</style></DisplayText><record><keywords><keyword>Aged</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Basosquamous</keyword><keyword>Cross-Sectional Studies</keyword><keyword>Facial Neoplasms</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Risk Factors</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> factors for incomplete excision of basal cell carcinomas</title><secondary-title>Acta Derm Venereol</secondary-title></titles><pages>44-7</pages><number>1</number><contributors><authors><author>Bogdanov-Berezovsky, A.</author><author>Cohen, A. D.</author><author>Glesinger, R.</author><author>Cagnano, E.</author><author>Krieger, Y.</author><author>Rosenberg, L.</author></authors></contributors><language>eng</language><added-date format="utc">1572013107</added-date><ref-type name="Journal Article">17</ref-type><dates><year>2004</year></dates><rec-number>252</rec-number><last-updated-date format="utc">1572013107</last-updated-date><accession-num>15040477</accession-num><electronic-resource-num>10.1080/00015550310020585</electronic-resource-num><volume>84</volume></record></Cite></EndNote>28Single centre4 yearsPlastics1 478 BCC10.8%Talbot et al.2004, New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Talbot</Author><Year>2004</Year><IDText>Incomplete primary excision of cutaneous basal and squamous cell carcinomas in the Bay of Plenty</IDText><DisplayText><style face="superscript">27</style></DisplayText><record><dates><pub-dates><date>Apr</date></pub-dates><year>2004</year></dates><keywords><keyword>Aged</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Basosquamous</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Educational Status</keyword><keyword>Family Practice</keyword><keyword>Female</keyword><keyword>General Surgery</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm, Residual</keyword><keyword>New Zealand</keyword><keyword>Retrospective Studies</keyword><keyword>Sex Factors</keyword><keyword>Skin</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> primary excision of cutaneous basal and squamous cell carcinomas in the Bay of Plenty</title><secondary-title>N Z Med J</secondary-title></titles><pages>U848</pages><number>1192</number><contributors><authors><author>Talbot, S.</author><author>Hitchcock, B.</author></authors></contributors><edition>2004/04/23</edition><language>eng</language><added-date format="utc">1572013162</added-date><ref-type name="Journal Article">17</ref-type><rec-number>253</rec-number><last-updated-date format="utc">1572013162</last-updated-date><accession-num>15107870</accession-num><volume>117</volume></record></Cite></EndNote>27Regional0.5 years Plastics818 NMSC11.3%General Practice1003 NMSC16%Wilson et al. 2004, UK ADDIN EN.CITE <EndNote><Cite><Author>Wilson</Author><Year>2004</Year><IDText>Surgical management of incompletely excised basal cell carcinomas of the head and neck</IDText><DisplayText><style face="superscript">26</style></DisplayText><record><dates><pub-dates><date>Aug</date></pub-dates><year>2004</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Cohort Studies</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Neoplasm, Residual</keyword><keyword>Reoperation</keyword><keyword>Retrospective Studies</keyword><keyword>Risk Factors</keyword></keywords><urls><related-urls><url> management of incompletely excised basal cell carcinomas of the head and neck</title><secondary-title>Br J Oral Maxillofac Surg</secondary-title></titles><pages>311-4</pages><number>4</number><contributors><authors><author>Wilson, A. W.</author><author>Howsam, G.</author><author>Santhanam, V.</author><author>Macpherson, D.</author><author>Grant, J.</author><author>Pratt, C. A.</author><author>Townend, J. V.</author></authors></contributors><language>eng</language><added-date format="utc">1572013254</added-date><ref-type name="Journal Article">17</ref-type><rec-number>254</rec-number><last-updated-date format="utc">1572013254</last-updated-date><accession-num>15225948</accession-num><electronic-resource-num>10.1016/j.bjoms.2004.02.030</electronic-resource-num><volume>42</volume></record></Cite></EndNote>26Regional10 yearsMaxillofacial3 795 BCC6.2%Deo et al.2005, India ADDIN EN.CITE <EndNote><Cite><Author>Deo</Author><Year>2005</Year><IDText>Surgical management of skin cancers: experience from a regional cancer centre in North India</IDText><DisplayText><style face="superscript">39</style></DisplayText><record><dates><pub-dates><date>2005 Jul-Sep</date></pub-dates><year>2005</year></dates><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Databases as Topic</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>India</keyword><keyword>Male</keyword><keyword>Medical Audit</keyword><keyword>Middle Aged</keyword><keyword>Oncology Service, Hospital</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Utilization Review</keyword></keywords><urls><related-urls><url> management of skin cancers: experience from a regional cancer centre in North India</title><secondary-title>Indian J Cancer</secondary-title></titles><pages>145-50</pages><number>3</number><contributors><authors><author>Deo, S. V.</author><author>Hazarika, S.</author><author>Shukla, N. K.</author><author>Kumar, S.</author><author>Kar, M.</author><author>Samaiya, A.</author></authors></contributors><language>eng</language><added-date format="utc">1572013323</added-date><ref-type name="Journal Article">17</ref-type><rec-number>255</rec-number><last-updated-date format="utc">1572013323</last-updated-date><accession-num>16276015</accession-num><volume>42</volume></record></Cite></EndNote>39Single centre7 yearsSurgical oncology 14 BCC0%43 SCC0%Griffiths et al. 2007, UK ADDIN EN.CITE <EndNote><Cite><Author>Griffiths</Author><Year>2007</Year><IDText>Basal cell carcinoma histological clearance margins: an analysis of 1539 conventionally excised tumours. Wider still and deeper?</IDText><DisplayText><style face="superscript">16</style></DisplayText><record><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword></keywords><urls><related-urls><url> cell carcinoma histological clearance margins: an analysis of 1539 conventionally excised tumours. Wider still and deeper?</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>41-7</pages><number>1</number><contributors><authors><author>Griffiths, R. W.</author><author>Suvarna, S. K.</author><author>Stone, J.</author></authors></contributors><edition>2006/09/01</edition><language>eng</language><added-date format="utc">1571999638</added-date><ref-type name="Journal Article">17</ref-type><dates><year>2007</year></dates><rec-number>246</rec-number><last-updated-date format="utc">1571999638</last-updated-date><accession-num>17126265</accession-num><electronic-resource-num>10.1016/j.bjps.2006.06.009</electronic-resource-num><volume>60</volume></record></Cite></EndNote>16Single centre5 yearsPlastics1 539 BCC8.4%Dhepnorrarat et al.2009, Australia ADDIN EN.CITE <EndNote><Cite><Author>Dhepnorrarat</Author><Year>2009</Year><IDText>Incompletely excised skin cancer rates: a prospective study of 31,731 skin cancer excisions by the Western Australian Society of Plastic Surgeons</IDText><DisplayText><style face="superscript">40</style></DisplayText><record><dates><pub-dates><date>Oct</date></pub-dates><year>2009</year></dates><keywords><keyword>Australia</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Skin Neoplasms</keyword><keyword>Surgery, Plastic</keyword></keywords><urls><related-urls><url> excised skin cancer rates: a prospective study of 31,731 skin cancer excisions by the Western Australian Society of Plastic Surgeons</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>1281-5</pages><number>10</number><contributors><authors><author>Dhepnorrarat, R. C.</author><author>Lee, M. A.</author><author>Mountain, J. A.</author></authors></contributors><edition>2008/08/08</edition><language>eng</language><added-date format="utc">1572013480</added-date><ref-type name="Journal Article">17</ref-type><rec-number>257</rec-number><last-updated-date format="utc">1572013480</last-updated-date><accession-num>18691954</accession-num><electronic-resource-num>10.1016/j.bjps.2008.04.028</electronic-resource-num><volume>62</volume></record></Cite></EndNote>40Regional7 yearsPlastics21 677 BCC4.0%8 355 SCC3.7%Haque Hussain et al.2009, UK ADDIN EN.CITE <EndNote><Cite><Author>Haque Hussain</Author><Year>2009</Year><IDText>Managing squamous cell carcinomas: audit on the mode of referral and adequacy of surgical excision</IDText><DisplayText><style face="superscript">41</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2009</year></dates><keywords><keyword>Carcinoma, Squamous Cell</keyword><keyword>Clinical Audit</keyword><keyword>Family Practice</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Referral and Consultation</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> squamous cell carcinomas: audit on the mode of referral and adequacy of surgical excision</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>224-5</pages><number>1</number><contributors><authors><author>Haque Hussain, S. S.</author><author>Shams, N.</author><author>Garioch, J. J.</author></authors></contributors><edition>2008/11/28</edition><language>eng</language><added-date format="utc">1572298311</added-date><ref-type name="Journal Article">17</ref-type><rec-number>271</rec-number><last-updated-date format="utc">1572298311</last-updated-date><accession-num>19067692</accession-num><electronic-resource-num>10.1111/j.1365-2133.2008.08942.x</electronic-resource-num><volume>160</volume></record></Cite></EndNote>41Single centre0.5 yearsDermatology80 SCC7.5%Plastics8.3%General Practice15 SCC43%Macbeth et al. 2009, UK ADDIN EN.CITE <EndNote><Cite><Author>Macbeth</Author><Year>2009</Year><IDText>Audit of incomplete excision rates of basal cell carcinoma: analysis of 1972 cases from four U.K. regions</IDText><DisplayText><style face="superscript">22</style></DisplayText><record><dates><pub-dates><date>Sep</date></pub-dates><year>2009</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Clinical Competence</keyword><keyword>England</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Neoplasm, Residual</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> of incomplete excision rates of basal cell carcinoma: analysis of 1972 cases from four U.K. regions</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>710-2</pages><number>3</number><contributors><authors><author>Macbeth, A. E.</author><author>Torley, D.</author><author>Casie Chetty, N.</author><author>Hepburn, N.</author><author>Hussain, K.</author><author>Blasdale, C.</author><author>von der Werth, J.</author><author>Garioch, J. J.</author><author>Levell, N. J.</author></authors></contributors><edition>2009/07/03</edition><language>eng</language><added-date format="utc">1572013556</added-date><ref-type name="Journal Article">17</ref-type><rec-number>258</rec-number><last-updated-date format="utc">1572013556</last-updated-date><accession-num>19575756</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09346.x</electronic-resource-num><volume>161</volume></record></Cite></EndNote>224 regionsBetween 1 month - 1 year per region. Totalling 3.25 years Dermatology955 BCC10%General Practice254 BCC33%Twist.2009, UK ADDIN EN.CITE <EndNote><Cite><Author>Twist</Author><Year>2009</Year><IDText>Rate of incomplete excision of basal cell carcinomas by General Practitioners with Special Interest</IDText><DisplayText><style face="superscript">23</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2009</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Dermatology</keyword><keyword>Family Practice</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Neoplasm, Residual</keyword><keyword>Skin Neoplasms</keyword><keyword>Specialization</keyword><keyword>Wales</keyword></keywords><urls><related-urls><url> of incomplete excision of basal cell carcinomas by General Practitioners with Special Interest</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>187</pages><number>1</number><contributors><authors><author>Twist, M.</author></authors></contributors><edition>2009/03/26</edition><language>eng</language><added-date format="utc">1572013772</added-date><ref-type name="Journal Article">17</ref-type><rec-number>259</rec-number><last-updated-date format="utc">1572013772</last-updated-date><accession-num>19416253</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09129.x</electronic-resource-num><volume>161</volume></record></Cite></EndNote>23Single centre3 yearsGeneral Practice (special interest)124 BCC1.6%Malik et al. 2010, Ireland ADDIN EN.CITE <EndNote><Cite><Author>Malik</Author><Year>2010</Year><IDText>Risk and outcome analysis of 1832 consecutively excised basal cell carcinomas in a tertiary referral plastic surgery unit</IDText><DisplayText><style face="superscript">15</style></DisplayText><record><dates><pub-dates><date>Dec</date></pub-dates><year>2010</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Cheek</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Nose Neoplasms</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword><keyword>Young Adult</keyword></keywords><urls><related-urls><url> and outcome analysis of 1832 consecutively excised basal cell carcinomas in a tertiary referral plastic surgery unit</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>2057-63</pages><number>12</number><contributors><authors><author>Malik, V.</author><author>Goh, K. S.</author><author>Leong, S.</author><author>Tan, A.</author><author>Downey, D.</author><author>O&apos;Donovan, D.</author></authors></contributors><edition>2010/03/11</edition><language>eng</language><added-date format="utc">1571990457</added-date><ref-type name="Journal Article">17</ref-type><rec-number>245</rec-number><last-updated-date format="utc">1571990457</last-updated-date><accession-num>20226750</accession-num><electronic-resource-num>10.1016/j.bjps.2010.01.016</electronic-resource-num><volume>63</volume></record></Cite></EndNote>15Single centre5 yearsPlastics1 832 BCC14%Salmon et al.2010, New Zealand ADDIN EN.CITE <EndNote><Cite><Author>Salmon</Author><Year>2010</Year><IDText>Surgical excision of skin cancer: the importance of training</IDText><DisplayText><style face="superscript">21</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2010</year></dates><keywords><keyword>Ambulatory Surgical Procedures</keyword><keyword>Clinical Competence</keyword><keyword>Dermatology</keyword><keyword>Family Practice</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>New Zealand</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Specialization</keyword></keywords><urls><related-urls><url> excision of skin cancer: the importance of training</title><secondary-title>Br J Dermatol</secondary-title></titles><pages>117-22</pages><number>1</number><contributors><authors><author>Salmon, P.</author><author>Mortimer, N.</author><author>Rademaker, M.</author><author>Adams, L.</author><author>Stanway, A.</author><author>Hill, S.</author></authors></contributors><edition>2009/10/10</edition><language>eng</language><added-date format="utc">1571946122</added-date><ref-type name="Journal Article">17</ref-type><rec-number>243</rec-number><last-updated-date format="utc">1571946122</last-updated-date><accession-num>19818068</accession-num><electronic-resource-num>10.1111/j.1365-2133.2009.09548.x</electronic-resource-num><volume>162</volume></record></Cite></EndNote>21Regional0.3 years Dermatology743 BCC181 SCC0% (included Moh’s)*ENT, Ophthalmology, Gen. surgeons 20%*General Practice23%*General Practice (special interest)21.5%*Seretis et al.2010, Greece ADDIN EN.CITE <EndNote><Cite><Author>Seretis</Author><Year>2010</Year><IDText>Epidemiology of surgical treatment of nonmelanoma skin cancer of the head and neck in Greece</IDText><DisplayText><style face="superscript">42</style></DisplayText><record><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Female</keyword><keyword>Greece</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword></keywords><urls><related-urls><url> of surgical treatment of nonmelanoma skin cancer of the head and neck in Greece</title><secondary-title>Dermatol Surg</secondary-title></titles><pages>15-22</pages><number>1</number><contributors><authors><author>Seretis, K.</author><author>Thomaidis, V.</author><author>Karpouzis, A.</author><author>Tamiolakis, D.</author><author>Tsamis, I.</author></authors></contributors><edition>2009/11/13</edition><language>eng</language><added-date format="utc">1571258214</added-date><ref-type name="Journal Article">17</ref-type><dates><year>2010</year></dates><rec-number>232</rec-number><last-updated-date format="utc">1571258214</last-updated-date><accession-num>19912277</accession-num><electronic-resource-num>10.1111/j.1524-4725.2009.01379.x</electronic-resource-num><volume>36</volume></record></Cite></EndNote>42Single centre2 yearsMaxillofacial 125 BCC3.3%54 SCC5.8%Delaney et al.2012, UK ADDIN EN.CITE <EndNote><Cite><Author>Delaney</Author><Year>2012</Year><IDText>Excising squamous cell carcinomas: comparing the performance of GPs, hospital skin specialists and other hospital specialists</IDText><DisplayText><style face="superscript">43</style></DisplayText><record><dates><pub-dates><date>Oct</date></pub-dates><year>2012</year></dates><keywords><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Biopsy</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Clinical Competence</keyword><keyword>Dermatology</keyword><keyword>Female</keyword><keyword>General Practice</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Medical Staff, Hospital</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Surgery, Plastic</keyword></keywords><urls><related-urls><url> squamous cell carcinomas: comparing the performance of GPs, hospital skin specialists and other hospital specialists</title><secondary-title>Fam Pract</secondary-title></titles><pages>541-6</pages><number>5</number><contributors><authors><author>Delaney, E. K.</author><author>Duckworth, L.</author><author>Thompson, W. D.</author><author>Lee, A. J.</author><author>Murchie, P.</author></authors></contributors><edition>2012/02/09</edition><language>eng</language><added-date format="utc">1572298998</added-date><ref-type name="Journal Article">17</ref-type><rec-number>272</rec-number><last-updated-date format="utc">1572298998</last-updated-date><accession-num>22321614</accession-num><electronic-resource-num>10.1093/fampra/cms007</electronic-resource-num><volume>29</volume></record></Cite></EndNote>43Regional1 yearDermatology72 SCC13.9%Plastics443 SCC12.9%General Practice207 SCC14.5%Stolle et al.2013, Denmark ADDIN EN.CITE <EndNote><Cite><Author>Stolle</Author><Year>2013</Year><IDText>A single center retrospective study on 959 excisions of non-melanoma skin cancer in 2011</IDText><DisplayText><style face="superscript">19</style></DisplayText><record><dates><pub-dates><date>Nov</date></pub-dates><year>2013</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Extremities</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Hospitalization</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm, Residual</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Retrospective Studies</keyword><keyword>Scalp</keyword><keyword>Skin Neoplasms</keyword><keyword>Torso</keyword><keyword>Tumor Burden</keyword><keyword>Young Adult</keyword></keywords><urls><related-urls><url> single center retrospective study on 959 excisions of non-melanoma skin cancer in 2011</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><pages>1630-2</pages><number>11</number><contributors><authors><author>Stolle, L. B.</author><author>Kjerkegaard, U. K.</author></authors></contributors><edition>2013/06/14</edition><language>eng</language><added-date format="utc">1571257915</added-date><ref-type name="Journal Article">17</ref-type><rec-number>231</rec-number><last-updated-date format="utc">1571257915</last-updated-date><accession-num>23751973</accession-num><electronic-resource-num>10.1016/j.bjps.2013.05.021</electronic-resource-num><volume>66</volume></record></Cite></EndNote>19Single centre1 year Plastics616 BCC9.6%179 SCCRobinson et al. 2015, UK ADDIN EN.CITE <EndNote><Cite><Author>Robinson</Author><Year>2015</Year><IDText>Histopathological variation of incompletely excised basal cell carcinoma&apos;s and the variation with the grade of surgeon - implications for revalidation</IDText><DisplayText><style face="superscript">24</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2015</year></dates><keywords><keyword>Carcinoma, Basal Cell</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Medical Audit</keyword><keyword>Medical Staff, Hospital</keyword><keyword>Neoplasm, Residual</keyword><keyword>Northern Ireland</keyword><keyword>Reoperation</keyword><keyword>Retrospective Studies</keyword><keyword>Skin Neoplasms</keyword><keyword>Surgery, Plastic</keyword><keyword>Basal Cell Carcinoma</keyword><keyword>Revalidation</keyword><keyword>Surgical outcomes</keyword></keywords><urls><related-urls><url> variation of incompletely excised basal cell carcinoma&apos;s and the variation with the grade of surgeon - implications for revalidation</title><secondary-title>Eur J Surg Oncol</secondary-title></titles><pages>165-8</pages><number>1</number><contributors><authors><author>Robinson, A. J.</author><author>Walsh, M.</author><author>Hill, C.</author></authors></contributors><edition>2014/11/06</edition><language>eng</language><added-date format="utc">1572014211</added-date><ref-type name="Journal Article">17</ref-type><rec-number>263</rec-number><last-updated-date format="utc">1572014211</last-updated-date><accession-num>25468457</accession-num><electronic-resource-num>10.1016/j.ejso.2014.10.059</electronic-resource-num><volume>41</volume></record></Cite></EndNote>24Single centre1 year Plastics392 BCC4.8%Cho et al.2016, Australia ADDIN EN.CITE <EndNote><Cite><Author>Cho</Author><Year>2016</Year><IDText>Scalp Basal Cell Carcinoma: Review of 2,202 Cases</IDText><DisplayText><style face="superscript">29</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2016</year></dates><keywords><keyword>Age Factors</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Invasiveness</keyword><keyword>Neoplasm, Residual</keyword><keyword>Retrospective Studies</keyword><keyword>Scalp</keyword><keyword>Sex Factors</keyword><keyword>Skin Neoplasms</keyword><keyword>South Australia</keyword></keywords><urls><related-urls><url> Basal Cell Carcinoma: Review of 2,202 Cases</title><secondary-title>Dermatol Surg</secondary-title></titles><pages>834-41</pages><number>7</number><contributors><authors><author>Cho, M.</author><author>Lee, J.</author><author>James, C. L.</author><author>Marshman, G.</author><author>Huilgol, S. C.</author></authors></contributors><language>eng</language><added-date format="utc">1572014245</added-date><ref-type name="Journal Article">17</ref-type><rec-number>264</rec-number><last-updated-date format="utc">1572014245</last-updated-date><accession-num>27243131</accession-num><electronic-resource-num>10.1097/DSS.0000000000000783</electronic-resource-num><volume>42</volume></record></Cite></EndNote>29Regional 5 yearsDermatology2 202 scalp BCC16%Luz et al.2016, Brazil ADDIN EN.CITE <EndNote><Cite><Author>Luz</Author><Year>2016</Year><IDText>Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma</IDText><DisplayText><style face="superscript">44</style></DisplayText><record><dates><pub-dates><date>2016 Nov-Dec</date></pub-dates><year>2016</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Algorithms</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Mohs Surgery</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Practice Guidelines as Topic</keyword><keyword>Reproducibility of Results</keyword><keyword>Risk Assessment</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword><keyword>Tumor Burden</keyword></keywords><urls><related-urls><url> of effectiveness of a surgical treatment algorithm for basal cell carcinoma</title><secondary-title>An Bras Dermatol</secondary-title></titles><pages>726-731</pages><number>6</number><contributors><authors><author>Luz, F. B.</author><author>Ferron, C.</author><author>Cardoso, G. P.</author></authors></contributors><language>eng</language><added-date format="utc">1572174571</added-date><ref-type name="Journal Article">17</ref-type><rec-number>268</rec-number><last-updated-date format="utc">1572174571</last-updated-date><accession-num>28099591</accession-num><electronic-resource-num>10.1590/abd1806-4841.20165919</electronic-resource-num><volume>91</volume></record></Cite></EndNote>44Single team1.2 yearsDermatology881 BCC4.1%Keith et al.2017, UK ADDIN EN.CITE <EndNote><Cite><Author>Keith</Author><Year>2017</Year><IDText>British Association of Dermatologists&apos; national audit on nonmelanoma skin cancer excision, 2014</IDText><DisplayText><style face="superscript">13</style></DisplayText><record><dates><pub-dates><date>Jan</date></pub-dates><year>2017</year></dates><keywords><keyword>Clinical Audit</keyword><keyword>Dermatologic Surgical Procedures</keyword><keyword>Dermatology</keyword><keyword>Diagnosis, Differential</keyword><keyword>Humans</keyword><keyword>Melanoma</keyword><keyword>Neoplasm Seeding</keyword><keyword>Prevalence</keyword><keyword>Referral and Consultation</keyword><keyword>Skin Neoplasms</keyword><keyword>Societies, Medical</keyword><keyword>United Kingdom</keyword></keywords><urls><related-urls><url> Association of Dermatologists&apos; national audit on nonmelanoma skin cancer excision, 2014</title><secondary-title>Clin Exp Dermatol</secondary-title></titles><pages>46-53</pages><number>1</number><contributors><authors><author>Keith, D. J.</author><author>de Berker, D. A.</author><author>Bray, A. P.</author><author>Cheung, S. T.</author><author>Brain, A.</author><author>Mohd Mustapa, M. F.</author></authors></contributors><language>eng</language><added-date format="utc">1571244524</added-date><ref-type name="Journal Article">17</ref-type><rec-number>224</rec-number><last-updated-date format="utc">1571244524</last-updated-date><accession-num>28028856</accession-num><electronic-resource-num>10.1111/ced.12990</electronic-resource-num><volume>42</volume></record></Cite></EndNote>13National 0.4 yearsDermatology2 167 BCC2.3%491 SCCStathopoulos et al.2017, UK ADDIN EN.CITE <EndNote><Cite><Author>Stathopoulos</Author><Year>2017</Year><IDText>Head and neck nonmelanoma cutaneous malignancy treatment in a skin cancer referral center</IDText><DisplayText><style face="superscript">30</style></DisplayText><record><dates><pub-dates><date>Feb</date></pub-dates><year>2017</year></dates><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Biopsy</keyword><keyword>Carcinoma, Basal Cell</keyword><keyword>Carcinoma, Squamous Cell</keyword><keyword>Diagnosis, Differential</keyword><keyword>Female</keyword><keyword>Head and Neck Neoplasms</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Neoplasm Metastasis</keyword><keyword>Neoplasm Recurrence, Local</keyword><keyword>Predictive Value of Tests</keyword><keyword>Reconstructive Surgical Procedures</keyword><keyword>Skin Neoplasms</keyword><keyword>Treatment Outcome</keyword></keywords><urls><related-urls><url> and neck nonmelanoma cutaneous malignancy treatment in a skin cancer referral center</title><secondary-title>Oral Surg Oral Med Oral Pathol Oral Radiol</secondary-title></titles><pages>183-187</pages><number>2</number><contributors><authors><author>Stathopoulos, P.</author><author>Igoumenakis, D.</author><author>Shuttleworth, J.</author><author>Frawley, T.</author><author>Ennis, C.</author><author>Battista, E.</author><author>Ameerally, P.</author></authors></contributors><edition>2016/10/13</edition><language>eng</language><added-date format="utc">1572014320</added-date><ref-type name="Journal Article">17</ref-type><rec-number>265</rec-number><last-updated-date format="utc">1572014320</last-updated-date><accession-num>27989709</accession-num><electronic-resource-num>10.1016/j.oooo.2016.10.004</electronic-resource-num><volume>123</volume></record></Cite></EndNote>30Single team4.8 yearsMaxillofacial178 SCC5.6%Cole et al.2018, UK ADDIN EN.CITE <EndNote><Cite><Author>Cole</Author><Year>2019</Year><IDText>High-risk basal cell carcinoma excision in primary care: a retrospective observational study of compliance with NICE guidance</IDText><DisplayText><style face="superscript">45</style></DisplayText><record><dates><pub-dates><date>02</date></pub-dates><year>2019</year></dates><keywords><keyword>dermatological tumours</keyword><keyword>histopathology</keyword><keyword>primary care</keyword><keyword>surgical pathology</keyword></keywords><urls><related-urls><url> basal cell carcinoma excision in primary care: a retrospective observational study of compliance with NICE guidance</title><secondary-title>BMJ Open</secondary-title></titles><pages>e023299</pages><number>11</number><contributors><authors><author>Cole, S. J.</author><author>Howes, R.</author><author>Meehan, C.</author><author>Cole, R.</author></authors></contributors><edition>2019/02/22</edition><language>eng</language><added-date format="utc">1572296520</added-date><ref-type name="Journal Article">17</ref-type><rec-number>270</rec-number><last-updated-date format="utc">1572296520</last-updated-date><accession-num>30798290</accession-num><electronic-resource-num>10.1136/bmjopen-2018-023299</electronic-resource-num><volume>8</volume></record></Cite></EndNote>45Two hospitalsUnclear time periodGeneral Practice (including special interest)200 BCC5.5%Ramdas et al.2018, NetherlandsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYW1kYXM8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFyPjxJ

RFRleHQ+RGlmZmVyZW5jZXMgaW4gUmF0ZSBvZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBD

ZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9naXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2Vu

ZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdlIENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjM0PC9zdHlsZT48L0Rpc3Bs

YXlUZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+

QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxs

PC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+

Q3Jvc3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8

L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJh

bCBQcmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29y

ZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgRXhjaXNpb248L2tleXdvcmQ+PGtl

eXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdl

b25zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+

QmFzYWwgY2VsbCBjYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+Q29tcGFyYXRpdmUgc3R1ZHk8

L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJh

bCBwcmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgZXhjaXNpb248L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+UGh5c2ljaWFuczwva2V5

d29yZD48a2V5d29yZD5QbGFzdGljIHN1cmdlb25zPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkg

b2YgaGVhbHRoIGNhcmU8L2tleXdvcmQ+PGtleXdvcmQ+U3VyZ2VyeTwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8zMDA4NjU0MTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNDIxLTk4

MzI8L2lzYm4+PGN1c3RvbTI+UE1DNjE3Mjc5NjwvY3VzdG9tMj48dGl0bGVzPjx0aXRsZT5EaWZm

ZXJlbmNlcyBpbiBSYXRlIG9mIENvbXBsZXRlIEV4Y2lzaW9uIG9mIEJhc2FsIENlbGwgQ2FyY2lu

b21hIGJ5IERlcm1hdG9sb2dpc3RzLCBQbGFzdGljIFN1cmdlb25zIGFuZCBHZW5lcmFsIFByYWN0

aXRpb25lcnM6IEEgTGFyZ2UgQ3Jvc3MtU2VjdGlvbmFsIFN0dWR5PC90aXRsZT48c2Vjb25kYXJ5

LXRpdGxlPkRlcm1hdG9sb2d5PC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjg2LTkx

PC9wYWdlcz48bnVtYmVyPjMtNDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5SYW1kYXMsIEsuPC9hdXRob3I+PGF1dGhvcj52YW4gTGVlLCBDLjwvYXV0aG9yPjxhdXRob3I+

QmVjaywgUy48L2F1dGhvcj48YXV0aG9yPkJpbmRlbHMsIFAuPC9hdXRob3I+PGF1dGhvcj5Ob29y

ZGhvZWsgSGVndCwgVi48L2F1dGhvcj48YXV0aG9yPlBhcmRvLCBMLjwvYXV0aG9yPjxhdXRob3I+

VmVyc25lbCwgUy48L2F1dGhvcj48YXV0aG9yPk5panN0ZW4sIFQuPC9hdXRob3I+PGF1dGhvcj52

YW4gZGVuIEJvcywgUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+

MjAxOC8wOC8wNzwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5h

bCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMTg8L3llYXI+PC9kYXRlcz48

cmVjLW51bWJlcj4yMzU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxNjEyMzM0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMDA4NjU0MTwv

YWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTE1OS8wMDA0OTAzNDQ8

L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MjM0PC92b2x1bWU+PC9yZWNvcmQ+PC9D

aXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYW1kYXM8L0F1dGhvcj48WWVhcj4yMDE4PC9ZZWFyPjxJ

RFRleHQ+RGlmZmVyZW5jZXMgaW4gUmF0ZSBvZiBDb21wbGV0ZSBFeGNpc2lvbiBvZiBCYXNhbCBD

ZWxsIENhcmNpbm9tYSBieSBEZXJtYXRvbG9naXN0cywgUGxhc3RpYyBTdXJnZW9ucyBhbmQgR2Vu

ZXJhbCBQcmFjdGl0aW9uZXJzOiBBIExhcmdlIENyb3NzLVNlY3Rpb25hbCBTdHVkeTwvSURUZXh0

PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3JpcHQiPjM0PC9zdHlsZT48L0Rpc3Bs

YXlUZXh0PjxyZWNvcmQ+PGtleXdvcmRzPjxrZXl3b3JkPkFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+

QWdlZCwgODAgYW5kIG92ZXI8L2tleXdvcmQ+PGtleXdvcmQ+Q2FyY2lub21hLCBCYXNhbCBDZWxs

PC9rZXl3b3JkPjxrZXl3b3JkPkNsaW5pY2FsIENvbXBldGVuY2U8L2tleXdvcmQ+PGtleXdvcmQ+

Q3Jvc3MtU2VjdGlvbmFsIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8

L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RmVtYWxlPC9r

ZXl3b3JkPjxrZXl3b3JkPkdlbmVyYWwgUHJhY3RpY2U8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJh

bCBQcmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPkh1bWFuczwva2V5d29yZD48a2V5d29y

ZD5NYWxlPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgRXhjaXNpb248L2tleXdvcmQ+PGtl

eXdvcmQ+TWlkZGxlIEFnZWQ8L2tleXdvcmQ+PGtleXdvcmQ+UmV0cm9zcGVjdGl2ZSBTdHVkaWVz

PC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdl

b25zPC9rZXl3b3JkPjxrZXl3b3JkPlN1cmdlcnksIFBsYXN0aWM8L2tleXdvcmQ+PGtleXdvcmQ+

QmFzYWwgY2VsbCBjYXJjaW5vbWE8L2tleXdvcmQ+PGtleXdvcmQ+Q29tcGFyYXRpdmUgc3R1ZHk8

L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2lzdHM8L2tleXdvcmQ+PGtleXdvcmQ+R2VuZXJh

bCBwcmFjdGl0aW9uZXJzPC9rZXl3b3JkPjxrZXl3b3JkPk1hcmdpbnMgb2YgZXhjaXNpb248L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+UGh5c2ljaWFuczwva2V5

d29yZD48a2V5d29yZD5QbGFzdGljIHN1cmdlb25zPC9rZXl3b3JkPjxrZXl3b3JkPlF1YWxpdHkg

b2YgaGVhbHRoIGNhcmU8L2tleXdvcmQ+PGtleXdvcmQ+U3VyZ2VyeTwva2V5d29yZD48L2tleXdv

cmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292

L3B1Ym1lZC8zMDA4NjU0MTwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xNDIxLTk4

MzI8L2lzYm4+PGN1c3RvbTI+UE1DNjE3Mjc5NjwvY3VzdG9tMj48dGl0bGVzPjx0aXRsZT5EaWZm

ZXJlbmNlcyBpbiBSYXRlIG9mIENvbXBsZXRlIEV4Y2lzaW9uIG9mIEJhc2FsIENlbGwgQ2FyY2lu

b21hIGJ5IERlcm1hdG9sb2dpc3RzLCBQbGFzdGljIFN1cmdlb25zIGFuZCBHZW5lcmFsIFByYWN0

aXRpb25lcnM6IEEgTGFyZ2UgQ3Jvc3MtU2VjdGlvbmFsIFN0dWR5PC90aXRsZT48c2Vjb25kYXJ5

LXRpdGxlPkRlcm1hdG9sb2d5PC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjg2LTkx

PC9wYWdlcz48bnVtYmVyPjMtNDwvbnVtYmVyPjxjb250cmlidXRvcnM+PGF1dGhvcnM+PGF1dGhv

cj5SYW1kYXMsIEsuPC9hdXRob3I+PGF1dGhvcj52YW4gTGVlLCBDLjwvYXV0aG9yPjxhdXRob3I+

QmVjaywgUy48L2F1dGhvcj48YXV0aG9yPkJpbmRlbHMsIFAuPC9hdXRob3I+PGF1dGhvcj5Ob29y

ZGhvZWsgSGVndCwgVi48L2F1dGhvcj48YXV0aG9yPlBhcmRvLCBMLjwvYXV0aG9yPjxhdXRob3I+

VmVyc25lbCwgUy48L2F1dGhvcj48YXV0aG9yPk5panN0ZW4sIFQuPC9hdXRob3I+PGF1dGhvcj52

YW4gZGVuIEJvcywgUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+PGVkaXRpb24+

MjAxOC8wOC8wNzwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBm

b3JtYXQ9InV0YyI+MTU3MTYxMjMzNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5h

bCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PGRhdGVzPjx5ZWFyPjIwMTg8L3llYXI+PC9kYXRlcz48

cmVjLW51bWJlcj4yMzU8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRj

Ij4xNTcxNjEyMzM0PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4zMDA4NjU0MTwv

YWNjZXNzaW9uLW51bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTE1OS8wMDA0OTAzNDQ8

L2VsZWN0cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+MjM0PC92b2x1bWU+PC9yZWNvcmQ+PC9D

aXRlPjwvRW5kTm90ZT5=

ADDIN EN.CITE.DATA 34Regional6 yearsPlastics1 040 BCC17%Dermatology1 015 BCC7%General Practice 931 BCC30%Keith et al.2019, UK ADDIN EN.CITE <EndNote><Cite><Author>Keith</Author><Year>2019</Year><IDText>British Association of Dermatologists (BAD) National Audit on Non-Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists</IDText><DisplayText><style face="superscript">14</style></DisplayText><record><dates><pub-dates><date>Jul</date></pub-dates><year>2019</year></dates><urls><related-urls><url> Association of Dermatologists (BAD) National Audit on Non-Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists</title><secondary-title>Clin Exp Dermatol</secondary-title></titles><contributors><authors><author>Keith, D. J.</author><author>Bray, A. P.</author><author>Brain, A.</author><author>Mohd Mustapa, M. F.</author><author>Barrett, H. E.</author><author>Lane, S.</author><author>Emmerich, M.</author><author>Jakes, A.</author><author>Barrett, P. D.</author><author>de Berker, D. A. R.</author></authors></contributors><edition>2019/07/02</edition><language>eng</language><added-date format="utc">1571244524</added-date><ref-type name="Journal Article">17</ref-type><rec-number>223</rec-number><last-updated-date format="utc">1571244524</last-updated-date><accession-num>31265150</accession-num><electronic-resource-num>10.1111/ced.14034</electronic-resource-num></record></Cite></EndNote>14National 0.4 yearsDermatology2162 BCC3.0%882 SCCKiely et al.2019, UK ADDIN EN.CITE <EndNote><Cite><Author>Kiely</Author><Year>2019</Year><IDText>A retrospective study of 694 Basal Cell Carcinoma excisions to quantify deep margin documentation and clearance compared to histological type and surgical margin</IDText><DisplayText><style face="superscript">33</style></DisplayText><record><dates><pub-dates><date>Jun</date></pub-dates><year>2019</year></dates><keywords><keyword>BCC</keyword><keyword>Skin biopsy</keyword><keyword>Skin cancer</keyword><keyword>Surgical excision</keyword></keywords><urls><related-urls><url> retrospective study of 694 Basal Cell Carcinoma excisions to quantify deep margin documentation and clearance compared to histological type and surgical margin</title><secondary-title>J Plast Reconstr Aesthet Surg</secondary-title></titles><contributors><authors><author>Kiely, J. R.</author><author>Patel, A. J. K.</author></authors></contributors><edition>2019/06/27</edition><language>eng</language><added-date format="utc">1571628129</added-date><ref-type name="Journal Article">17</ref-type><rec-number>242</rec-number><last-updated-date format="utc">1571628129</last-updated-date><accession-num>31331722</accession-num><electronic-resource-num>10.1016/j.bjps.2019.06.002</electronic-resource-num></record></Cite></EndNote>33Single centre1.3 yearsPlastics694 BCC6.4%TotalsMeanMedianBCC - Dermatology 7.1%5.6%BCC - Plastics9.7%7.9%BCC - General Practice17.5%17.8%BCC - total11.1%7%SCC - Dermatology6.7%5.3%SCC - Plastics9.7%9.6%SCC - General Practice25.5%22.3%SCC - total11.8%9.0%Table SEQ Table \* ARABIC 1: Published studies of non-melanoma skin cancer since 2000 and their incomplete excision rate. Abbreviations used are NMSC = non-melanoma skin cancer, BCC = basal cell carcinoma, SCC= squamous cell carcinoma, UK = United Kingdom, USA = United States of America. * represents incomplete excision margin for all malignant lesions including melanomaAims, objectives, rationale and hypothesis To conduct a national audit of the treatment of non-melanoma skin cancer by Plastic Surgery units within the UK. This will establish the incomplete excision rate, early complications (bleeding, infection, graft/flap failure) and further management of incomplete excisions (re-excision, referral for radiotherapy) on a national scale. We hypothesize that Plastic Surgeons are treating a different subset of patients to Dermatology in the UK in terms of 1) lesion size, 2) histological subtype, 3) cosmetically sensitive areas 4) and utilising different reconstructions. We hypothesize that these will affect the incomplete excision rate causing it to be higher than that observed by UK Dermatologists.This study will allow patients to be better streamed to appropriate services and would enable more accurate information during counselling about the risks of incomplete excision or other complications.MethodsAchieving nation-wide data collection In order to recruit all Plastic Surgery units in the UK, a trainee collaborative approach will be used. The NMSC: PlastUK Collaborative is a group of trainees recruited from the Reconstructive Surgery Trials Network. The Reconstructive Surgery Trials Network is the UK clinical trials network for plastic and hand surgery. Collaborators will be asked to collect prospective data on non-melanoma skin cancer excisions during a 2.5 month period (16th March to 31st May 2020). Patients will be followed up to their first clinic appointment (up to 3 months later). Each patient’s data will be input to a secure database, hosted by REDCap system. In total, 50 Plastic Surgery units have been identified, and collaborators are expected to be recruited from >95% of these units. Units will additionally be contacted through other means such as via the British Association of Plastic Aesthetic and Reconstructive Surgeons (BAPRAS) and directly through email. Audit design This audit will compare the incomplete excision rate in UK Plastic Surgery units to the world-wide published data already discussed (BCC 7% median or 11% mean, SCC 9% median or 12% mean) and to a systematic review of this which is currently underway. To allow direct comparison of between Plastic Surgery units and Dermatology, the data collection will be based primarily on the two previous national Dermatology auditsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5LZWl0aDwvQXV0aG9yPjxZZWFyPjIwMTc8L1llYXI+PElE

VGV4dD5Ccml0aXNoIEFzc29jaWF0aW9uIG9mIERlcm1hdG9sb2dpc3RzJmFwb3M7IG5hdGlvbmFs

IGF1ZGl0IG9uIG5vbm1lbGFub21hIHNraW4gY2FuY2VyIGV4Y2lzaW9uLCAyMDE0PC9JRFRleHQ+

PERpc3BsYXlUZXh0PjxzdHlsZSBmYWNlPSJzdXBlcnNjcmlwdCI+MTMsIDE0PC9zdHlsZT48L0Rp

c3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRhdGU+SmFuPC9kYXRlPjwvcHVi

LWRhdGVzPjx5ZWFyPjIwMTc8L3llYXI+PC9kYXRlcz48a2V5d29yZHM+PGtleXdvcmQ+Q2xpbmlj

YWwgQXVkaXQ8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ2ljIFN1cmdpY2FsIFByb2NlZHVy

ZXM8L2tleXdvcmQ+PGtleXdvcmQ+RGVybWF0b2xvZ3k8L2tleXdvcmQ+PGtleXdvcmQ+RGlhZ25v

c2lzLCBEaWZmZXJlbnRpYWw8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3

b3JkPk1lbGFub21hPC9rZXl3b3JkPjxrZXl3b3JkPk5lb3BsYXNtIFNlZWRpbmc8L2tleXdvcmQ+

PGtleXdvcmQ+UHJldmFsZW5jZTwva2V5d29yZD48a2V5d29yZD5SZWZlcnJhbCBhbmQgQ29uc3Vs

dGF0aW9uPC9rZXl3b3JkPjxrZXl3b3JkPlNraW4gTmVvcGxhc21zPC9rZXl3b3JkPjxrZXl3b3Jk

PlNvY2lldGllcywgTWVkaWNhbDwva2V5d29yZD48a2V5d29yZD5Vbml0ZWQgS2luZ2RvbTwva2V5

d29yZD48L2tleXdvcmRzPjx1cmxzPjxyZWxhdGVkLXVybHM+PHVybD5odHRwczovL3d3dy5uY2Jp

Lm5sbS5uaWguZ292L3B1Ym1lZC8yODAyODg1NjwvdXJsPjwvcmVsYXRlZC11cmxzPjwvdXJscz48

aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+QnJpdGlzaCBBc3NvY2lhdGlvbiBv

ZiBEZXJtYXRvbG9naXN0cyZhcG9zOyBuYXRpb25hbCBhdWRpdCBvbiBub25tZWxhbm9tYSBza2lu

IGNhbmNlciBleGNpc2lvbiwgMjAxNDwvdGl0bGU+PHNlY29uZGFyeS10aXRsZT5DbGluIEV4cCBE

ZXJtYXRvbDwvc2Vjb25kYXJ5LXRpdGxlPjwvdGl0bGVzPjxwYWdlcz40Ni01MzwvcGFnZXM+PG51

bWJlcj4xPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBK

LjwvYXV0aG9yPjxhdXRob3I+ZGUgQmVya2VyLCBELiBBLjwvYXV0aG9yPjxhdXRob3I+QnJheSwg

QS4gUC48L2F1dGhvcj48YXV0aG9yPkNoZXVuZywgUy4gVC48L2F1dGhvcj48YXV0aG9yPkJyYWlu

LCBBLjwvYXV0aG9yPjxhdXRob3I+TW9oZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjwvYXV0aG9y

cz48L2NvbnRyaWJ1dG9ycz48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRkZWQtZGF0ZSBmb3Jt

YXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFtZT0iSm91cm5hbCBB

cnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjI0PC9yZWMtbnVtYmVyPjxsYXN0LXVw

ZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRhdGVkLWRhdGU+PGFj

Y2Vzc2lvbi1udW0+MjgwMjg4NTY8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9uaWMtcmVzb3VyY2Ut

bnVtPjEwLjExMTEvY2VkLjEyOTkwPC9lbGVjdHJvbmljLXJlc291cmNlLW51bT48dm9sdW1lPjQy

PC92b2x1bWU+PC9yZWNvcmQ+PC9DaXRlPjxDaXRlPjxBdXRob3I+S2VpdGg8L0F1dGhvcj48WWVh

cj4yMDE5PC9ZZWFyPjxJRFRleHQ+QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0

cyAoQkFEKSBOYXRpb25hbCBBdWRpdCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNp

b24gMjAxNiBpbiBjb2xsYWJvcmF0aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9s

b2dpc3RzPC9JRFRleHQ+PHJlY29yZD48ZGF0ZXM+PHB1Yi1kYXRlcz48ZGF0ZT5KdWw8L2RhdGU+

PC9wdWItZGF0ZXM+PHllYXI+MjAxOTwveWVhcj48L2RhdGVzPjx1cmxzPjxyZWxhdGVkLXVybHM+

PHVybD5odHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8zMTI2NTE1MDwvdXJsPjwv

cmVsYXRlZC11cmxzPjwvdXJscz48aXNibj4xMzY1LTIyMzA8L2lzYm4+PHRpdGxlcz48dGl0bGU+

QnJpdGlzaCBBc3NvY2lhdGlvbiBvZiBEZXJtYXRvbG9naXN0cyAoQkFEKSBOYXRpb25hbCBBdWRp

dCBvbiBOb24tTWVsYW5vbWEgU2tpbiBDYW5jZXIgRXhjaXNpb24gMjAxNiBpbiBjb2xsYWJvcmF0

aW9uIHdpdGggdGhlIFJveWFsIENvbGxlZ2Ugb2YgUGF0aG9sb2dpc3RzPC90aXRsZT48c2Vjb25k

YXJ5LXRpdGxlPkNsaW4gRXhwIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PGNv

bnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPktlaXRoLCBELiBKLjwvYXV0aG9yPjxhdXRob3I+

QnJheSwgQS4gUC48L2F1dGhvcj48YXV0aG9yPkJyYWluLCBBLjwvYXV0aG9yPjxhdXRob3I+TW9o

ZCBNdXN0YXBhLCBNLiBGLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgSC4gRS48L2F1dGhvcj48

YXV0aG9yPkxhbmUsIFMuPC9hdXRob3I+PGF1dGhvcj5FbW1lcmljaCwgTS48L2F1dGhvcj48YXV0

aG9yPkpha2VzLCBBLjwvYXV0aG9yPjxhdXRob3I+QmFycmV0dCwgUC4gRC48L2F1dGhvcj48YXV0

aG9yPmRlIEJlcmtlciwgRC4gQS4gUi48L2F1dGhvcj48L2F1dGhvcnM+PC9jb250cmlidXRvcnM+

PGVkaXRpb24+MjAxOS8wNy8wMjwvZWRpdGlvbj48bGFuZ3VhZ2U+ZW5nPC9sYW5ndWFnZT48YWRk

ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvYWRkZWQtZGF0ZT48cmVmLXR5cGUgbmFt

ZT0iSm91cm5hbCBBcnRpY2xlIj4xNzwvcmVmLXR5cGU+PHJlYy1udW1iZXI+MjIzPC9yZWMtbnVt

YmVyPjxsYXN0LXVwZGF0ZWQtZGF0ZSBmb3JtYXQ9InV0YyI+MTU3MTI0NDUyNDwvbGFzdC11cGRh

dGVkLWRhdGU+PGFjY2Vzc2lvbi1udW0+MzEyNjUxNTA8L2FjY2Vzc2lvbi1udW0+PGVsZWN0cm9u

aWMtcmVzb3VyY2UtbnVtPjEwLjExMTEvY2VkLjE0MDM0PC9lbGVjdHJvbmljLXJlc291cmNlLW51

bT48L3JlY29yZD48L0NpdGU+PC9FbmROb3RlPgB=

ADDIN EN.CITE.DATA 13, 14 with only minor alterations. The alterations will be 1) not record risk for bleeding, risk for infection, cardiac devices or other risks, as this data was not published in the previous national Dermatology audits 2) record actual measurements of margins (rather than a range) which will allow more detailed analysis 3) additional data will be collected on the presence of lesion ulceration, the use of prophylactic antibiotics and if patients are referred on for further treatment (re-excision or radiotherapy). See table 1 and Data collection sheet v2.3 for details. Inclusion and exclusion criteria All adult patients who had a pre-operative diagnosis of non-melanoma skin cancer and undergo surgical excision will be included. Those undergoing excision via Moh’s micrographic surgery or with intra-operative frozen section will be excluded, as will incision, shave or punch biopsies. Ethics Ethics approval is not required, as the project will be classified as audit and will not involve access to sensitive or identifiable information. This was confirmed using the HRA decision tool ADDIN EN.CITE <EndNote><Cite><Author>Health Research Authority</Author><Year>2019</Year><IDText>Do I need NHS Ethics approval?</IDText><DisplayText><style face="superscript">46</style></DisplayText><record><urls><related-urls><url> I need NHS Ethics approval?</title></titles><contributors><authors><author>Health Research Authority,</author><author>Medical Research Council,</author></authors></contributors><added-date format="utc">1572970182</added-date><ref-type name="Web Page">12</ref-type><dates><year>2019</year></dates><rec-number>273</rec-number><last-updated-date format="utc">1572970244</last-updated-date></record></Cite></EndNote>46.Statistical analysis Statistical analysis will be performed comparing the novel data to the previous Dermatology audits. Group differences in continuous variables will be evaluated using the Mann-Whitney U test and Students t-test depending on data distribution. Group differences in nominal data will be analysed using Fisher’s exact test or Pearson’s chi-square test. Significance will be set at the level of p≤0.05. Statistical analysis will be carried out in SPSS version 25 (IBM, USA). Definitions A lesion will be considered incompletely excised if residual tumour is found at either the peripheral or deep margin. ‘Closely’ or ‘near to’ excised lesions will be considered as fully excised in line with previous studies and recorded as suchPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GbGVpc2NoZXI8L0F1dGhvcj48WWVhcj4yMDAxPC9ZZWFy

PjxJRFRleHQ+VGhlIHNwZWNpYWx0eSBvZiB0aGUgdHJlYXRpbmcgcGh5c2ljaWFuIGFmZmVjdHMg

dGhlIGxpa2VsaWhvb2Qgb2YgdHVtb3ItZnJlZSByZXNlY3Rpb24gbWFyZ2lucyBmb3IgYmFzYWwg

Y2VsbCBjYXJjaW5vbWE6IHJlc3VsdHMgZnJvbSBhIG11bHRpLWluc3RpdHV0aW9uYWwgcmV0cm9z

cGVjdGl2ZSBzdHVkeTwvSURUZXh0PjxEaXNwbGF5VGV4dD48c3R5bGUgZmFjZT0ic3VwZXJzY3Jp

cHQiPjIwPC9zdHlsZT48L0Rpc3BsYXlUZXh0PjxyZWNvcmQ+PGRhdGVzPjxwdWItZGF0ZXM+PGRh

dGU+RmViPC9kYXRlPjwvcHViLWRhdGVzPjx5ZWFyPjIwMDE8L3llYXI+PC9kYXRlcz48a2V5d29y

ZHM+PGtleXdvcmQ+QWdlZDwva2V5d29yZD48a2V5d29yZD5DYXJjaW5vbWEsIEJhc2FsIENlbGw8

L2tleXdvcmQ+PGtleXdvcmQ+Q2xpbmljYWwgQ29tcGV0ZW5jZTwva2V5d29yZD48a2V5d29yZD5G

ZW1hbGU8L2tleXdvcmQ+PGtleXdvcmQ+SHVtYW5zPC9rZXl3b3JkPjxrZXl3b3JkPk1hbGU8L2tl

eXdvcmQ+PGtleXdvcmQ+TWVkaWNpbmU8L2tleXdvcmQ+PGtleXdvcmQ+TWlkZGxlIEFnZWQ8L2tl

eXdvcmQ+PGtleXdvcmQ+TmVvcGxhc20sIFJlc2lkdWFsPC9rZXl3b3JkPjxrZXl3b3JkPk9kZHMg

UmF0aW88L2tleXdvcmQ+PGtleXdvcmQ+UXVhbGl0eSBvZiBIZWFsdGggQ2FyZTwva2V5d29yZD48

a2V5d29yZD5SZXRyb3NwZWN0aXZlIFN0dWRpZXM8L2tleXdvcmQ+PGtleXdvcmQ+U2tpbiBOZW9w

bGFzbXM8L2tleXdvcmQ+PGtleXdvcmQ+U3BlY2lhbGl6YXRpb248L2tleXdvcmQ+PC9rZXl3b3Jk

cz48dXJscz48cmVsYXRlZC11cmxzPjx1cmw+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9w

dWJtZWQvMTExNzQzNzk8L3VybD48L3JlbGF0ZWQtdXJscz48L3VybHM+PGlzYm4+MDE5MC05NjIy

PC9pc2JuPjx0aXRsZXM+PHRpdGxlPlRoZSBzcGVjaWFsdHkgb2YgdGhlIHRyZWF0aW5nIHBoeXNp

Y2lhbiBhZmZlY3RzIHRoZSBsaWtlbGlob29kIG9mIHR1bW9yLWZyZWUgcmVzZWN0aW9uIG1hcmdp

bnMgZm9yIGJhc2FsIGNlbGwgY2FyY2lub21hOiByZXN1bHRzIGZyb20gYSBtdWx0aS1pbnN0aXR1

dGlvbmFsIHJldHJvc3BlY3RpdmUgc3R1ZHk8L3RpdGxlPjxzZWNvbmRhcnktdGl0bGU+SiBBbSBB

Y2FkIERlcm1hdG9sPC9zZWNvbmRhcnktdGl0bGU+PC90aXRsZXM+PHBhZ2VzPjIyNC0zMDwvcGFn

ZXM+PG51bWJlcj4yPC9udW1iZXI+PGNvbnRyaWJ1dG9ycz48YXV0aG9ycz48YXV0aG9yPkZsZWlz

Y2hlciwgQS4gQi48L2F1dGhvcj48YXV0aG9yPkZlbGRtYW4sIFMuIFIuPC9hdXRob3I+PGF1dGhv

cj5CYXJsb3csIEouIE8uPC9hdXRob3I+PGF1dGhvcj5aaGVuZywgQi48L2F1dGhvcj48YXV0aG9y

PkhhaG4sIEguIEIuPC9hdXRob3I+PGF1dGhvcj5DaHVhbmcsIFQuIFkuPC9hdXRob3I+PGF1dGhv

cj5EcmFmdCwgSy4gUy48L2F1dGhvcj48YXV0aG9yPkdvbGl0eiwgTC4gRS48L2F1dGhvcj48YXV0

aG9yPld1LCBFLjwvYXV0aG9yPjxhdXRob3I+S2F0eiwgQS4gUy48L2F1dGhvcj48YXV0aG9yPk1h

aXplLCBKLiBDLjwvYXV0aG9yPjxhdXRob3I+S25hcHAsIFQuPC9hdXRob3I+PGF1dGhvcj5MZXNo

aW4sIEIuPC9hdXRob3I+PC9hdXRob3JzPjwvY29udHJpYnV0b3JzPjxsYW5ndWFnZT5lbmc8L2xh

bmd1YWdlPjxhZGRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2PC9hZGRlZC1kYXRlPjxy

ZWYtdHlwZSBuYW1lPSJKb3VybmFsIEFydGljbGUiPjE3PC9yZWYtdHlwZT48cmVjLW51bWJlcj4y

NDc8L3JlYy1udW1iZXI+PGxhc3QtdXBkYXRlZC1kYXRlIGZvcm1hdD0idXRjIj4xNTcyMDEyNzM2

PC9sYXN0LXVwZGF0ZWQtZGF0ZT48YWNjZXNzaW9uLW51bT4xMTE3NDM3OTwvYWNjZXNzaW9uLW51

bT48ZWxlY3Ryb25pYy1yZXNvdXJjZS1udW0+MTAuMTA2Ny9tamQuMjAwMS4xMTAzOTY8L2VsZWN0

cm9uaWMtcmVzb3VyY2UtbnVtPjx2b2x1bWU+NDQ8L3ZvbHVtZT48L3JlY29yZD48L0NpdGU+PC9F

bmROb3RlPgB=

ADDIN EN.CITE.DATA 20. -376555479425Table 2: Data collection fields used to collect data by trainees in Plastic Surgery units in the UK. Primarily based on the previous UK national Dermatology audits. Patient demographicsDemographics Age, genderNumber of lesions being excised Pre-operative details Clinical diagnosis (BCC vs SCC)Biopsy proven?Presence of ulceration Body siteIf < 10mm from previous treatment scar (for recurrence)Primary or re-excisionOperation detailsDate of surgery Prophylactic antibiotic usePlanned clinical margin Peripheral, deep, not statedType of immediate reconstructionLeft open (or delayed reconstruction), direct closure, full-thickness skin graft, split-thickness skin graft, flap Histological detailsBCC, SCC, Bowens, Actinic Keratosis, Melanoma, Benign, OtherSubtype of BCCLargest tumour diameter (mm)Margins Peripheral margin (mm)Deep margin (mm)Involved? At which margin?ComplicationsBleeding Infection Graft/flap failure for other reason Further treatmentNo further treatment plannedClinical surveillanceListed for re-excision Referral for radiotherapy Discharged from Plastic Surgery 00Table 2: Data collection fields used to collect data by trainees in Plastic Surgery units in the UK. Primarily based on the previous UK national Dermatology audits. Patient demographicsDemographics Age, genderNumber of lesions being excised Pre-operative details Clinical diagnosis (BCC vs SCC)Biopsy proven?Presence of ulceration Body siteIf < 10mm from previous treatment scar (for recurrence)Primary or re-excisionOperation detailsDate of surgery Prophylactic antibiotic usePlanned clinical margin Peripheral, deep, not statedType of immediate reconstructionLeft open (or delayed reconstruction), direct closure, full-thickness skin graft, split-thickness skin graft, flap Histological detailsBCC, SCC, Bowens, Actinic Keratosis, Melanoma, Benign, OtherSubtype of BCCLargest tumour diameter (mm)Margins Peripheral margin (mm)Deep margin (mm)Involved? At which margin?ComplicationsBleeding Infection Graft/flap failure for other reason Further treatmentNo further treatment plannedClinical surveillanceListed for re-excision Referral for radiotherapy Discharged from Plastic Surgery In terms of complications, ‘bleeding’ will be defined as requiring return to theatre or consultation with healthcare professional due to this (includes GP/A&E who may apply direct pressure only). ‘Infection’ will be defined as requiring antibiotics, causing wound dehiscence or graft/flap failure. ‘Listed for re-excision’ will only be those patients who after discussion were formally re-listed. If patients will be monitored then they will not be included, also those who declined further surgery will not be included, but in both instances the numbers will be recorded. 4564050-32600300Data collection sheet v2.3QuestionResponsesDemographicsAgeGenderHow many suspected non-melanoma skin cancer lesions are being excised?1, 2, 3, 4, 5If 2 or more is selected, then all questions below will be repeated for the 2nd, 3rd lesions etcPre-op diagnosis (from Plastic Surgery)BCCSCCUnknown or biopsy provenIs the lesion ulcerated? Yes, No, Unknown Body siteHead and neckScalpPeriocular, temple, forehead or eyebrowCheek or chin Ear (or within 2cm)Nose (or within 1cm) or lipsNeckTrunkLimbHand or footGenitalia, perineum or perianal areaUnknown Is this area within 10mm of a previous treatment scar?Yes, No, Unknown Type of excisionDate of surgery PrimaryRe-excision Unknown Planned clinical margin from op notePeripheral (mm or unknown)Deep (mm, tissue layer or unknown)Type of immediate reconstructionLeft open (or delayed reconstruction) Direct closureSkin graftFull thickness skin graftSplit thickness skin graftUnknownFlap Unknown Did the patient receive prophylactic antibiotics? At inductionYes, No, UnknownPost-opYes, No, Unknown Histological diagnosisBCCSubtypes – can select more than one if mixedNodularInfiltrativeSuperficialMicronodularMorpheaformSclerosingAdenoidFibroepithliomatousOtherUnknownSCCActinic keratosisBowen’s DiseaseMelanomaBenign – therefore skip next 2 questions OtherLargest tumour diameterSize in mm (or unknown)Margins (from histology report)Peripheral (mm or involved)Deep margin (mm or involved) Complications Definitions above NoneBleedingInfectionGraft/flap failure for other reasonsOtherUnknown / patient not followed upFurther treatmentListed for re-excision Yes, No, UnknownReferral for radiotherapyYes, No, Unknown Discharged from Plastic Surgery?4484536-41346800References ADDIN EN.REFLIST 1. National Cancer Intelligence Network (NCIN). Non-melanoma skin cancer in England, Scotland, Northern Ireland, and Ireland. 2013.2. National Cancer Registration and Analysis Service (NCRAS). Non-melanoma skin cancer: Incidence and mortality rates in England, Scotland, and Northern Ireland. 2013.3. Vallejo-Torres L, Morris S, Kinge JM, Poirier V, Verne J. Measuring current and future cost of skin cancer in England. J Public Health (Oxf) 2014: 36: 140-8.4. Pascal RR, Hobby LW, Lattes R, Crikelair GF. Prognosis of "incompletely excised" versus "completely excised" basal cell carcinoma. Plast Reconstr Surg 1968: 41: 328-32.5. Park AJ, Strick M, Watson JD. Basal cell carcinomas: do they need to be followed up? J R Coll Surg Edinb 1994: 39: 109-11.6. Goldberg DP. Assessment and surgical treatment of basal cell skin cancer. Clin Plast Surg 1997: 24: 673-86.7. Griffiths RW. Audit of histologically incompletely excised basal cell carcinomas: recommendations for management by re-excision. Br J Plast Surg 1999: 52: 24-8.8. Telfer NR, Colver GB, Morton CA, Dermatologists BAo. Guidelines for the management of basal cell carcinoma. Br J Dermatol 2008: 159: 35-48.9. Motley R, Kersey P, Lawrence C, et al. Multiprofessional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma. Br J Dermatol 2002: 146: 18-25.10. Geohas J, Roholt NS, Robinson JK. Adjuvant radiotherapy after excision of cutaneous squamous cell carcinoma. J Am Acad Dermatol 1994: 30: 633-6.11. England N. 2013/14 NHS STANDARD CONTRACT FOR CANCER: SKIN (ADULT). 2013.12. George S, Pockney P, Primrose J, et al. A prospective randomised comparison of minor surgery in primary and secondary care. The MiSTIC trial. Health Technol Assess 2008: 12: iii-iv, ix-38.13. Keith DJ, de Berker DA, Bray AP, et al. British Association of Dermatologists' national audit on nonmelanoma skin cancer excision, 2014. Clin Exp Dermatol 2017: 42: 46-53.14. Keith DJ, Bray AP, Brain A, et al. British Association of Dermatologists (BAD) National Audit on Non-Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists. Clin Exp Dermatol 2019.15. Malik V, Goh KS, Leong S, et al. Risk and outcome analysis of 1832 consecutively excised basal cell carcinomas in a tertiary referral plastic surgery unit. J Plast Reconstr Aesthet Surg 2010: 63: 2057-63.16. Griffiths RW, Suvarna SK, Stone J. Basal cell carcinoma histological clearance margins: an analysis of 1539 conventionally excised tumours. Wider still and deeper? J Plast Reconstr Aesthet Surg 2007: 60: 41-7.17. Barry J, Oon SF, Watson R, Barnes L. The management of basal cell carcinomas. Ir Med J 2006: 99: 179-81.18. Timmons MJ, Hessel KC, Kranidhiotis NM. Complete excision of basal cell carcinomas. Br J Plast Surg 2002: 55: 362.19. Stolle LB, Kjerkegaard UK. A single center retrospective study on 959 excisions of non-melanoma skin cancer in 2011. J Plast Reconstr Aesthet Surg 2013: 66: 1630-2.20. Fleischer AB, Feldman SR, Barlow JO, et al. The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: results from a multi-institutional retrospective study. J Am Acad Dermatol 2001: 44: 224-30.21. Salmon P, Mortimer N, Rademaker M, et al. Surgical excision of skin cancer: the importance of training. Br J Dermatol 2010: 162: 117-22.22. Macbeth AE, Torley D, Casie Chetty N, et al. Audit of incomplete excision rates of basal cell carcinoma: analysis of 1972 cases from four U.K. regions. Br J Dermatol 2009: 161: 710-2.23. Twist M. Rate of incomplete excision of basal cell carcinomas by General Practitioners with Special Interest. Br J Dermatol 2009: 161: 187.24. Robinson AJ, Walsh M, Hill C. Histopathological variation of incompletely excised basal cell carcinoma's and the variation with the grade of surgeon - implications for revalidation. Eur J Surg Oncol 2015: 41: 165-8.25. Dieu T, Macleod AM. Incomplete excision of basal cell carcinomas: a retrospective audit. ANZ J Surg 2002: 72: 219-21.26. Wilson AW, Howsam G, Santhanam V, et al. Surgical management of incompletely excised basal cell carcinomas of the head and neck. Br J Oral Maxillofac Surg 2004: 42: 311-4.27. Talbot S, Hitchcock B. Incomplete primary excision of cutaneous basal and squamous cell carcinomas in the Bay of Plenty. N Z Med J 2004: 117: U848.28. Bogdanov-Berezovsky A, Cohen AD, Glesinger R, et al. Risk factors for incomplete excision of basal cell carcinomas. Acta Derm Venereol 2004: 84: 44-7.29. Cho M, Lee J, James CL, Marshman G, Huilgol SC. Scalp Basal Cell Carcinoma: Review of 2,202 Cases. Dermatol Surg 2016: 42: 834-41.30. Stathopoulos P, Igoumenakis D, Shuttleworth J, et al. Head and neck nonmelanoma cutaneous malignancy treatment in a skin cancer referral center. Oral Surg Oral Med Oral Pathol Oral Radiol 2017: 123: 183-87.31. Kumar P, Orton CI, McWilliam LJ, Watson S. Incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit. Br J Plast Surg 2000: 53: 563-6.32. Kumar P, Watson S, Brain AN, et al. Incomplete excision of basal cell carcinoma: a prospective multicentre audit. Br J Plast Surg 2002: 55: 616-22.33. Kiely JR, Patel AJK. A retrospective study of 694 Basal Cell Carcinoma excisions to quantify deep margin documentation and clearance compared to histological type and surgical margin. J Plast Reconstr Aesthet Surg 2019.34. Ramdas K, van Lee C, Beck S, et al. Differences in Rate of Complete Excision of Basal Cell Carcinoma by Dermatologists, Plastic Surgeons and General Practitioners: A Large Cross-Sectional Study. Dermatology 2018: 234: 86-91.35. Penington A. Ulceration and antihypertensive use are risk factors for infection after skin lesion excision. ANZ J Surg 2010: 80: 642-5.36. Chan SA, Wernham AGH, Stembridge N, et al. Do perioperative antibiotics reduce the risk of surgical-site infections following excision of ulcerated skin cancers? A Critically Appraised Topic. Br J Dermatol 2018: 178: 394-99.37. Hallock GG, Lutz DA. A prospective study of the accuracy of the surgeon's diagnosis and significance of positive margins in nonmelanoma skin cancers. Plast Reconstr Surg 2001: 107: 942-7.38. Hussain M, Earley MJ. The incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit. Ir Med J 2003: 96: 18-20.39. Deo SV, Hazarika S, Shukla NK, et al. Surgical management of skin cancers: experience from a regional cancer centre in North India. Indian J Cancer 2005: 42: 145-50.40. Dhepnorrarat RC, Lee MA, Mountain JA. Incompletely excised skin cancer rates: a prospective study of 31,731 skin cancer excisions by the Western Australian Society of Plastic Surgeons. J Plast Reconstr Aesthet Surg 2009: 62: 1281-5.41. Haque Hussain SS, Shams N, Garioch JJ. Managing squamous cell carcinomas: audit on the mode of referral and adequacy of surgical excision. Br J Dermatol 2009: 160: 224-5.42. Seretis K, Thomaidis V, Karpouzis A, Tamiolakis D, Tsamis I. Epidemiology of surgical treatment of nonmelanoma skin cancer of the head and neck in Greece. Dermatol Surg 2010: 36: 15-22.43. Delaney EK, Duckworth L, Thompson WD, Lee AJ, Murchie P. Excising squamous cell carcinomas: comparing the performance of GPs, hospital skin specialists and other hospital specialists. Fam Pract 2012: 29: 541-6.44. Luz FB, Ferron C, Cardoso GP. Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma. An Bras Dermatol 2016: 91: 726-31.45. Cole SJ, Howes R, Meehan C, Cole R. High-risk basal cell carcinoma excision in primary care: a retrospective observational study of compliance with NICE guidance. BMJ Open 2019: 8: e023299.46. Health Research Authority, Medical Research Council. Do I need NHS Ethics approval? 2019. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download