Open Surgical Biopsy

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Open Surgical Biopsy
• Semimembranosus
• Midpoint between tuber
ischei and Achilles
tendon
Stephanie Valberg copyright
Open Surgical biopsy
• Lidocaine subcutaneously (10
ml)
• 2 inch vertical incision
• Incise skin, subcutaneous
tissue
• Vertical incision through
fascia
Stephanie Valberg copyright
Open Surgical Biopsy
• Undermine the
fascia on one side
• Make 2 parallel
vertical incisions ½
inch apart
Stephanie Valberg copyright
Open Surgical Biopsy
-hold muscle in one
place with forcep then
transect dorsally
-free biopsy ½” deep
then transect ventrally
Stephanie Valberg copyright
Open Surgical Biopsy
• 1” cube of muscle wrapped in saline
moistened gauze, placed in a hard container
and shipped overnight on icepacks
Stephanie Valberg copyright
Open Surgical Technique
• Close dead space
with subcutaneous
layers
• Close skin with
intradermal sutures
or staples
• Small scar
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Histochemistry
• Muscle requires great care to freeze for
histochemistry because;
– Muscle is 80% water, 19 % protein, 1%
glycogen
– Ice crystals form readily in muscle cells placed
in liquid nitrogen
– This causes holes called freeze artifacts
Stephanie Valberg copyright
Freezing Muscle biopsies
• Samples can be shipped to the lab chilled on
ice packs within 24h
• Samples can be shipped frozen on dry ice
and thawed in the lab, oriented and frozen
in methylbutane, but this creates artifacts
Stephanie Valberg copyright
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