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 Stephanie Valberg copyright 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