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Stephanie Valberg copyright
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 1” cube of muscle wrapped in saline moistened gauze, placed in a hard container moistened gauze, placed in a hard container and shipped overnight on icepacksand 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