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Surgical Pearl: The use of a wooden toothpick for the removal of a specimen from the biopsy site
PEARLS Stuart J. Salasche, MD Surgical Pearls Editor
Mark G. Lebwohl, MD Medical Pearls Editor
Surgical Pearl: The use of a wooden toothpick for the removal of a specimen from the biopsy site Mohamed Abdel-Monaem Abdel-Aal, MD, and Hussein M. M. Hassab-El-Naby, MD Cairo, Egypt
P
unch biopsy is a standard procedure for obtaining a specimen of the skin for histologic examination. It is quick and easy to perform and causes only a small wound. In most instances, a 3- to 4-mm biopsy punch is adequate. After the biopsy specimen has been loosened with the biopsy punch, it should be handled very gently and should not be grasped with forceps. Some clinicians squeeze the specimen manually out of its socket or spear it obliquely with the syringe needle that was used for injection of the local anesthesia.1 In some cases, especially when the specimen is From the Department of Dermatology, Faculty of Medicine, AlAzhar University, Cairo, Egypt. Reprint requests: Hussein Hassab-El-Naby, MD, 27A Bagdad St, Korba, Heliopolis, Cairo 11341, Egypt. J Am Acad Dermatol 2003;48:115. Copyright © 2003 by the American Academy of Dermatology, Inc. 0190-9622/2003/$30.00 ⫹ 0 doi:10.1067/mjd.2003.129
Direct all Surgical Pearl submissions to Dr Stuart J. Salasche, 5300 N Montezuma Trail, Tucson, AZ 85750.
scant, soft, or fragile, the use of the syringe needle may damage the specimen; the tip of the needle may produce a hole in the tissue or damage the wall of a cyst or fat lobules, and hence, alter the findings. Attempting to spear a specimen with a syringe needle may also increase the chance of an accidental needle stick. We use a simple method to transfer the biopsy sample to the specimen bottle. After cutting the base of the specimen through the subcutaneous fat with scissors, we touch the side of the specimen with a sterilized wooden toothpick. The specimen sticks to the toothpick, and then we transfer it to the bottle containing the suitable fixative. This avoids tissue damage that may occur when using a forceps or when a syringe needle is used to handle the specimen. REFERENCE 1. Ackerman AB. Biopsy: why, where, when, how. J Dermatol Surg 1975;1:21-3.
Direct all Medical Pearl submissions to Dr Mark G. Lebwohl, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1048, New York, NY 10029.
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Mark G. Lebwohl, MD Medical Pearls Editor
Surgical Pearl: The use of a wooden toothpick for the removal of a specimen from the biopsy site Mohamed Abdel-Monaem Abdel-Aal, MD, and Hussein M. M. Hassab-El-Naby, MD Cairo, Egypt
P
unch biopsy is a standard procedure for obtaining a specimen of the skin for histologic examination. It is quick and easy to perform and causes only a small wound. In most instances, a 3- to 4-mm biopsy punch is adequate. After the biopsy specimen has been loosened with the biopsy punch, it should be handled very gently and should not be grasped with forceps. Some clinicians squeeze the specimen manually out of its socket or spear it obliquely with the syringe needle that was used for injection of the local anesthesia.1 In some cases, especially when the specimen is From the Department of Dermatology, Faculty of Medicine, AlAzhar University, Cairo, Egypt. Reprint requests: Hussein Hassab-El-Naby, MD, 27A Bagdad St, Korba, Heliopolis, Cairo 11341, Egypt. J Am Acad Dermatol 2003;48:115. Copyright © 2003 by the American Academy of Dermatology, Inc. 0190-9622/2003/$30.00 ⫹ 0 doi:10.1067/mjd.2003.129
Direct all Surgical Pearl submissions to Dr Stuart J. Salasche, 5300 N Montezuma Trail, Tucson, AZ 85750.
scant, soft, or fragile, the use of the syringe needle may damage the specimen; the tip of the needle may produce a hole in the tissue or damage the wall of a cyst or fat lobules, and hence, alter the findings. Attempting to spear a specimen with a syringe needle may also increase the chance of an accidental needle stick. We use a simple method to transfer the biopsy sample to the specimen bottle. After cutting the base of the specimen through the subcutaneous fat with scissors, we touch the side of the specimen with a sterilized wooden toothpick. The specimen sticks to the toothpick, and then we transfer it to the bottle containing the suitable fixative. This avoids tissue damage that may occur when using a forceps or when a syringe needle is used to handle the specimen. REFERENCE 1. Ackerman AB. Biopsy: why, where, when, how. J Dermatol Surg 1975;1:21-3.
Direct all Medical Pearl submissions to Dr Mark G. Lebwohl, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1048, New York, NY 10029.
115