Cryostat Use and Tissue Processing in Mohs Micrographic Surgery

Hanke, C. William; Lee, M W

doi:10.1111/j.1524-4725.1989.tb03109.x

Cited by 31 publications

(29 citation statements)

References 4 publications

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“…b Number of sections when the sample "chunked out," not able to obtain a section with near complete margins. [1][2][3][4]. There are also several papers describing less commonly used methods such as the cryomold [5], Miami special [6], special discs [7], and gradual freezing with liquid nitrogen [8].…”

Section: Discussionmentioning

confidence: 97%

Tissue preparation for MOHS’ frozen sections: a comparison of three techniques

Bakhtar

Davidson

et al. 2007

Virchows Arch

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Accurate, efficient frozen section analysis is important for tumor control. A few studies address the technical issues. More are needed, especially as new technologies become available. The objective of this study is to compare the efficiency of three techniques of flattening tissue for microscopically oriented histologic surgery (MOHS): conventional frozen sectioning, Cryocup, and CryoHist. Conventional chuck/heat sink-frozen section preparation were compared with Cryocup and CryoHist to determine the most efficient technique to examine 100% of the surgical margin of 4-cm diameter, full thickness, fresh autopsy cylinders of anterior abdominal skin, which were marked on their deep and peripheral margins. The specimens were frozen sectioned at 5 microm until all the marking dye was gone from the deep surface, and 95% of the perimeter epidermis could be seen. The conventional chuck required an average of 304 micrometers to clear the deep margin and four fifths did not contain 95% of the epidermal margin. The Cryocup required an average of 284 microm to examine the deep margin and 95% of the epidermal margin. The CryoHist required an average of 104 microm to examine the deep margin and 95% of the epidermal border. The new techniques improve the efficiency and presumably the accuracy of tumor margin analysis.

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Section: Discussionmentioning

confidence: 97%

Tissue preparation for MOHS’ frozen sections: a comparison of three techniques

Bakhtar

Davidson

et al. 2007

Virchows Arch

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“…Forceps placement followed by a heat extractor compression is the most used and most useful. 20 Flattening the outside margin against a frozen surface such as a glass slide is also popular but lengthens the processing time. 20 Various embedding media are available and can even be colored to help separate the multiple cases that are simultaneously processed.…”

Section: The Preparation Of Frozen Sections For Skin Cancer Removalmentioning

confidence: 99%

“…20 Flattening the outside margin against a frozen surface such as a glass slide is also popular but lengthens the processing time. 20 Various embedding media are available and can even be colored to help separate the multiple cases that are simultaneously processed. 17 Tissue dehydration during grossing will solve most embedding problems.…”

Section: The Preparation Of Frozen Sections For Skin Cancer Removalmentioning

confidence: 99%

Peripheral Frozen Sections

Davis¹,

Pellowski²

2005

Pathology Case Reviews

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Skin cancer cure rates of 99% can be promised to the patient if the entire peripheral margin of a cutaneous excision is verified to be free of that cancer. Preparing frozen sections to examine only the peripheral margin may seem esoteric to the surgical pathologist. This technique was historically named Mohs' micrographic surgery and is typically performed by a dermatologist in an outpatient clinic, away from the observation of other medical specialists. This treatise provides detailed specifics on how to prepare tissue for peripheral margin evaluation. Along the way, it also provides a brief history of Frederic Mohs' discoveries of the 1930s and how several generations of skin cancer surgeons have refined Mohs' techniques to offer the cutting-edge advantages of the highest cure rates and normal skin sparing.

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“…Numerous methods and devices have been designed to facilitate these key steps of tissue processing in MMS. Some of these methods are: manual (direct) technique, microscope slide technique, Bard-Parker scalpel, freezing bar technique, plastic "Cryomolds", "Davidson Cryocup" metal molds, Carter's device, Koehn's modification of Carter's device, "Miami Special" clamps, Gormley's device, Motley & Holt's device, Marini's "CryoSystem", Franks' device, and "CryoHist" [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. Some inaccuracies of tissue processing are unavoidable and depend on the unique features of a particular device or technique.…”

Section: Introductionmentioning

confidence: 99%

A new laboratory device with mathematically based positioning of a frozen tissue block facilitating precise sectioning of large specimens

Bieniek

Matusiak²,

Woźniak³

et al. 2016

pjp

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Mohs micrographic surgery (MMS) is a treatment method aiming at thorough, personalized eradication of skin cancers by mean of staged excision of tissues surrounding the tumor with complete (100%) histopathological examination of their margins. In many MMS laboratories, the excised tissue is divided, shaped, frozen in a cryostat with a heat extractor and positioned manually (with the block on the object disc) in an articulated cryostat chuck during cutting. However, these activities may be difficult, time-consuming and associated with the risk of imprecise tissue sectioning. Development of a laboratory device allowing for processing of large tissue specimens, with the function of mechanical, mathematically steered positioning of the tissue block surface directly to the microtome knife cutting place, eliminating the need for manual adjustment. The prototype device was designed and manufactured. Its functioning was tested on 513 histological slides produced during 212 operations of skin cancers using MMS. The depth of the first complete sections and the diameter of sections were measured. Complete sections were obtained at an average depth of 81.60 μm (min. 20 μm, max. 180 μm, SD = 29.15), whereas the average diameter of sections was 18.11 mm (min. 4 mm, max. 42 mm, SD = 9.10). The histological processing of large specimens with mathematically based positioning of the tissue surface in relation to the cryotome knife cutting plane is precise, fast and easy. The device can be useful in those MMS centers which continue to employ manual setting of the cryostat chuck or share the cryostat with other users, which prevents fixing the chuck position (including large hospital settings). It may also be helpful in centers using a cryostat with a fixed chuck, for the correction of minimal inaccuracies of its preset position.

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Cryostat Use and Tissue Processing in Mohs Micrographic Surgery

Cited by 31 publications

References 4 publications

Tissue preparation for MOHS’ frozen sections: a comparison of three techniques

Tissue preparation for MOHS’ frozen sections: a comparison of three techniques

Peripheral Frozen Sections

A new laboratory device with mathematically based positioning of a frozen tissue block facilitating precise sectioning of large specimens

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