Mohs Tissue Mapping and Processing: A Survey Study

Silapunt, Sirunya; Peterson, S. Ray; Alcalay, Joseph; Goldberg, Leonard Harry

doi:10.1046/j.1524-4725.2003.29347.x

Cited by 36 publications

(46 citation statements)

References 11 publications

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“…A survey of Mohs surgeons published in 2003 showed a great variety of the devices and techniques used to flatten, to freeze, and to prepare the tissues in Mohs surgery, among them, the heat extractor flattening in the cryostat (22.6%), relaxing incisions (16.1%), heat extractor and relaxing incisions (14.2%), freezing on a glass slide (10.3%), relaxing incision and glass slide (9.4%), and the Miami Special technique (3.9%) are the most commonly used 10 . Other less used devices, such as the Davidson Cryocup TM (Bradley Products Inc., Bloomington, MN), CryoHist TM (Cryo Histology, Inc., Shawnee, KS), the Cryo-Embedder TM ( Salt Lake City, UT), the face-down cryoembedding of tissue using stainless stell embedding wells, and the use of dry ice have been described to optimize the tissue preparation process 8,9,11,12 .…”

Section: Many Innovative Techniques Have Been Developed To Improvementioning

confidence: 99%

Validation of a new technique to freezing and embedding tissue in Mohs surgery, using an animal model

Sanchez

Filho²,

Russo

2016

Acta Cir. Bras.

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PURPOSE:To validate the innovative Dry Ice method, comparing it with two standard methods currently used for tissue processing in Mohs surgery, the Heat Sink method and the Miami Special. METHODS:Forty eight samples of pigs kin with the standard beveled Mohs technique were used, and randomly allocated into six groups. Each group was processed with one of the 3 methods and evaluated for: The freezing time, the depth required to cut into the block to obtain a complete section, and the quality of histological slides analyzed with a image software. The statistical analysis was performed with the software SAS ® System. The inferential analysis was made by one-way ANOVA. RESULTS:The Miami Special showed a processing time significantly shorter than Dry Ice method and Heat Sink method. There was no significant difference in the depth required to cut into the blocks, and area of surgical margins visualized. CONCLUSION:The Dry Ice method was as efficient as the other two methods currently used in Mohs surgery, considering the individual advantages and disadvantages of each method.

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Section: Many Innovative Techniques Have Been Developed To Improvementioning

confidence: 99%

Validation of a new technique to freezing and embedding tissue in Mohs surgery, using an animal model

Sanchez

Filho²,

Russo

2016

Acta Cir. Bras.

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“…A large proportion of surgeons use relaxing incisions. 18,19 In HT dialect, the incisions will also "line up" the leading edge of the epidermis for better sectioning. This is analogous to cutting a box to flatten it, conforms 3 dimensions to 2, and gives your HT less work (Fig.…”

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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Mohs Tissue Mapping and Processing: A Survey Study

Abstract: There is variability in mapping and processing techniques employed Mohs micrographic surgeons and their histotechnicians. As long as the integrity of each step of Mohs tissue mapping and processing is preserved, the high cure rate of the technique should be maintained.

Cited by 36 publications

References 11 publications

Validation of a new technique to freezing and embedding tissue in Mohs surgery, using an animal model

Validation of a new technique to freezing and embedding tissue in Mohs surgery, using an animal model

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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