The Preparation of Frozen Sections for Micrographic Surgery

Miller, Loretta J.; Argényi, Zsolt B.; Whitaker, Duane C.

doi:10.1111/j.1524-4725.1993.tb00994.x

Cited by 31 publications

(31 citation statements)

References 12 publications

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“…In terms of ice artifact and overall histology, our study, albeit small, strongly supports the previous suggestions by Miller and colleagues 3 and Mellen and colleagues 4 that flash freezing of tissue in an isopentane histobath produces superior histology (Figure 2) and expedites slide preparation. Our MMS surgeons favored histology from flash frozen tissue, and the time to opacify tissue surrounded by embedding medium in the histobath was considerably faster than time to freeze in the cryostat (range 15–40 vs 40–240 seconds).…”

Section: Discussionsupporting

confidence: 90%

“…Studies aimed at minimizing this ice artifact in MMS frozen sections are scarce. Miller and colleagues 3 noted that choice of embedding media can affect freeze artifact; they also compared liquid nitrogen, isopentane cooled in liquid nitrogen, and the cryostat and heat extractor methods and found that the isopentane method came closest to vitrification of the tissue and that the cryostat method produced varying degrees of ice artifact. Data from the current study do not substantiate these claims, and there is no comparison of the quality of each method.…”

mentioning

confidence: 99%

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Flash Freezing of Mohs Micrographic Surgery Tissue Can Minimize Freeze Artifact and Speed Slide Preparation

Erickson

Clark

Larson

et al. 2011

Dermatologic Surgery

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

Flash Freezing of Mohs Micrographic Surgery Tissue Can Minimize Freeze Artifact and Speed Slide Preparation

Erickson

Clark

Larson

et al. 2011

Dermatologic Surgery

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“…14 The essence of this treatise is to describe the preparation of peripheral (en face) frozen sections for the purpose of removing skin cancer. The variables to be discussed include removing, grossing, marking, mounting, embedding, freezing, sectioning, adhering, fixing, staining, clearing, and covering slides and mapping residual cancer.…”

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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The Preparation of Frozen Sections for Micrographic Surgery

Abstract: Presently all preparation techniques may introduce some degree of artifact. However, we feel the process described herein is adaptable to all Mohs surgery laboratories and will result in high quality specimens with minimal artifact.

Cited by 31 publications

References 12 publications

Flash Freezing of Mohs Micrographic Surgery Tissue Can Minimize Freeze Artifact and Speed Slide Preparation

Flash Freezing of Mohs Micrographic Surgery Tissue Can Minimize Freeze Artifact and Speed Slide Preparation

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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