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Open Surgical Biopsy

• Semimembranosus

• Midpoint between tuber ischei and Achilles tendon

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Open Surgical biopsy

• Lidocaine subcutaneously (10 ml)

• 2 inch vertical incision

• Incise skin, subcutaneous tissue

• Vertical incision through fascia

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Open Surgical Biopsy

• Undermine the fascia on one side

• Make 2 parallel vertical incisions ½ inch apart

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Open Surgical Biopsy

-hold muscle in one place with forcep then transect dorsally-free biopsy ½” deep then transect ventrally

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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

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Open Surgical Technique

• Close dead space with subcutaneous layers

• Close skin with intradermal sutures or staples

• Small scar

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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

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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