What is a Skin Biopsy?

The advantage of biopsy surgery is to accurately remove the most representative tissue of the tumor under direct vision, which meets the requirements of pathological examination, and the correct diagnosis rate can reach 99%.

Biopsy

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The advantage of biopsy surgery is to accurately remove the most representative tissue of the tumor under direct vision, which meets the requirements of pathological examination, and the correct diagnosis rate can reach 99%.

Chinese name

Biopsy

Foreign name

incisional biopsy

Biopsy

Surgical biopsy

Orthopaedics / Bone Oncology Surgery / Diagnostic Surgery

77.4001

The disadvantage is that the tissue is larger than the puncture biopsy, and in some blood-rich tumors, sometimes the bleeding is even more difficult to stop, or it causes infection. Such as improper bone removal is likely to cause pathological fractures. The purpose of biopsy surgery is not only to determine the nature of the tumor, but more importantly to determine the tumor cell type and the degree of differentiation from the pathology.

Biopsy surgery is suitable for:

1. Clinically, if a malignant tumor or metastatic tumor is considered, it should be diagnosed by biopsy.

2. The tumor grows in the fibula, scapula body, clavicle, ribs, etc. It can be combined with diagnostic biopsy and therapeutic resection (ie, whole or extensive resection) for a one-time resection and pathology examination.

3. If the biopsy fails, the nature of the tumor, or patients with suspected malignant changes, should not wait and see. Biopsy surgery should be performed in time to confirm the diagnosis as soon as possible. Whether surgical biopsy has caused the spread of malignant tumors has been a subject of serious concern, but so far no one has submitted any objective and evidence-based reports.

A local skin disease or tumor has ulcerated, and an open biopsy can easily lead to infection. No additional incision is required during the biopsy. Tumor tissue can be removed from the ulcer for examination.

1. Basically the same as general aseptic surgery. The surgeon should be familiar with the medical history and the location and pathological characteristics of the tumor shown on the X-ray film, and be proficient in the anatomy and surgical technique of the removal site.

2. Prepare appropriate surgical instruments, pathological specimen containers, and preservation solutions.

3. Inform the pathologist to the surgical site for consultation, and jointly select the most representative part of the tumor to obtain the material.

When the tumor is small or shallow, it can be done with local anesthesia. If the tumor is deep and large, or there are important blood vessels, nerves and other tissues nearby, block anesthesia or general anesthesia can be selected. Arrange the patient in a comfortable and easy-to-use position.

1. In principle, the incision should be selected at the superficial position from the most active part of tumor growth. The incision does not need to be too long. Generally, the incision of the longitudinal axis of the limb is used, and the length of 3 to 5 cm can be used.

After skin incision, no extensive subcutaneous peeling is performed. Nerve and blood vessel damage should be reduced. Special attention should be paid to protecting the head veins of the upper limbs and the large and small saphenous veins of the lower limbs.

2. After incision of deep fascia, the surgical field must be clear, clean, hemostatic, and ligated securely. Choose the shortest direction to incise the muscle space or directly separate the muscle fibers. Use the hook to pull to the sides to enter the deep part to reach the tumor surface or the bone segment of the tumor. Be careful not to incise the unnecessary exposed muscle space fascia.

3. Before cutting the tumor tissue, use dry gauze to fill and protect the surrounding tissue to prevent bleeding of the cut tumor and the surrounding tumor cells. If the tumor is still within the scope of the bone marrow, you can make multiple holes in the bone cortex of the tumor (avoid a rough knock to cause a fracture) to form a small oval window. You can see the tumor in the bone marrow cavity by removing the bone cover.

4. After the tumor tissue is exposed, use a sharp knife to cut a small amount of wedge-shaped tumor tissue sufficient for pathological examination. During operation, try to be as gentle as possible to avoid excessive squeezing or pinching and try not to stain the removed tumor mass. Surrounding normal tissue to prevent tumor cells from spreading. The removed tissue should be immediately placed in the container holding the specimen. Locally, dry gauze or gelatin sponge can be used for stuffing and suture the fascia to stop bleeding. The removed bone cap is placed back in place to close the bone cavity. After removing the gauze that is used to protect the surrounding tissue, it should not be reused for centralized processing.

5. After taking the biopsy field, rinse it with an appropriate amount of isotonic saline or a dilute solution prepared with antitumor drugs, and then close the cut fascia or myofascial fascia closely.

6. Cortical and subcutaneous incisions are layered and sutured without drainage strips.

1. The incision should be selected in the shortest way to reveal the tumor and the biopsy is taken.

2. Tumor tissue and blood flowing out of the tumor should be isolated and protected with dry gauze to avoid contamination of surrounding tissues.

3. The obtained specimens should be immediately collected in a special container or bottle, and at the same time, injected into a 0.1% formaldehyde solution for storage and sent to the pathologist for examination as soon as possible.

1. If the biopsy wound is large and deep, you can use effective antibiotics for several days to prevent wound infection.

2. If biopsy is performed to remove more bone or the original bone has been damaged by tumor, the external fixation should be strengthened with plaster splint to prevent pathological fracture.

3. If the biopsy incision is in good condition, the suture can be removed at 7-14 days.

The main complications of biopsy are bleeding and infection of the wound. In neck, chest, lumbar spine, and pelvic biopsy, attention should be paid to the presence of blood vessels, nerve damage, pneumothorax, hemothorax, and intra-abdominal bleeding. If suspicious, it should be checked in time and dealt with in a timely manner.