Amputation - Revision history

Mikael Häggström: Templated

2021-09-17T16:55:18Z

Templated

← Older revision		Revision as of 12:55, 17 September 2021
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	*Skin and soft tissues at proximal margin.		*Skin and soft tissues at proximal margin.
	:*If margin is close to gangrene- perpendicular sections		:*If margin is close to gangrene- perpendicular sections
	:*If far, submit ~~enface~~		:*If far, submit {{en face}}

	===Gross report===		===Gross report===

Mikael Häggström: +Leg

2021-07-08T18:10:30Z

+Leg

← Older revision		Revision as of 14:10, 8 July 2021
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	==More specific guidelines==		==More specific guidelines==
	*[[toe]]		*[[Digit]] (finger or toe)
			*[[Leg amputation]]

	==Gross processing==		==Gross processing==

Mikael Häggström: /* Gross processing */ Expanded

2021-07-08T18:09:48Z

Gross processing: Expanded

← Older revision		Revision as of 14:09, 8 July 2021
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	==Gross processing==		==Gross processing==
	~~Either before or after a general inspection~~, fix the body part in formalin, ~~such as~~ overnight for digits, and then leaving it for 5-6 hours in a relatively strong '''decalcifying''' solution.		For relatively small amputations (up to trans-metatarsal amputations), fix the body part in formalin, either before or after a general inspection. It can be done overnight for digits, and then leaving it for 5-6 hours in a relatively strong '''decalcifying''' solution.

	*Measure '''length''' and average '''diameter'''		*Measure '''length''' and average '''diameter'''
	*Determine the anatomic '''location''' of the cut.		*Determine the anatomic '''location''' of the cut.
	*~~Ink~~ the surgical margins differently for soft tissue and bony margin, where samples are to be taken.		*At least for amputated digits, ink the surgical margins differently for soft tissue and bony margin, where samples are to be taken.

	'''Sections''' for microscopy are taken as follows:		'''Sections''' for microscopy are taken as follows:
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	For amputations resected by cutting across bone:		For amputations resected by cutting across bone:
	*~~Ink~~ the bone at the proximal margin, submit perpendicular section of bony margin.		*For at least amputated digits, ink the bone at the proximal margin, submit perpendicular section of bony margin.
	*Skin and soft tissues at proximal margin.		*Skin and soft tissues at proximal margin.
	:*If margin is close to gangrene- perpendicular sections		:*If margin is close to gangrene- perpendicular sections
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	===Gross report===		===Gross report===
	Example:		Example for digits:
	{\|class=wikitable		{\|class=wikitable
	\| {{Moderate-begin}}A. Labeled - ___. The specimen is received in formalin and consists of an amputated __.{{Moderate-end}} It measures ___ cm in length and ___ cm in average diameter. It is resected ___ {{Comment-begin}}location{{Comment-end}}. {{Finding-begin}}The proximal ___ cm of the specimen is not covered by skin and soft tissue.{{Finding-end}} The skin and soft tissue margins appear <viable / necrotic>. The skin surface appears ___ {{Finding-begin}}and displays an (ulcerated/necrotic/gangrenous) lesion, cm from the cutaneous margin{{Finding-end}}. The nail(s) is/are <color/thickened/absent/necrotic>. The soft tissue surgical margin is inked blue {{Comment-begin}}for example{{Comment-end}}, and the bony surgical margin of the ___ {{Comment-begin}}specific bone involved{{Comment-end}} is inked green {{Comment-begin}}for example{{Comment-end}}. On cut sections, the bone subjacent to the ulcer shows no gross abnormalities. Representative sections are submitted for microscopic examination in ___ cassettes following decalcification.		\| {{Moderate-begin}}A. Labeled - ___. The specimen is received in formalin and consists of an amputated __.{{Moderate-end}} It measures ___ cm in length and ___ cm in average diameter. It is resected ___ {{Comment-begin}}location{{Comment-end}}. {{Finding-begin}}The proximal ___ cm of the specimen is not covered by skin and soft tissue.{{Finding-end}} The skin and soft tissue margins appear <viable / necrotic>. The skin surface appears ___ {{Finding-begin}}and displays an (ulcerated/necrotic/gangrenous) lesion, cm from the cutaneous margin{{Finding-end}}. The nail(s) is/are <color/thickened/absent/necrotic>. The soft tissue surgical margin is inked blue {{Comment-begin}}for example{{Comment-end}}, and the bony surgical margin of the ___ {{Comment-begin}}specific bone involved{{Comment-end}} is inked green {{Comment-begin}}for example{{Comment-end}}. On cut sections, the bone subjacent to the ulcer shows no gross abnormalities. Representative sections are submitted for microscopic examination in ___ cassettes following decalcification.

Mikael Häggström: Expanded

2020-10-06T15:55:32Z

Expanded

← Older revision		Revision as of 11:55, 6 October 2020
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	*[[~~Toe~~]]		{{Top
			\|author1=[[User:Mikael Häggström\|Mikael Häggström]]
			\|author2=
			}}
			This article deals with surgical (non-traumatic) amputations:

			{{Comprehensiveness\|otherlegend=yes}}

			==More specific guidelines==
			*[[toe]]

			==Gross processing==
			Either before or after a general inspection, fix the body part in formalin, such as overnight for digits, and then leaving it for 5-6 hours in a relatively strong '''decalcifying''' solution.

			*Measure '''length''' and average '''diameter'''
			*Determine the anatomic '''location''' of the cut.
			*Ink the surgical margins differently for soft tissue and bony margin, where samples are to be taken.

			'''Sections''' for microscopy are taken as follows:

			For amputations disarticulated at the joint:
			*Perpendicular sections of articular cartilage and adjacent bone. State which bone in key of sections

			Gangrene:
			*Submit cross sections of each bone with associated gangrene if appropriate, generally sagittal/longitudinal. State what bone in the key of sections.

			For amputations resected by cutting across bone:
			*Ink the bone at the proximal margin, submit perpendicular section of bony margin.
			*Skin and soft tissues at proximal margin.
			:*If margin is close to gangrene- perpendicular sections
			:*If far, submit enface

			===Gross report===
			Example:
			{\|class=wikitable
			\| {{Moderate-begin}}A. Labeled - ___. The specimen is received in formalin and consists of an amputated __.{{Moderate-end}} It measures ___ cm in length and ___ cm in average diameter. It is resected ___ {{Comment-begin}}location{{Comment-end}}. {{Finding-begin}}The proximal ___ cm of the specimen is not covered by skin and soft tissue.{{Finding-end}} The skin and soft tissue margins appear <viable / necrotic>. The skin surface appears ___ {{Finding-begin}}and displays an (ulcerated/necrotic/gangrenous) lesion, cm from the cutaneous margin{{Finding-end}}. The nail(s) is/are <color/thickened/absent/necrotic>. The soft tissue surgical margin is inked blue {{Comment-begin}}for example{{Comment-end}}, and the bony surgical margin of the ___ {{Comment-begin}}specific bone involved{{Comment-end}} is inked green {{Comment-begin}}for example{{Comment-end}}. On cut sections, the bone subjacent to the ulcer shows no gross abnormalities. Representative sections are submitted for microscopic examination in ___ cassettes following decalcification.
			\|}

			==See also==
			*[[Soft tissues]]
			{{Bottom}}

Mikael Häggström: Linked

2020-10-06T15:36:21Z

Linked

New page

*[[Toe]]