[Histonet] Re: Bone Saw
Mike Pence (where?) asks: I am trying to see what everyone is using at your grossing station for bone saw to cut femoral heads and toes for osteo. If you are using a Stryker saw how are you holding the specimens to make good thin sections? Three suggestions were: Mopec ZawBones double-bladed saw http://media3.mopec.com/media/pdf/AutopsyAccessories%28Page76%29.pdf Dremel tool We use a small [table-top] band saw from MAR-MED. cuts through a femoral head like a hot knife through soft butter. You let the blade do the job, don't force the bone. Just very little consistent pressure. Well, I've worked in about 80 pathology services, mostly small ones, in the last 50 years, and here's what I've observed. Good Management Practice is of course to deny the pathologist all but the most basic grossing tools. The cowboy way is to do no sawing at all. Jiss chuck the femoral head or tibial plateau into Decal for a few weeks, then cut it with a scalpel. Of course the sections are uninterpretable, IHC is impossible, and you probably can't bill successfully after so long. Pathologists who insist on microscopic examination (to run up the bill) do the decalcification the cowboy way, in my experience. Most common saw is the Satterlee amputation saw (Google it for an illustration). Tried and true - I've seen them in Civil War re-enactments, chrome plating and all. You're fortunate if you have one - they cost about $100 each, so you couldn't get one today. Google it for an illustration. We're having an ice storm here in east Tennessee this week, and yesterday I sawed four femoral heads from little old ladies who'd slipped on the ice. (You hold the femoral head in a wad of paper towels.) If a pathology service doesn't have any kind of a saw, I go to a hardware store and buy whatever hacksaw they have on the shelf, for about $7. They don't last very long. I've once used one of the double-bladed hacksaws, like the MOPEC ZawBones mentioned earlier. Made for medical use, they cost around $500, so no, you can't have one. Some pathologists use the Stryker oscillating saw they use at the autopsy table, but there's no way to immobilize a loose specimen (such as a femoral head) safely, and it's likely to fly up in your face. Also, the Stryker saw overheats the specimen and damages the histology. Band saws and scroll saws are often recommended, but I've never seen one used. They're heavy, have a large footprint on the table, and cost several hundred dollars, so, no, you can't have one. Femoral heads from fractures need microscopic examination, to look for metastatic cancer (pathologic fracture). Osteoarthritis can be gross-only, as can most knee replacement specimens. Most fracture specimens are osteoporotic and easy to cut - I record the difficulty of sawing in the gross description - the femoral head is slabbed with a hand saw without much difficulty/with considerable difficulty. Bob Richmond Samurai Pathologist Maryville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Bone Saw
We also use the little table-top band saw from Mar-Med. It has a small footprint, splash guards, and is just awesome for cutting thin beautiful sections. We use toothed forceps to hold the specimen and keep fingers out of the way. Like the man said, a hot knife through soft butter! We have 3 Pathologists and one PA and they all LOVE it. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 I am trying to see what everyone is using at your grossing station for bone saw to cut femoral heads and toes for osteo. If you are using a Stryker saw how are you holding the specimens to make good thin sections? We use a small band saw from MAR-MED. cuts through a femoral head like a hot knife through soft butter. You let the blade do the job, don't force the bone. Just very little consistent pressure. Rich Y - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Bone Saw
What is clean-up like? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud Sent: Wednesday, February 18, 2015 12:19 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Bone Saw We also use the little table-top band saw from Mar-Med. It has a small footprint, splash guards, and is just awesome for cutting thin beautiful sections. We use toothed forceps to hold the specimen and keep fingers out of the way. Like the man said, a hot knife through soft butter! We have 3 Pathologists and one PA and they all LOVE it. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 I am trying to see what everyone is using at your grossing station for bone saw to cut femoral heads and toes for osteo. If you are using a Stryker saw how are you holding the specimens to make good thin sections? We use a small band saw from MAR-MED. cuts through a femoral head like a hot knife through soft butter. You let the blade do the job, don't force the bone. Just very little consistent pressure. Rich Y - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: Bone Saw
In the event you don't have a band saw, I wish I did, we have a vice that has a suction cup bottom that we attach to the top of one of our specimen carts. It holds the bone well enough to get reasonable sections. If I had to do too many more than I do, I'd request a band saw. When I'm done, I just clean up the saw, the cart and I'm done. Douglas A. Porter, HT (ASCP) Pathologist Assistant IT Coordinator Sparrow / CAP-Lab, PLC 2508 South Cedar Street Lansing, MI 48910-3138 517-372-5520 (phone) 517-372-5540 (fax) doug.por...@caplab.org www.caplab.org The information contained in this message may be privileged and/or confidential and protected from disclosure. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, copying, forwarding or capture of this communication is strictly prohibited. If you have received this communication in error, please notify me immediately by return e-mail and delete this and all copies. Thank-you. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mike Pence Sent: Wednesday, February 18, 2015 1:56 PM To: 'Terri Braud'; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Bone Saw What is clean-up like? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Terri Braud Sent: Wednesday, February 18, 2015 12:19 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Bone Saw We also use the little table-top band saw from Mar-Med. It has a small footprint, splash guards, and is just awesome for cutting thin beautiful sections. We use toothed forceps to hold the specimen and keep fingers out of the way. Like the man said, a hot knife through soft butter! We have 3 Pathologists and one PA and they all LOVE it. Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 I am trying to see what everyone is using at your grossing station for bone saw to cut femoral heads and toes for osteo. If you are using a Stryker saw how are you holding the specimens to make good thin sections? We use a small band saw from MAR-MED. cuts through a femoral head like a hot knife through soft butter. You let the blade do the job, don't force the bone. Just very little consistent pressure. Rich Y - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet - No virus found in this message. Checked by AVG - www.avg.com Version: 2015.0.5646 / Virus Database: 4284/9137 - Release Date: 02/18/15 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Re: Bone saw
Christine Bark asks about saws for cutting surgical pathology bone specimens like femoral heads. I posted something to Histonet about this fairly recently - here it is again. Stephen Peters, a pathologist in Hackensack NJ, describes for us a bone saw he's invented. His Web site is distinctly worth looking at, the whole thing, not just the saw. http://pathologyinnovations.com/bone_vise.htm Some other possibilities for sawing bone: Many of the small pathology services I work for have no way of sawing bone. (It's amazing how many pathologists there are who are so poorly trained that they think you decalcify a femoral head by tossing the whole thing in formalin for a month.) In that circumstance, I head for the nearest hardware store and buy a five dollar hacksaw which I leave behind at the end of the week. The Civil War vintage Satterlee amputation saw is still available, and is a serviceable hand saw that doesn't go dull quickly. (I've seen them, complete with chrome plating, at Civil War re-enactments.) This is the tool I most commonly use. One of the standard vendors offers a simple device for slabbing a femoral head, the SawBones, absurdly overpriced at $500, not something a hospital would be likely to buy for a mere pathologist. Several years ago I attended a continuing medical education program where the lecturer recommended a scroll saw, a large table saw that's about impossible to injure yourself with. At the time they cost about $100 for Made in China, otherwise $200. The disadvantage, in a cramped pathology lab, is its large footprint. You can look at these things at your local Home Depot. There's no way to cut a femoral head safely with an oscillating autopsy saw (Stryker saw), though this is probably the most common way to cut bone. I think femoral heads removed for fracture (not for osteoarthritis) really do need to be examined microscopically, because of the occasional pathologic fracture (fracture through metastatic cancer in the bone). I've seen several of these, not all with a previous cancer diagnosis. (But I see no reason to examine knee replacement material microscopically, if you know how to do the gross description properly - which admittedly most pathologists don't.) (I have no connection with any of the businesses I've mentioned.) Bob Richmond Samurai Pathologist Knoxville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
