Tissue Biopsy Punches

Cutting Edge Technique

When you have small lesions or small tissue areas for biopsy, we have historically used an incisional or excisional technique using a blade such as a #15 blade. Tissue punches are a nice alternative and give a clean, round tissue cut. You control the depth of the excision as you use the biopsy punch. The technique is to tense up the tissue area and then rotate the punch on the surface of the tissue watching the depth of cut on the blade of the punch. You can then hold the central portion of the specimen with a tissue forceps and either excise it with a tissue scissors or a blade removing it at the desired level.

Round Punches Through Medical Suppliers or Online

Biopsy punches can be purchased through your medical supplier or online. I use a 5 or 8 mm round punch. If I am getting larger than that then I would use a blade for excision. You can Google Miltex Sterile Disposable Biopsy Punches; 8 mm typically come in a box of 50. After excision on unattached mucosa, I would usually place one or two 4-0 plain gut sutures to approximate the tissue although this is not necessary.

Mucosal Grafts from the Palate

I also use these to harvest attached mucosal grafts from the palate, especially if I am performing a single site extraction and graft. In those cases, I would oversew the graft with 5-0 or 6-0 nylon to try to keep firm pressure over the graft at the site. I have also used this technique to regain a bib of attached mucosa along the facial aspect of the crest of the ridge in an area such as where we have placed an implant and there are poor tissue contours or a thin tissue biotype. My preferred technique for the thin tissue biotype however, is still an interpositional graft with a partial thickness attached mucosal graft which usually can be taken nicely from the tuberosity area.

Dr. Wagner is an expert in all things tissue biopsy punches. For more information, call (262) 634-4646 today.

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