1. Care and Handling of Surgical Specimens

2. Objectives Define the types of surgical specimens.
Understand the Surgical Technologist’s role in caring for each type of specimen.
Discuss the methods of specimen preparation for laboratory studies.

3. Specimens
Fluid, tissue, or foreign bodies may be removed from the body to determine nature or treatment of a disease or condition.
The STSR must be familiar with the proper care and handling of all surgical specimens.

4. Specimen Methods Needle aspiration Incisional biopsy Core biopsy
Cultures
Excisional biopsy

5. Needle Aspiration
Fine needle and syringe are used to withdraw a fluid sample for laboratory testing.

6. Incisional Biopsy
Lesion is incised and a portion is removed for study.

7. Incisional Biopsy
Core or punch biopsies allow for removal of tissue sample with a minimal invasive technique.

8. Incisional Biopsy
Special culture tubes are designed with cotton tipped swabs to study fluid in or around the lesion.

9. Excisional Biopsy
The entire lesion or tumor is removed for study.

10. Laboratory Studies Permanent/Fixed Fresh/Frozen section
Culture and sensitivity
Gram stain

11. Permanent/Fixed
Tissue specimen is placed in an appropriate cup and a preservative such as formalin is added.
Kidney stones and fresh/frozen section specimens must never be placed in formalin.

12. Permanent/Fixed
Permanent specimens are sent to the pathology department for routine studies.
Usually sent to pathology anytime after procedure is completed.

13. Fresh/Frozen Section
Tissue specimen is placed in an appropriate cup without any preservative added. (as is)
Specimens are submitted to pathology intraoperatively as soon as they are obtained.

14. Fresh/Frozen Section
Pathologist will freeze the tissue and slicing a very thin portion for microscopic examination.
Pathologist will then inform the surgeon of the findings.
Clear margins

16. Culture and Sensitivity
Bacteriological studies performed on fluid/tissue obtained during a biopsy to identify the organism.
Aerobic
Anaerobic

17. Gram Stain
Bacteriological studies performed on fluid/tissue obtained during a biopsy.
Sample is stained with crystal violet and iodine to identify the type of organism.
Gram Positive stain Blue
Gram Negative stain Pink

18. Responsibility for Specimens
The STSR and the circulator are both ethically and legally responsible for proper handling of surgical specimens.
Proper labeling and handling are of the utmost importance.

19. Responsibility for Specimens
Lost, mishandled, or mislabeled specimens could lead to:
Misdiagnosis
Unnecessary surgery
Unnecessary trauma or disfigurement

20. Specimen Handling in the Sterile Field
Specimens will be obtained by the surgeon and passed to the STSR.
The STSR should be aware of the identity and origin of location of the specimen.
Ask the surgeon how the specimen is to be labeled.
Ask how the specimen is to be prepared. ?

21. Specimen Handling in the Sterile Field
The STSR must have a appropriate container or area ready.
Specimen cup
Emesis basin
Telfa pad
**Special considerations for contaminated specimens.

22. Specimen Handling in the Sterile Field
Never use a counted sponge to store or transport a specimen.
Multiple specimens must be maintained in separate containers and labeled correctly.
Unless indicated, specimens should be kept moistened with saline solution.

23. Specimen Handling in the Sterile Field
The surgeon may choose to orientate the specimen with special markings or sutures.
Example:
Left breast mass, short suture is superior, long suture is lateral.

25. Passing the Specimen to the Circulator
Before passing any specimen off the sterile field ask permission from the surgeon.
Communicate to the circulator the type of specimen and how the specimen is to be prepared.

26. Passing the Specimen to the Circulator
Remove the specimen without contaminating the sterile field.
Use a basin or instrument to pass to circulator.
The circulator uses standard precautions and PPE during the transfer.

27. Passing the Specimen to the Circulator
The specimen is placed in the proper container and labeled appropriately.
If a permanent specimen, formalin is added to the container until the tissue is submerged.
If the outside of the container is contaminated with bioburden, it must be decontaminated before it is submitted to pathology.

28. Review and Summary Specimen methods Laboratory studies
Specimen responsibility
Specimen handling