Читать книгу Ridley's The Vulva - Группа авторов - Страница 156

A sterile technique is used for all types of biopsy.

1 The area is first disinfected with chlorhexidine as this allows a clear view of the lesion, which can be obstructed with other antiseptics such as iodine.

2 The skin should be stretched so that it is held taut, and the punch biopsy inserted and gently rotated with firm pressure. The sample will elevate and can then be removed at the base with sharp scissors or scalpel. It should not be crushed as it is removed. A small core of tissue is then obtained. The cervical biopsy forceps should not be used for vulval biopsies as they crush the tissue and do not provide adequate samples (Figure 7.2). Diathermy and other techniques can be used for haemostasis, but not to remove the specimen as the heat artefact makes histological interpretation difficult.

3 The biopsy site can be sutured with an absorbable thin suture (4/0 or 5/0). For shave biopsies, haemostasis can be achieved with the application of silver nitrate.

4 Adhesive dressings are not helpful; a folded piece of soft gauze is adequate, which can be held in place with underwear.