Hard-pressed packing carton can be used in the surgical pathology grossing room for support of bones with irregular configuration, especially with attached soft tissue. This material is in abundance in every laboratory after outpacking different kinds of equipment. The variety of configurations of the packing carton gives many options for immobilization. The carton does not hamper with the saw because the saw can cut it through easily. The relative roughness of the carton’s surface gently
grasps the specimen’s inevitably uneven surface. It has advantage in comparison with Styrofoam material that is fragile, more rigid, and leaves sticky white crumbs. The carton gadget can be discarded.
The saw cuts through the specimen and carton without crashes that often occur towards the end of sawing. While having a collection of disposable material, it would be responsible to state that every calcified specimen can be cut without preliminary decalcification, including bones in facial-maxillary surgery and calcified tumor, providing valuable sections for margin evaluation for resection or other diagnostic questions.
Although the wooden bone support gadget like The Davidson Marking System holding stand is my primary tool for bone cutting, the hard-pressed packing carton becomes more and more useful.
Now I use also the standard hard-pressed carton cafeteria tray because the cup holder sometimes fits some bones. The standard pressed carton eggs container is too soft, unfortunately.
Disposable hard-pressed cafeteria trays with cup holders (one, two or four) are the most ubiquitous and suitable immobilization gadgets for bone cutting, especially if the specimen has an unusual configuration.
Here are examples of hard-pressed carton cafeteria trays in action.
The sternum with adjusted ribs and the skin flap in an osteomyelitis case is securely placed on four cups holder tray.
Many serial longitudinal sections have been made without any difficulty.
|Serial section throught he carton|
The femoral head with unusual configuration in a sickle cell anemia patient is placed in the cup holder tightly.
A cross section has been made. A fragment of a hard-pressed packing carton had been placed beneath the tray to allow the saw’s handle to move more easily that is especially important while doing the last cuts.
A complcated specimen of the bone after sarcoma chemotherapy.
Cut in a half
Dimenstein IB: Hard Pressed Cardboard for Bone Grossing Immobilization. AAPA Newsletter, 2007 Vol. XXXV No.4:25