Prepare for Procedure

Prepare for a Procedure

Muscle and/or Nerve Biopsy

Before the Biopsy
Each biopsy requires a pre-biopsy history and physical exam by your internist or referring physician and blood testing. The blood work, history and physical exam must be completed within 30 days of the surgical procedure.

If your biopsy will be in the leg or ankle, you will not be able to bear weight on that limb for 48 hours after the procedure. If you will need crutches or a walker, you can either bring your own or obtain them in the pre-op area before your biopsy. If you will require a wheelchair, it is recommended that you make these arrangements on your own prior to the day of the biopsy. If your biopsy will be in your arm, there are only minor limitations on your activity for 48 hours after the procedure.

The Day of the Biopsy
Your surgery will be scheduled for a Monday afternoon, between 12:15 PM and 3:15 PM. You will report to the Outpatient Surgery Center located in the basement of the Johns Hopkins Outpatient Center.

We ask that you come two hours prior to your scheduled procedure for registration and nursing evaluation.

After your surgery is scheduled, you will be mailed written instructions for exactly what to do to prepare. It is imperative that you avoid aspirin, aspirin-containing products and non-steroidal anti-inflammatory medications for 7-10 days prior to the biopsy. If you are taking Coumadin (warfarin) or Plavix, you must consult your prescribing physician.

You may eat a light meal the morning of your procedure. The procedure is done with local anesthetic. Your surgery will take approximately one hour to an hour an a half. Please plan to be in the surgical center for a total of at least four hours. Please make arrangements to have someone drive you home after the procedure.

After The Biopsy
Your incision site must stay dry for two weeks if closed with sutures or three weeks if closed with staples. Waterproof protectors, i.e. AquaShield?, for the arm or leg can be purchased from a medical supply store. Patients with incisions closed with staples need to schedule an appointment for staple removal three weeks post-op.

Your referring physician will provide you with the results of your biopsy. Results of muscle biopsies are available within one-to-two weeks. Results of nerve biopsies take up to four weeks.

Skin Biopsy

Over the last few years, Johns Hopkins has developed skin biopsy as a useful tool to assess the state of the sensory nerves in the skin. By taking a small piece of skin, we are able to assess the number of nerve fibers and evaluate the "health" of the sensory nerves.

How is skin biopsy performed?
Skin biopsy is a very simple procedure which is performed in the outpatient setting and which takes 10 to 15 minutes. First, the skin is thoroughly cleaned and the skin is numbed by making small injection of a local anesthetic. Then, a sample of skin is taken by a biopsy from the numb area of the skin. Finally, a Band-Aid dressing is used to cover the biopsy site. Generally, the skin heals easily within one to two weeks. The risk of bleeding or infection is extremely low.
After the biopsy, the skin sample is processed in a special laboratory. The results are made available to your doctor within two weeks.

What can be learned from skin biopsy?
Skin biopsy can give us information about the state of health of the small nerve fibers in the skin. This may give important clues to your doctor as to what is causing your symptoms and may help in correctly diagnosing sensory neuropathy. This can lead to appropriate treatment for the underlying problem.

Biopsy Site Care:
Your biopsy site should be kept clean and should not be submerged in water (i.e. no swimming, hot tubs, baths, etc.) for a few days. The bandage should be changed at least once a day and should be changed if becomes wet or damp. Once a substantial scab has formed or new skin beings to grow over the area and bleeding has stopped, the bandage can be removed. In the long term, minimal scaring may occur. In most cases, the biopsy site is indistinguishable within a few months. In a few instances the biopsy site may form a protrusion or bump but continue to heal normally.