[Histonet] Tissue Sections

[Bauer, Karen]

Hi to all...
 
I know we've all talked about this before, and I've spent the last hour searching the archives for any information that I could use.  Since there were no real answers to help me out, I'm turning to the pros for assistance.
 
Lately we have been experiencing a lot of headaches with sections falling off, bad sections, and folding around the tissue edges.  We have not changed anything that we have been doing and it's not all the slides.  I asked the pathologist how many slides he's finding like that and he stated probably 15 to 20 slides a day.  15-20 out of 200 plus are coming out crappy, when all of the others are fine.  Everything is processed, embedded, cut, stained and coverslipped the same, but some come out beautiful and some come out very bad.  Whenever they ask for recuts on the bad slides, they say they are always beautiful.  A lot of times, the recuts are cut by the same tech that cut it the first time.
 
I've talked to the staff a lot about this occurrence and know all are knowledgeable of proper cutting techniques.  They all turn in quality work.  We have really slowed down our cutting in the morning in order to hand in that "perfect" slide.  They macroscopically look great when we put them on the slide, but when the doctor gets them, crappy ones show up.  
 
We've thought about water trapped under the section and have let them drain vertically and air dry longer before we put them in the oven.  We've let them cool after the oven to make sure the sections are adhered securely before putting the slides in xylene.  We stain by hand, so we make sure we gently dip the slides and not dip aggressively.  We coverslip by hand also.  While coverslipping, there are many times that I see the edges of tissues move slightly when I put the coverslip on, so I know the tissue is not adhering.  
 
We have a slide etcher, so we use the ColorMark slides with the black backing.  We use charged slides for all of our prostate cores, breast cores, and any small core biopsies that usually require special stains or IPs.  We use plain ColorMark slides for all other routine Histology cases.  We've tried using charged slides for all tissues, but were still getting bad slides here and there.
 
As I said, all tissues are treated the same, but only 15-20 slides out of 200+ are coming out bad.  Our techs rotate cutting, so I know it's not just cutting techniques.  It's happening to all of us.  It's gotten to the point that our doctors are focusing on the few bad slides and it's driving them crazy.
 
I'm open for any suggestions.  We are thinking about trying different slides or maybe putting an adhesive in the waterbath (yep, I know about adhesive and not using charged slides).  Vendors who have different black backed slides than ColorMark for etching are welcome to reply.
 
Thanks in advance,
 
Karen Bauer HT(ASCP)
Histology Supervisor
Luther Hospital
Eau Claire,  WI
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