Novel Use of Nail Surgical Instruments for Grossing of Nail Pathology Specimens: Improving Laboratory Safety for Histotechnicians and Other Staff

Summary: The processing of nail specimens is often challenging given the complex anatomy and physical characteristics of the nail plate. Standard cutting tools, such as scalpels, struggle with the rigidity and irregular surfaces of the nail plate. Scalpel slipping or breakage during nail grossing can lead to cutting injuries and may also compromise histologic examination secondary to specimen fragmentation or uneven sections. The English Anvil Nail Splitter and Double Action Nail Nipper are two instruments commonly used by dermatologic surgeons during nail surgery. The Nail Splitter consists of a scissors-like upper blade and wedge shaped lower blade that offers a mechanical advantage for splitting hardened and thickened nails. Similarly, the Nail Nipper allows for precise trimming of the nail plate. We herein describe our experience employing both of these instruments in nail grossing. Successful grossing involves an effective cutting instrument, immobilization of the specimen, and correct specimen orientation. By stabilizing the nail plate with forceps and making clean decisive cuts with the Nail Splitter or Nipper, we have created a simple and reproducible technique to efficiently process nail specimens with the desired orientation. This novel method allows for high quality nail sections while also minimizing risk of injuries for technicians.