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TOTAL-FIX

The TOTAL FIX fixative is manufactured by Medical Chemical Corporation and is a single vial system for the preservation of fecal specimens.  TOTAL FIX-preserved fecal specimens can be used for the formalin sedimentation concentration, permanent stained smears (trichrome or iron-hematoxylin), and certain fecal immunoassays for Cryptosporidium spp. and Giardia lamblia.

MSDS Sheet

ADDITIONA INFORMATION PER PARASITOLOGY PRODUCTS

COMMENTS REGARDING PREPARATION OF FECAL SMEARS FOR PERMANENT STAINING [TRICHROME, IRON-HEMATOXYLIN, MODIFIED ACID-FAST (COCCIDIA), MODIFIED TRICHROME (MICROSPORIDIA)] FROM TOTAL-FIX

            In order to increase the sensitivity of the permanent stained smear, the fecal smears can be prepared from concentrated stool sediment.  HOWEVER, if the concentrated sediment has been rinsed with saline and/or formalin, one may need to use albumin to "glue" the material onto the slide prior to staining.  If the fixative used contains PVA (plastic powder used to glue the stool onto the slide), then albumin may not be necessary.  HOWEVER, AGAIN, if rinses have been performed using saline/formalin, then the PVA has been rinsed out. 

            Some of the fixatives that do not contain PVA (single vial systems that can be used for the O&P, as well as the fecal immunoassays, including TOTAL FIX), will also stick to the slides if the specimen is centrifuged and the slides prepared from the first centrifugation sediment (no rinse fluid used).  Then, the full concentration with rinses can be performed.  Also, these slides can be dried for two hours in the incubator or overnight at room temp.  If prepared and dried using these recommendations, the stool will not fall off the slides during staining.  So, if smears of the sediment are prepared prior to the use of rinse solutions, no albumin is required; if smears of the sediment are prepared after rinse solutions/complete sedimentation procedure, then albumin is generally recommended, particularly if there is a lot of rinse fluid left in the tube at the end of the centrifugation process.  When the sediment is mixed with the fluid in the bottom of the tube, albumin may be necessary for stool adherence to the glass slide (coat the slide with albumin prior to the addition of the fecal sediment material).  Either approach will provide excellent fecal smears ready for staining.  Each laboratory can try the albumin vs no albumin approach to see if their method requires extra “glue” for adherence of the fecal material to the slide (similar to the approach used for sodium acetate-acetic acid-formalin (SAF).

            Remember, specimens collected in this fixative can also be used for fecal immunoassay testing (see table above). 

*If the vial is shaken prior to testing, allow the large fecal debris to settle out before taking the specimen for immunoassay testing.