A technique to perfuse cadavers that extends the useful life of fresh tissues: The Duke experience

Messmer, Caroline; Kellogg, Ryan T; Zhang, Yixin; Baiak, Andresa; Leiweke, Clinton; Marcus, Jeffrey R.; Levin, L. Scott; Zenn, Michael R.; Erdmann, Detlev

doi:10.1002/ase.159

Cited by 33 publications

(30 citation statements)

References 18 publications

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“…The requirements on the tissues of body donors differ, regarding their appropriateness and usability for different settings of student dissection courses and clinical workshops. A wide variety of fixatives (Spranger, ; Rack, ; Kunz and Wilcke, ; Thiel, ; Drake, ; Whitehead and Savoia, ; Messmer et al, ; Hammer et al, ; Janczyk et al, ; Jaung et al, ) are described in literature. The most commonly used fixative, formaldehyde, causes the visual and haptic properties of biological tissues to change dramatically (Scribbans, ; Sharma et al, ; Jansen et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…There is a variety of fixative agents that are currently proposed to lower or abandon the use of formaldehyde, e.g. ethanol‐glycerin (Hammer et al, ), isopropanol (Spranger, ), methanol (Bradbury and Hoshino, ; Jaung et al, ), phenoxyethanol (Frølich et al, ; Wineski and English, ) and commercially available fixatives (Whitehead and Savoia, ; Messmer et al, ). Another alternative is the Thiel fixation, also called Graz fixation (Jaung et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques

Hammer

Löffler

Bechmann

et al. 2014

Anatomical Sciences Ed

134

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Thiel-fixed specimens have outstandingly lifelike visual and haptic properties. However, the original Thiel method is expensive and requires an elaborate setup. It is therefore of principal interest to modify the Thiel method in order to make it available to a broader user group. A modified Thiel embalming method will be described in detail and compared to ethanol-glycerin fixation with the help of illustrative examples. The visual properties, haptic properties, the usability for performing histological investigations, costs and potential health aspects will be considered. Tissues fixed with the modified Thiel technique gave results similar to the original method, providing more realistic visual and haptic properties than ethanol-glycerin embalming. However, Thiel fixation is significantly more expensive and requires more precautions to minimize potential health hazards than ethanol-glycerin-fixed tissues. In contrast to ethanol-glycerin-fixed specimens, the Thiel-fixed specimens are not suitable for histological investigations. Both modes of fixation are inappropriate for biomechanical testing. Modified Thiel embalming simplifies the availability of body donors with lifelike properties and has cost-saving advantages to the original technique. Thiel-embalmed body donors are ideally suited for clinical workshops but have restrictions for student dissection courses in facilities with limited storage space, air circulation or technical staff. Vice versa, ethanol-glycerin-fixed body donors are well suited for student dissection courses in such an environment but are limited in their use for clinical workshops. Modified Thiel embalming therefore ideally complements ethanol-glycerin fixation in order to provide customized solutions for clinical workshops and student dissection courses in a wide range of applications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques

Hammer

Löffler

Bechmann

et al. 2014

Anatomical Sciences Ed

134

View full text Add to dashboard Cite

show abstract

“…It was proposed that cadavers would stay intact for 30 days after being thawed, or 45 days if they were never stored below zero. The removal of blood decrease the growth of bacteria and unlike other preservation techniques, mold growth was not observed during the period of which the cadaver was sued (Messmer et al, ).…”

Section: Non‐formalin Based Solutionsmentioning

confidence: 99%

Human preservation techniques in anatomy: A 21st century medical education perspective

et al. 2015

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Anatomy is the cornerstone of education for healthcare professionals with the use of human material providing an excellent teaching tool in the modern curricula. The ability and quality of preservation of human remains has enabled such use. The introduction of formaldehyde as a preservative in 1893 was an important step in the history of preservation. With the European Union directive on the use of formaldehyde and its expected banning, anatomists are trying to find a more convenient and safe substitute. In this review, we compare the different techniques used based on the need for embalming, fixative used, period of preservation and the features of the embalmed specimen. The fact that embalming is used in different disciplines, multiple purposes and described in different languages has led to the development of ambiguous interchangeable terminology. Overall, there is a lack of information specifically classifying, listing and comparing different embalming techniques, and this may be due to the fact that no internationally recognized experimental standards are adhered to in this field. Anatomists strive to find an embalming technique that allows the preserved specimen to accurately resemble the living tissue, preserve the body for a long period of time and reduces health risk concerns related to working with cadavers. There is a need for embalming to shift to an independent modern day science with well-founded research at the heart of it. While this may take time and agreement across nations, we feel that this review adds to the literature to provide a variety of different methods that can be employed for human tissue preservation depending on the desired outcome.

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“…To maximize the benefits to residents of dissecting and performing procedures, Barton et al (2009) suggest using cadavers embalmed with phenol, alcohol and glycerol. Messmer and colleagues from Duke University Medical Center advocate the use of commer-cially available mixtures containing conditioners and methyl alcohol to obtained preservation with natural feel to the tissues (Messmer et al, 2010). These so-called ''soft-preserved'' tissues more closely mimic the texture of human tissue in vivo.…”

Section: Discussionmentioning

confidence: 98%

Body parts removed during surgery: A useful training source

Macchi

Porzionato

Stecco

et al. 2011

Anatomical Sciences Ed

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Current undergraduate medical curricula provides relatively little time for cadaver dissection. The Department of Human Anatomy and Physiology at the University of Padova has organized a pilot project with the University Hospital for the donation of body parts that are surgically removed for therapeutic purposes and destined under Italian law for destruction. The aim of the project is to improve residents' practical training skills. A survey over the last two years has shown that about 60 body parts were available each year. These included 13 upper limbs or their parts (i.e., forearm with hand, hand, and fingers) and 47 lower limbs or their parts (i.e., legs with feet, feet, or toes). The residents explained the aim of the project to potential donors, and, if patients were willing to donate, their informed consent was obtained. The residents were present in the operating theater during the surgical procedure. In the post-operative phase, the same residents performed dissections on the body part(s), following a teaching schedule prepared by a clinical anatomist, who also assisted residents during their studies. Residents also acted as tutors for undergraduate medical students who attended these dissections. The underlying pathology for which the body part was removed was examined, and surgical procedures were practiced on the body part itself. Our project provided an opportunity for a close relationship between anatomists and surgeons, reinforcing core knowledge of anatomy by appreciation of its clinical importance. The active involvement of residents as learners and as teachers in the various steps of this project improved their knowledge of surgical techniques and helped to establish a sense of ethical responsibility and respect for the human body. This approach involves study of anatomical structures from new perspectives and leads to improved surgical practice.

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A technique to perfuse cadavers that extends the useful life of fresh tissues: The Duke experience

Cited by 33 publications

References 18 publications

Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques

Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques

Human preservation techniques in anatomy: A 21st century medical education perspective

Body parts removed during surgery: A useful training source

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