embalming -alok

8/4/2019 Embalming -Alok

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BY: ALOK SAXENA
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The beginnings of the art and

techniques of embalming are

associated principally with ancient

Egypt.


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An accidental unearthing of natural mummy possibly ledthe Egyptian to firmly believe in an afterlife.


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The ultimate punishment for the living, according to

Egyptians was not living in hell, but ceasing to exist!!

The heart of the dead person was weighed against "thefeather of truth," a symbol of Ma'at (the goddess of truth,

justice, and order).


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The heart was not taken out of the body because itwas the centre of intelligence and feeling and theman will need it in the afterlife.

LiverLungsIntestines

Stomach

Imsety

Hapy

Duamutef

Qebehsenuef


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A long hook was used to smash thebrain and pull it out through the nose.


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After the organs were removed, the body was washedwith wine and rubbed with spices. The alcohol in the wine

acted as an antiseptic, helping to kill bacteria.


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The corpse was then covered with natron for40 days to dry out.


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Finally 68th to the 70th day----coffined.


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Middle Ages(Era of Anatomists)During middle ages, there were increasing

number of those who wanted to study the humanbody and preservation was no longer for thepurpose of an after-life but for study purposes.


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Crusades period (1095 to 1291)

There were series of wars & no preservationtechnique was developed.

The procedure included removal of soft tissues

and then boiling the bones until they were free ofall soft tissues.

The bones were then dried and wrapped within

bull hides and returned to their homeland for finalrites.


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William Harvey (1578-1657)

Embalming by arterial injectionas a mortuary practice was

developed after Harveys

discovery of circulation.


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The English word ---

to put on balm (spices & perfumes).

EMBALMINGPerfusion of the cadaver withfixative fluid for the purpose

of preventing putrefaction.


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In the middle ages embalming became an art.

Dr. Frederick Ruysch

(1665-1717)

His secret formula wasBalsamic spirit.

1 pound of tartar dissolvedin 6 pounds of water, towhich he added half poundof sal ammoniac.

After filtration it was readyfor embalming.


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Hunter Brothers

Hunter brothers were permitted to be sole agency forembalming and for performing anatomical dissections in thecity of London. William Hunter and John Hunter injected thefemoral artery with a solution composed of oil of turpentine,oil of lavender and vermilion dye.

1718-1783 1728-1793


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This is the scene from a battlefield showing theembalmer searching for cadavers. He would ignorethe cries of the injured, but look for dead bodies that

he had been paid to embalm.


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The modern embalming is defined as the

study and science of treating a deadhuman body to achieve antisepticcondition, premortem appearance andpreservation.


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The Embalming process acts on the body proteins.

It changes the colloidal nature of proteins and forms a

lattice-work of inert, more stable, longer-lasting and

firm substance that can no longer serve as food for

bacteria.

This new protein form cannot be broken down by the

enzymes from body cells or bacteria.


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The process of embalming consists

fundamentally of an injection of some

suitable disinfecting preservative (arterial

fluid) into the vascular system augmented

by the relieving of the blood from the veins.


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Receipt of the Dead Body

In the Anatomy Department the dead

body is received as1. Unclaimed Body

2. Donated Body


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Most important is legal documentation

Identification of the body. Consent. Death certificate.

No objection from police.

Clearance from the embassy.


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NOW WE ARE READY TO

EMBALM


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Transferthe body on the Embalmingtable.


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Removeclothing frombody and shave hair.


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Wash andDisinfect the body.


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Size of vessel-should be sufficiently large to affordproper insertion of cannula.

Depth of location of vessel-superficial enough toavoid unnecessary dissection.

Proximity to the heart- In unautopsied body,vessels should be close to both aorta and right

atrium.

Special cases of infants - vessels of choice areabdominal aorta and inferior vena cava.


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ARTERIES VEINS

Right femoral artery

Right common carotidartery

Both right and leftcommon carotidarteries

Right axillary artery

Femoral vein

Internal jugular vein

Right atrium ,using atrocar (in difficultcases)

Vessels of right side of thebody are commonly used ???


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ARTERIES VEINS

Abdominal aorta isused directly forinjection.

Inferior vena cava

Other sites

Right and left common carotid arteries

Right and left femoral (external or common illiac) arteries

Right and left subclavian (axillary) arteries


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Most commonly used artery for injection is

Femoral Artery.

And most common vein for drainage is FemoralVein.

But there are other sites also..

Common carotid artery and internal jugular vein

Axillary artery and axillary vein

Radial artery


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After exposure pass two ligatures under theartery.

Use a scalpel to open the artery.

Now cannulate the artery towards the

heart.


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Transverse Diagonal T-shaped Wedge-shaped


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Arteries are empty after death, therefore,

best suited to carry the fluid to the tissues.

They do not collapse when cut.

Veins are large, thin walled with valves,

usually engorged after death and collapse ifempty.


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The hooks areused mainly inretraction ofskin andsuperficial fascia

In raising theartery or a vein

to the surfaceof the skin forarterialinjection.


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IN UNAUTOPSIED BODIES IN AUTOPSIED BODIES

One point injection

Split injection

Multipoint injection

(in case of failure of

one point injection

technique)

Six point injection


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Done by embalming machines.

Gravity method

Electric pump method


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Traditional, simplest, most commonlypracticed and least expensive method .

It requires a graduated glass bottle of the

capacity of ten litres with an outlet with a Tconnection which leads to two rubber tubingsconnected to two cannula.

One Cannula is directed downwards and the

other upwards.

The T connection contains a screw clamp tocontrol the rate of flow of the fluid.


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After the cannula is secured, theembalming bottle is filled with the arterialfluid and kept at a height of 4-6 feet from

the embalming table.

By the pressure of gravity the fluid startsflowing

Complete injection takes nearly 7-8 hrs


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ADVANTAGES DISADVANTAGE

This can be asubstitute when there

is a electric powerfailure.

This method provides

a slow, steady andmore thoroughdistribution of fluid.

The method is timeconsuming and needsconstant refilling ofthe bottle.


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ELECTRIC PUMP METHOD

Simple device wherepressure is generated toforce fluid from an

injection tank into thevascular system.

Duration it delivers 8-10 liters of arterial fluidwithin 30-45 min.


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Very high pressure should not be usedas it can rupture the arterial walls.


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Through veins.

Blood is present in large amounts inveins at the time of death..

Contents of drainage?

Purpose of the drainage?


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Methods of drainage Advantages Disadvantages

Alternate Thorough distributionof fluid

More time consuming

Concurrent(continuous) Less time consuming Incomplete Distributionof fluid

Intermittent Less time consumingwith thoroughdistribution of fluid


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Golden Rule for Drainage:

Good drainage can be expected

only when the interval between

Death and Embalming

is short.


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Of proper and complete embalming:

Skin looses elasticity.

Face becomes fixed.

Fluid oozes out from orifices.


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Arterial embalming- arterial fluid is injectedinto selected artery.

Cavity embalming- involves two steps:

Aspiration of the cavities and their contents.

Injection of a strong preservative chemical.

If the cavity treatment is not donethe continuedactivity of the bacterial flora, already exist in theviscera, will promote putrefaction and ultimatelycause failure of embalming.


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Hypodermic embalmingusing hypodermicneedle.

Surface embalmingusing cotton packssoaked in arterial or cavity fluid.


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What is an embalming fluid??

A disinfectant?

A preservative?

Will it prevent contamination?

Produces life like appearance?


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Preservatives

Germicides

Buffers

Wetting agents

Anticoagulants

Dyes

VehiclePerfuming agents


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Formalin/ formaldehyde -

Discovered in 1856 by August

Wilheld Von Hofmann.

It is 37% by weight or 40% by

volume of formaldehyde gas in

water.

Methyl alcohol acts as

stabilizer (about 10% is

added).

August Wilhelm vonHofmann


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It is a bactericidal but not aneffective fungicidal and insecticidal.

Other preservatives

Methanol and Phenol ..


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Germicides -

Eg:Phenol and its derivatives, zephiran

chloride and glutaraldehyde.

Buffers

Assist in stabilizing the pH and providegood medium for reaction of

preservatives with cellular proteins.

Eg. Sodium borate/ Bicarbonate/Carbonate and magnesium Carbonate

act as neutralizer of formalin.


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Wetting agents-

are used to lower the surface tension andsubsequently to facilitate the penetrationand distribution of embalming fluid throughvascular bed.

Eg. Glycerin, sorbitol and sodium

lauryl sulphate.

Anticoagulants-Eg. Sodium Citrate and oxalate.

D Si l h l l i f h


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DyesSimulates the natural coloring of thetissues.

Also enable the embalmer to detect patchyembalming effects if any.

Eg.Eosin

Vehicles A solvent that help the

ingredients in the solution in a stable anduniform state during transport through thevascular system to different parts of the

body.Eg. Water

PerfumesEg.Methyl salicylate


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Muscle relaxants-

Eg.Magnesium chloride

Recent view- relaxing agents are ineffective

in a cadaver.

But what about quantity of fluid???


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CHEMICALS

PURPOSE

AMOUNT (for 1 lit.)

FormalinMethanol Preservative 10.0%55.0%Sodium borate Buffer 15.0%Sodium citrate Anticoagulant 15.0%Glycerin Wetting agent 15.0% (20%*)Phenol Germicide 5.0%Water Vehicle 15.0% (10%*)Thymol (dissolve inalcohol) Fungicide Few crystals1% eosin Dye 5.0mlMethyl salicylate Perfume 10.0ml

(For 1 ltr) increaseglycerine and decreasewater in Thin subjects*


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CHEMICALS PURPOSE AMOUNTFormalinMethanol Preservative 60.0%25.0%Glycerin Wetting agent 2.5%Phenol Germicide 10.0%Mercuric chloride Insecticide and

disinfectant 1.0%Lavender Perfume 1.0%

(for 1 ltr fluid)


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Used to keep the dissections moist.

CHEMICALS PURPOSE AMOUNTGlycerin Wetting agent 75.0%Alcohol Preservative and

to mix thymol10.0%

Phenol Germicide 5.0%Water Vehicle 10.0%Thymol Fungicide Few crystals


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For immersing the embalmed cadavers.

CHEMICALS AMOUNTSFormalin 15.0%

Glycerin 20.0%

Phenol 5.0%

Water 60.0%


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To prevent drying of the isolateddissected parts.

CHEMICALS AMOUNTFormalin 5.0%

Glycerin 50.0%

Phenol 5.0%

Water 40.0%

Thymol Few crystals


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Use 10% formalin only.


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Burnt bodies.

Radiation bodies.

Fetuses.

Autopsied bodies.

Diseased bodies like ascites, bed

sores.


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HIV infected bodies

Treat the body with sodium hypochlorite(effective germicides)

Consider all bodies are potentially

dangerous with HIV (universal workprecautions) for minimizing the risk of

exposure to blood and body fluids.

(As per CDC ,Centers for disease

control, recommendations).


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Considerations for the health of

embalmers.

Considerations for disposal of human

remains and other infected materials.

Protective Equipment


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Protective Equipment


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The practice and purpose of embalminghas undergone a sea change over theyears and the guiding purpose hasshifted from predominantly cultural to

educational.

With advances in modern practice, we

can look forward to further glorificationof the dead in future.


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Thank you

embalming -alok

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