Int J Anat Res 2016, 4(3):2531-35. ISSN 2321-4287 2531

Original Research Article

EMBALMING FLUID - MODIFIED COMPOSITION FOR HOT ANDHUMID PLACESSuniti Raj Mishra *1, Jigyasa Passey 2, Rahul Singh 2, Raveena Singh 2, Sushobhana2, Priyanka Sinha 3.

ABSTRACT

Address for Correspondence: Prof. Dr. Suniti Raj Mishra, Professor & Head, Department of Anatomy,G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India. E-Mail: dr.suniti@yahoo.co.in

Background: The human cadaver is the chief member of the department of anatomy in any medical school or acollege, who draws the maximum attention, love, care and regard and so needs to be preserved well. Embalmingis a well known technique for preservation of cadavers with chemicals.Aim: It was felt that the composition of embalming fluid should vary with the climate of any place. In hot andhumid weather as seen in Kanpur, Uttar Pradesh the cadavers tend to putrefy faster as compared to cold places.Hence the present work was undertaken to formulate the composition of embalming fluid for a hot and humidplaces like Uttar Pradesh, India.Material and Methods: In addition to the old standard ingredients of embalming fluid viz. formalin, glycerineand carbolic acid being used in the department since past years, other antiseptic and antifungal ingredients likethymol, Potassium Nitrate, Naphthalene flakes, Boric Acid, Ammonium Bromide, sodium Citrate and plenty ofCommon Salt were added in the water. The embalming fluid so prepared was instilled in the body.Result and Conclusion: The cadavers with the modified embalming fluid were better preserved, soft and longlasting than the past years. It was concluded that the composition of the embalming fluid should be modifiedaccording to the climate of the place and antifungal agents must be added in the solution in the hot and humidplaces.KEY WORDS: Anatomy, Body Preservation, Cadaver, Dissection hall, Formalin Embalming fluid, Humid places.

INTRODUCTION

International Journal of Anatomy and Research,Int J Anat Res 2016, Vol 4(3):2531-35. ISSN 2321-4287

DOI: http://dx.doi.org/10.16965/ijar.2016.265

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Received: 20 May 2016 Accepted: 15 Jul 2016Peer Review: 20 May 2016 Published (O): 31 Jul 2016Revised: None Published (P): 31 Jul 2016

International Journal of Anatomy and ResearchISSN 2321-4287

www.ijmhr.org/ijar.htm

DOI: 10.16965/ijar.2016.265

*1 Professor, Department of Anatomy, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India2 Postgraduate resident, Department of Anatomy, G.S.V.M. Medical College, Kanpur, Uttar Pradesh,India3 Lecturer, Department of Anatomy, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India

Preservation of cadavers has been a practicesince ancient times [3-4].Embalming is a chemical process that is usedto preserve and sanitize the human body afterdeath [5].The desired properties required forsuccessful embalming of cadavers for grossanatomy teaching include: (1) good long term

The human cadaver is the first teacher and thefirst patient of a first year MBBS student whomhe examines and dissects minutely for the wholeone year [1-2]. The words of gratitude for thecadaver need to be actually expressed as properembalming and preservation as action.

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Suniti Raj Mishra , Jigyasa Passey, et all. EMBALMING FLUID - MODIFIED COMPOSITION FOR HOT AND HUMID PLACES.

structural preservation of organs and tissueswith minimal shrinkage or distortion; (2) preven-tion of over hardening, while maintaining flex-ibility and suppleness of internal organs; (3) pre-vention of desiccation; (4) prevention offungal or bacterial growth and spread within aspeciûc cadaver and to other cadavers in thedissection room; (5) reduction of potentialbiohazards (spread of infection to dissectionpersonnel and students); (6) reduction ofenvironmental chemical hazards and (7)retention of colour of tissues and organs whileminimising oxidation effects that result in‘browning’ [6].Most of the reports available [6-7] for thecomposition of embalming fluid are related tocold places which could not be used in our setup because of cost, technique, resources andrelative output. This led us try and findeconomical and practical solution for a placewith hot and humid weather.

The work was undertaken at department ofanatomy, GSVM Medical College, Kanpur, UttarPradesh, India. In the department, all the cadav-ers received were from persons who voluntarilydonated their bodies to medical science. Thecadavers reach the department within 24 h ofdeath and embalming is usually done on thesame day. The local temperature rangeexperienced at the place was 19 - 45 degreesCentigrade. It was experienced that the use ofconventional embalming fluid with formaline,glycerine and carbolic acid as constituent couldnot give desired results. Often the cadaverswould dry up, harden, darken and developmoulds after 2-3 months leading to disinterestamong the students and staff for furtherdissection. Based on the review of availableliterature, the embalming solution for onecadaver was constituted with the materialsviz. –a)Formalin (40%)- 2lit; b) Methyl alcohol /isopropyl alcohol /Surgical Spirit- 1 litre; c)Glycerin- 1lit; d) Phenol/ Carbolic acid – 0.5lit;e) Borax /Sodium tetraborate /sodium borate /boric acid – 50 gm; f) Sodium Citrate – 50 gm; g)Thymol – 50 gm; h) Naphthalene flakes- 50 gm{ d-h were boiled to dissolve in water}; sodiumchloride – 500gm; potassium nitrate- 250 gm;

MATERIALS AND METHODS

Ammonium Bromide – 250 ml; Eosin- 5 ml addedto adequate amount of water (fig. 1).

Fig. 1: Chemicals used for embalming.

The solution was made up to 12 litre with tapwater for one cadaver. For larger cadaver20litre of solution was made for embalming.Twenty cadavers received in the department ina period of 18months were embalmed withembalming fluid of above composition. Theresults were compared on the basis of overallexperience in past when the embalmingsolution (12 litre) was composed of onlyFormaline, Glycerine, Carbolic acid in 3:2:1ratio with tap water.All the above chemicals were of standard gradeexcept for the sodium chloride which wascommon household salt purchased from a localmarket. The embalming ûuid was perfused viathe femoral artery using a mechanical pressurepump at 750–1000 mmHg. The cadavers werethen kept submerged for a week in a stainlesssteel tank with 5% formaline solution with 500ml of thymol, naphthalene and turpentine oiladded to it. Then the cadavers were shifted inmortuary freezers at 4 °C, until further use.

RESULTS

The modified embalming mixture resulted incadavers with excellent dissection properties anda dissection room that was virtually free ofsmell. There was very little smell offormaldehyde in the dissection room. Thecadavers remained mould free and softthroughout the year. The colour of the softtissue and muscles was also pleasant as com-pared to the cadavers in past 2 yrs which usedto get too dry and dark within 2-3 months anddevelop mould and infection resulting in apeculiar bad smell in dissection hall. The lowformaldehyde levels in the dissection hall in theembalming solution allowed prolonged

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dissection by faculty and students without anyof the common complaints associated with form-aldehyde exposure such as eye-watering, or dis-turbances to the respiratory tract.

DISCUSSION

Embalming fluid acts to fix cellular proteins, sothat they are denatured and cannot act as anutrient source for bacteria. It also possessesbactericidal properties. Typically theembalming fluid is composed of- fixative orpreservative, disinfectant, modifying agent(buffer, anticoagulant, surfactant, humectants,dyes, perfuming agent, diluent [8-9]. The mostfrequently used fixatives and disinfectants areethanol, formalin, and phenol. 25 percentethanol and 0.5 percent formaldehyde wereshown to be effective against HIV [10].Commercial Formalin is 37 percent by weight or40 percent by volume of formaldehyde gas inwater. It becomes acidic on storage due toproduction of formic acid. It fixes tissue or cellsby irreversibly connecting a primary amine groupin a protein molecule with nitrogen in a proteinor DNA molecule through a -CH2- linkage calleda Schiff base. The crosslinking can cause DNAto keep cells from stopping the replicationprocess in exposed persons which can lead tocarcinoma [11]. Thus the toxic effects ofexposure to formaldehyde are irritation ofmucous membrane, upper respiratory tractirritation, contact dermatitis and mutatagenicityor carcinogenicity [12-13]. Besides, the higherconcentration of formaline causes hardening[14]. Despite its toxic effects, formaldehyde stillremains essential ingredient of compositionbecause of its proven efficiency and consistencyof results. The subject has been largelyneglected and relatively few reports onembalming of cadavers for gross anatomylaboratories have appeared or addressed thisissue [15-20]. Most of the reports deal with theneed to reduce the concentration of theformaldehyde in embalming fluids or the use offormaldehyde substitutes. Some of the workershave used Phenoxyethanol [17] and Glutaralde-hyde [21] as a good substitute but both are re-quired in very large volume. Besides, slow fixa-tion process and expenses make these not fea-sible for routine use in anatomy department.

We have also attempted to reduce the amountof formaline to just half in our composition andsubstituted other chemicals for better preser-vation.The surgical Spirit (methyl alcohol) added in thesolution helps in complete dispersion offormaldehyde into the body tissues as itprevents polymerization of formaldehyde andacts as an antirefrigerant. It also coagulates thealbumin and kills many organisms [15].The Carbolic acid (Phenol C6H5OH) is apowerful germicide and fungicide due to itsability to denaturate and precipitate protein andproteinaceous products and its ability effectivelyto destroy the cell wall due to its lipophiliccharacter [22].Commercial formalin becomes acidic on storagethrough production of formic acid. It convertshemoglobin into methaemoglobin which ispurple or black in color wherein ferrous iron isoxidized into ferric oxide; hence the embalmedbody turns dark or black some days afterembalming [23]. Sodium tetraborate or Boraxacts as a good buffer by making the forma-lin slightly alkaline with a pH of 9.   It   renders it more stable and affords protection againstmould growth and bacterial decomposition [20].The buffered formaline needs to be freshlyprepared. It works as insecticide, has been usedas a mild antiseptic or bacteriostatic and wasused for embalming purposes [24-25].Glycerine is a wetting agent, miscible withwater and alcohol and prevents water loss fromthe body and keeps it soft. It facilitates thedistribution of embalming fluid through vascu-lar bed, for optimum penetration into tissues andreduces the surface tension [23]. Its amount maybe further increased, if available.Salt has been used for centuries as a cheap andexcellent preservative in food stuffs in which ittypically provides environments that minimisebacterial and fungal spoilage [26-27]. Ourembalming solution with salt resulted inexcellent long-term preservation of cadavers asalso reported in past [28].Thymol [29] and naphthalene flakes[30] areknown to be very strong antimicrobial and anti-fungal agents , useful for embalming purpose.Ammonium bromide (Cetrimide) is a white

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powder, soluble in water and alcohol. Quartern-ary ammonium molecule released fromammonium bromide acts as antimicrobial agent.It is bactericidal against gram positive as wellas gram negative organisms. It has variableantifungal activity and effective against someviruses [23].Sodium Citrate acts as an anticoagulant and abuffer [9]. Potassium Nitrate acts as a preser-vative and antibacterial agent [31] but in caseit is not available, Sodium nitrate can also beused instead of it [20]. Eosin being a dye im-parts a reddish hue to tissues so vesselsappear more living.The above composition gave very good andsatisfactory results for routine anatomy teach-ing however for special purposes like Surgicalskill training and Postgraduate hands-on work-shops for many surgical disciplines soft embalm-ing with Thiel Solution has been widely appraisedfor the method provides high standard ofpreservation with natural texture and colors. TheTheil solution consists of monopropyleneglycol, ammonium nitrate, Potassium nitrate,Sodium Sulphite, Boric acid, Chlorocresol,formaline, ethanol, morpholene but the methodis very complicated and expensive to be usedas a routine for dissection hall [24]. In thepresent composition we have optimized thecomposition in view of availability, cost effec-tiveness and procedure.

The cadavers with the modified embalming fluidwere better preserved and softer than the pastyears. It was concluded that the composition ofthe embalming fluid should be modifiedaccording to the climate of the place andantifungal agents must be added in thesolution in the hot and humid places. Thecadavers remained free from growth of fungusand maggots with very little care throughout theyear. This is a cost effective method of embalm-ing besides it is environmentally safer for thestaff and students, who would otherwise beexposed to harmful bacteria and fungi on aregular basis during routine dissection.

CONCLUSION

The authors express their gratitude towards all

ACKNOWLEDGEMENTS

Conflicts of Interests: None

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How to cite this article:Suniti Raj Mishra , Jigyasa Passey, Rahul Singh, Raveena Singh,Sushobhana, Priyanka Sinha. EMBALMING FLUID - MODIFIEDCOMPOSITION FOR HOT AND HUMID PLACES. Int J Anat Res2016;4(3):2531-2535. DOI: 10.16965/ijar.2016.265

Suniti Raj Mishra , Jigyasa Passey, et all. EMBALMING FLUID - MODIFIED COMPOSITION FOR HOT AND HUMID PLACES.