Hayashi Shogo, Homma Hiroshi, Naito Munekazu, Oda Jun, Nishiyama Takahisa, Kawamoto Atsuo, Kawata Shinichi, Sato Norio, Fukuhara Tomomi, Taguchi Hirokazu, Mashiko Kazuki, Azuhata Takeo, Ito Masayuki, Kawai Kentaro, Suzuki Tomoya, Nishizawa Yuji, Araki Jun, Matsuno Naoto, Shirai Takayuki, Qu Ning, Hatayama Naoyuki, Hirai Shuichi, Fukui Hidekimi, Ohseto Kiyoshige, Yukioka Tetsuo, Itoh Masahiro
From the Department of Anatomy (SH, SK, TS, NQ, NH, SH, MI); Department of Emergency and Critical Care Medicine (HH, JO, KK, TS, TY); Department of Anesthesiology (TN, HF, KO), Tokyo Medical University, Tokyo, Japan; Department of Anatomy (MN), Aichi Medical University School of Medicine, Aichi, Japan; Department of Diagnostic Radiology/Division of Ultrasound (AK), Tokyo Medical University Hospital, Tokyo, Japan; Department of Primary Care and Emergency Medicine (NS), Graduate School of Medicine and University School of Medicine, Kyoto University, Kyoto, Japan; Advanced Disaster Medical and Emergency Critical Care Center (TF), Niigata University Medical and Dental Hospital, Niigata, Japan; Department of Emergency and Critical Care Medicine (HT), Kinki University School of Medicine, Osaka, Japan; Shock and Trauma Center (KM), Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan; Department of Emergency and Critical Care Medicine (TA), Nihon University School of Medicine Itabashi Hospital, Tokyo, Japan; Department of Orthopaedic Surgery (MI), Niigata City General Hospital, Niigata, Japan; Department of Colorectal Surgery (YN), National Cancer Center Hospital East, Chiba, Japan; Department of Plastic Surgery (JA), University of Tokyo Graduate School of Medicine, Tokyo, Japan; and Division of Gastroenterological and General Surgery (NM), Asahikawa Medical University School of Medicine, Hokkaido, Japan.
Medicine (Baltimore). 2014 Dec;93(27):e196. doi: 10.1097/MD.0000000000000196.
This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST.
本文评估了经饱和盐溶液(SSS)法防腐处理的尸体用于外科技能培训(SST)的适用性。利用尸体开展的SST课程已用于提升外科医生的技术,且不会对患者造成任何风险。提高SST的一个重要因素是标本的适用性,这取决于防腐处理方法。此外,使用尸体所涉及的感染风险和成本也是需要解决的问题。采用3种方法对6具尸体进行防腐处理:福尔马林溶液法、蒂尔溶液(TS)法和SSS法。对每具尸体进行细菌和真菌培养测试以及活动范围测量。14名外科医生对这3种防腐处理方法进行了评估,9名SST教员(7名创伤外科医生和2名骨科医生)通过21项操作对尸体进行了处理。此外,还对部分尸体进行了超声检查、中心静脉置管以及烧灼后自动缝合钉合的切口操作。SSS法具有足够的抗菌效果,所处理的尸体关节灵活,组织质量高,适合SST。外科医生评估经SSS法防腐处理的尸体与经TS法防腐处理的尸体高度相当。两种方法防腐处理的尸体超声图像都很清晰。在经SSS法防腐处理的尸体上可以进行中心静脉置管,然后通过X射线确认。在经TS法和SSS法防腐处理的尸体上可以对肺和肠道进行烧灼和自动缝合钉合的切口操作。经SSS法防腐处理的尸体对于SST非常有用。该方法简单,感染风险低,成本相对较低,能够使尸体更广泛地用于SST。