Reddy Raghuveer, Iyer Subramania, Pillay Minnie, Thankappan Krishnakumar, Ramu Janarthanan
Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University Kochi, Kerala, India.
Department of Anatomy, Amrita Institute of Medical Sciences, Amrita University Kochi, Kerala, India.
Indian J Plast Surg. 2017 Jan-Apr;50(1):29-34. doi: 10.4103/ijps.IJPS_219_16.
Surgical and anatomical training has been found to be most optimally simulated in a cadaver than any other available methods. Soft embalming methods have made the bodies more 'lifelike' and better suited for training. The widely accepted soft embalming techniques, including Thiel embalming, are designed for temperate climates. Their use in tropical locations has been found to be associated with poor short-term and long-term preservation of the bodies. In fact, adequate reports from tropical countries on effective methods for soft embalming are lacking.
This article details the modifications made in the Thiel embalming technique over a period of 2 years which has enabled us to preserve the anatomical features of bodies in an optimal way for longer periods in tropical conditions. This study was carried out in a tertiary care referral centre located in a tropical climate zone. A total of 13 frozen and thawed cadavers were used over a period of 2 years for developing such soft embalming technique. The efficacy of the technique was tested using these cadavers for varying types of surgical exercises on multiple occasions.
The conventionally described technique of Thiel embalming did not provide desired results. Hence, various modifications to this technique were instituted which helped us to get superior quality of soft-embalmed cadavers. In the final year, these cadavers were used successfully for workshops in flap dissection. Head and neck access surgery, arthroscopic and laparoscopic procedures as well as mock face and hand transplant dissections.
The Theil embalming technique for obtaining soft embalmed cadavers, even though found to be best in many centres in the world, has not been found to be suitable to tropical weather. By modifying it, we have succeeded in developing a technique suitable to the tropical weather. This technique yields cadavers suitable for various surgical simulation exercises. This technique also allows the body to be optimally used over several months in multiple occasions. These modifications are very simple and have been described in detail enabling it to be adopted by any surgical skill laboratory in the tropical countries.
研究发现，与其他现有方法相比，在尸体上进行外科手术和解剖训练能得到最理想的模拟效果。软组织防腐方法使尸体更具“真实感”，更适合用于训练。包括蒂尔防腐法在内的广泛认可的软组织防腐技术是为温带气候设计的。人们发现，在热带地区使用这些技术会导致尸体短期和长期保存效果不佳。事实上，热带国家缺乏关于有效软组织防腐方法的充分报告。
本文详细介绍了在两年时间里对蒂尔防腐技术所做的改进，这些改进使我们能够在热带条件下以最佳方式长期保存尸体的解剖特征。本研究在位于热带气候区的一家三级医疗转诊中心进行。在两年时间里，共使用了13具冷冻解冻后的尸体来开发这种软组织防腐技术。多次使用这些尸体进行不同类型的外科手术练习，以测试该技术的效果。
传统描述的蒂尔防腐技术未达到预期效果。因此，对该技术进行了各种改进，这有助于我们获得质量更高的软组织防腐尸体。在最后一年，这些尸体成功用于皮瓣解剖、头颈部入路手术、关节镜和腹腔镜手术以及模拟面部和手部移植解剖的工作坊。
用于获得软组织防腐尸体的蒂尔防腐技术，尽管在世界许多中心被认为是最佳方法，但并不适合热带气候。通过对其进行改进，我们成功开发出一种适合热带气候的技术。这种技术产生的尸体适合各种外科模拟练习。该技术还能使尸体在数月内多次得到最佳利用。这些改进非常简单，并已详细描述，任何热带国家的外科技能实验室都可采用。
