Putrefaction and decay of preserved cadaver and body parts is one of the major issues that the faculties of medicines in various third world countries are facing. In this study we focus on the meaning of body preservation, causes of putrefaction and we highlight our personal experiences at the Faculty of Medicine in Prince Sattam bin Abdulaziz University in KSA, in preserving the body cadavers. We studied different physical and chemical methods of preservation of cadavers and body parts at the faculty and their efficiency in preventing bacteria and fungi that cause putrefaction and decay.
Meaning of preservation
It’s the art and science of human body to treat it with chemical components for preservation by preventing or intercepting microorganisms such as bacteria and fungi which are classified as main causes of organic decomposition which lead to putrefaction [
Embalming is an ancient art established by old Egyptians [
In this study we will focus on Embalming for anatomy education. Most of faculties of medicine around the world use the body cadaver for teaching anatomy for medical student and for research, and this type of preservation is called (anatomical preservation) [
This type of preservation occurs by natural factors including freezing and dryness that may occur by dry-heat or dry-cold (
It can be divided according to the causative agents which cause preservation of dead body. They are:
A) Natural mummification: This is caused by the Mother Nature which occurs when buried in [
B) Artificial mummification or true mummification: This is the type of preservation that had been done by Ancient Egyptian civilization for religious concepts (
Different materials had been used in the mummification include materials that desiccate and dehydrate such as natron salt and vegetable materials and those act as anti-bacterial factors such as Mastic, Lichen, Myrrh, Bitumen, Cassia, Onions, Beeswax, Lichen, Coniferous resin, Henna and Gum Arabic [
Source: http://familypedia.wikia.com/wiki/%C3%96tzi_the Iceman
Source: http://news.softpedia.com/news/Scientists-Mummify-Human-Leg-in-Bizarre-and-Twisted-Experiment-482441.shtml#sgal_0
This is a method or technique used for the long term preservation of body or part of body [
As previously described many chemicals can be used to replace the fluid and fat this led to provide different techniques of plastination here we will mention some of this techniques.
a) Silicone plastination
Silicone plastination is one of most common techniques of plastination which can be used for body, organs, part of organ and slices [
Silicone plastination consist of four steps after preparation of specimen and are dehydration, defatting, hardening and formaldehyde embalming or fixation (
b) Epoxy plastination
This techniques of plastination is usually used for tissue examination especially slices of 2 - 4 mm [
Source: Ottone, N.E., Del Sol M. and Fuentes, R. (2016) Report on a Sheet Plastination Technique Using Commercial Epoxy Resin. International Journal of Morphology, 34, 1039-1043 [
According to T. Shahar [
・ Fixatives (if necessary)
・ Methylene chloride (MeCl) as defatting agents
・ Acetone
・ Epoxy resin
・ Epoxy hardeners to link the epoxy molecules
・ Epoxy plasticiser
c) Polyester plastination
The basic steps in this technique are also the same as described in the earlier procedure. In Polyester plastination the tissue fluids withdrawn and replaced by
Source: http://www1.zu.edu.eg/plastination/polyester_plastination_1_files/frame.htm
curable Polyester resin [
・ fixatives (if necessary)
・ acetone
・ methylene chloride (if necessary)
・ polyester resin.
The term of Embalming derived from Latin origin and it define as treatment of body cadavers with special chemicals so as prevent decay or putrefaction, it was an ancient culture and nowadays in modern culture it become substantial science and art due to social and science reason because the preserved body cadaver considered as an ideal teaching tool for anatomy and other branches medical science such as surgery, obstetrics, pathology and radiology [
a) Embalming in the ancient cultures
Many ancient cultures including Egyptian culture practiced embalming as they believed that decayed dead of the body would preclude it from life after death [
1) Washing surface and body cavity with palm wine.
2) Removal of brain and internal organs (viscera) and keep it in jars except the heart.
3) Left the internal organ to dry.
4) Cover body with natron salt to dry.
5) After 40 days the body is wash with wine and spices.
6) Return back the organs inside the body.
7) Wrapped the body with linen.
8) Place the body inside coffin.
b) Modern embalming
As the relevance of body cadavers in anatomical studies cannot be ruled out, the embalming for preservation became more important. The process of embalming consists of four steps can be summarized as the following:
・ Arterial embalming: it is the injection of embalming fluid through the blood vessels usually the common carotid artery. This is to replace the body fluid by embalming solution.
・ Cavity embalming: this refers to substitute gas and fluid in the organ and inner side of the body with embalming fluid using a trocar.
・ Hypodermic embalming: this is a complementary step to ensure that concentrated embalming fluid reach all parts of the body, especially to those sites of body where the arterial fluids might not reached. This is done by using hypodermic needle and is a case-by-case basis step.
・ Surface embalming and washing: this is a (as needed step) remedy or treatment in damaged area in the surface which may occur due to a lot of causes such as skin diseases, cancer, decomposition or other epidermal injury.
Erich Brenner [
The chemical components of embalming fluid used in modern embalming are variety which includes sterilization and disinfectant agents, preservatives, modifying agents (buffers, anticoagulants, and wetting agents) and dyes [
The biodegradation is the breakdown of complex organic materials into simpler chemicals by biochemical process [
The putrefaction is the destruction of the soft tissues of the body and is it done by two different groups of organisms, i.e., the scavengers and the true decomposers like (bacteria fungi protozoa) [
There are two types of scavengers: invertebrates (e.g. flies, ants, mites, dermestids cockroaches etc.) and vertebrates (e.g. fish reptiles, big birds like vultures or mammals like jackals, rodents etc.) [
After the death of the human being, foul odour from the decomposing body attracts the houseflies and blow flies [
Then the eggs hatch and the flies come out. Maggots secrets protolytic enzyme
Teaching (Dissection) | Long Term Storage | Disadvantage | Advantage | Technique |
---|---|---|---|---|
Not tested | Extremely well when the coffin sealed | Toxic | Long term storage | Salafia (c. 1927-1933) |
Not applicable | Not applicable | Only for isolated specimens | Good preservation of colour and form | Kaiserling (pulvertaft, 1950) |
Satisfactory | Satisfactory | No data available | Easy storage | Jores (1896, 1913) |
Highly satisfactory | No data available | Medium brown colour | Very active as fungicidal agent, soft and the plastic cheap | Woodburne & Lawrence (1952) |
Satisfactory | Possible | No data available | Good preservation of intestines doesn’t affect the the dissector’s skin, odourless, objects sty smooth and elastic, colour-preserving | Peters (1956) |
Satisfactory | Satisfactory | No data available | Soft and flexible less exsiccation | Erskine (1961) |
No data available | Successful for 2 years | No data available | Decrease rigidity increased bactercidity and fungicidity, less Browning | Richins et al. (1963) |
No data available | No data available | No data available | No data available | Dayton et al. (1965) |
No data available | No data available | No data available | No data available | Beck (1966) |
Satisfactory | No data available | No data available | Cheap, odourless | Tutsch (1975) |
Satisfactory | No data available | No adequate fixation of brains | Moderate degree of movability and adequate degree of hardness for dissection | Bradbury & Hoshino (1978) |
No data available | Almost unlimited, when vacuum packed | No data available | Increase fungicidity, cheap | Platzer et al. (1978) |
Facilitates micro-dissection | Satisfactory | No data available | Soft preservation, obviates excessive noxious fumes | Logan (1983) |
“Suitable” | Up to 10 years | Slight odour, headache, drowsiness, mild eye, nose and throat irritations | Soft and flexible | Frolich et al. (1984) |
Satisfactory | No data available | Fluid accumulation | Smooth, colour-preserving | Frewein et al. (1987) |
Satisfactory | No data available | No data available | “Well fixed” | Ikeda et al (1988) |
Satisfactory | Proved up to 2.5 years | No data available | Formaldehyde vapour levels below COSHH limits, improved tissue preservation, more nature coloration | O’sullivan& Mitchell (1993) |
Satisfactory up to 6 months | No data available | Grey hue of skin | Less toxic | Macdonald & MacGregor (1997) |
Satisfactory | No data available | No data available | Excellent preservative properties, minimal structural distoration, tissue supple, little desiccation, natural colours | Coleman & Kogan (1998) |
High acceptance | No data available | Expensive, disintegration of muscular tissue, limited for dissection | High colour preservation, smooth and flexible | Thiel (1992,2002) |
No data available | No data available | No data available | No data available | Powers (2003) |
No data available | No data Available | No data available | High mould preventiong | Mills (2010) |
No data available | When waxed, possible | Hardening outside the tank, >2 days for re-softening | Not structural distortion, not colour changes | Al-Hayani et al. (2011) |
No data available | Up to 1.5 years | No data available | Natueal appearance, odourless | Anichkov et al. (2011) |
Limited usability | Up to 1year | Yellowish coloration, corrosion, disintegration of abdominal organs | Neutral smell | Janczyk et al. (2011a) |
No data available | Up to 3 years | Expensive | Flexible tissues, aesthetic appearance, less toxic | Hammer et al. (2012) |
No data available | Up to 2 years | Less toxic, good preservative properties, low volatility | Shi et al. (2012) | |
No data available | No data available (good for short term preservation ≤ 6 months) | No data available | Good coloration and flexibility | Goyri-O’Neill et al. (2013) |
softening the skin and make the way easy into interior of the body [
The bacteria are the principal agents which ultimately bring about the final reduction of the biological refuse [
Systemic study of the cadaveric bacteriology was undertaken by Burn [
The first visible sign of putrefaction is a greenish discoloration of the skin due to the formation of sulfhaemoglobin in settled blood. The process progresses into distension of tissues due to the formation of various gases (hydrogen sulfide, carbon dioxide, methane, ammonia, sulfur dioxide and hydrogen), especially in the bowels [
There are other factors which affect the putrefaction like the weather. Putrefaction is increased in warm rather than in cold [
Some studies [
- Usually the unused cadavers stored in refrigerator at (0˚C - 1˚C).
- Regarding the embalmed cadavers stored in stainless steel tanks with 10% formaldehyde diluted in water, all the cadavers were injected with embalming fluid.
The evaluation of preservation factors in department of anatomy in Faculty of Medicine in Salman Bin Abdulaziz University will take place as the following:
The assessment of physical characteristics according to Benkhadra [
a) Sampling from cadaver for possible bacterial and fungal population
The samples were collected using standard swabbing procedures from different body parts of the 1) cadaver stored in 10% formalin, 2) cadaver stored in refrigerator at (0˚C - 1˚C), and 3) plastinated body parts stored at room temperature.
The swabs were taken from oral cavities, nasal cavities, upper limbs, abdomen, genital area and axilla (
b) Sampling for airborne bacteria/fungi
Sampling for possible airborne bacterial and fungal population was done in the respective rooms/labs where the specimens were kept. This is done by standard non-volumetric air sampling method. The nutrient agar and Muller Hinton agar plates were incubated at 370˚C for 48 hours and the Sabourad’s Dextrose
Agar plates were incubated at room temperature for 7 days.
Bacterial isolates were subjected to various morphological and biochemical characterization tests to determine the identity of the bacterial population using standard method [
Neither Nutrient Agar plates nor Muller Hinton Agar plates incubated with samples from different sites of plastination, refrigerated and preserved in forma-
lin cadavers/body parts described elsewhere in this article showed any growth of bacteria (
The same was the fate of the Sabourad’s Dextrose Agar (SDA) plates which were incubated for possible fungal growth from the cadavers and body parts. This, in turn, proves the higher efficiency of embalming and preservation methods performed at the faculty of medicine, Prince Sattam bin Abdulaziz University. The Nutrient Agar plates which were subjected for airborne bacterial sampling in the Anatomy laboratory where the plastination samples are kept showed the presence of Staphylococcus and Lactobacillus species. At the same time the plates sampled the air of the mortuary shown no growth of bacteria which justifies the intense fumigation effect and the intense odor of formalin which is used as preservative for the cadaver.
Alsharif, M.H.K., Musthafa, M., Elamin, A.Y., Ibnouf, E.O., Taha, K.M., Alfaki, M.A., Nour, Y.S. and Aldosari, K.H.M. (2017) A Brief Review on the Principles of Human Cadaver Preservation and Monitoring of Microbial Degradation. Forensic Medicine and Anatomy Research, 5, 19-31. https://doi.org/10.4236/fmar.2017.53003