The Six-Point Injection Technique: A Non-Immersion Method for Enhancing Cadaveric Tissue Quality

Authors

  • Patipath Suwannahoy Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
  • Attasit Boonsong Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
  • Kanchana Harnsiriwattanakit Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
  • Nathaporn Pangjaidee Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
  • Ranida Quiggins Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

DOI:

https://doi.org/10.59796/jcst.V15N3.2025.116

Keywords:

cadaver, embalming, femoral, formaldehyde, perfusion, Modified Embalming Method, MEM

Abstract

Two-point injections of embalming fluid without venous drainage, along with immersion in a post-fixative pool, has been used for several decades in the Department of Anatomy, Chiang Mai University (CMU). However, tissue decomposition was frequently observed during dissection. To address this, a Modified Embalming Method (MEM), utilizing a six-point injection technique with venous drainage, was tested. This study evaluates the effectiveness of MEM compared to the traditional two-point method with immersion. Ten cadavers were preserved and assessed for range of motion (ROM), histological integrity, and dissection quality. The cadavers were divided into two groups: five were embalmed using MEM and stored in plastic bags at room temperature, while the other five were preserved using the Present Embalming Method (PEM), which involved two-point injection without venous drainage followed by immersion. Both groups received the same embalming fluid. After one year, ROM was measured, and dissection quality was evaluated by ten dissectors. The MEM group showed greater joint mobility and superior tissue quality for both gross anatomical and histological analysis. The enhanced perfusion achieved by MEM ensured uniform distribution of fixative throughout the body. Furthermore, MEM eliminated the need for immersion, reduced chemical use, and allowed safe storage of cadavers in mortuary bags at room temperature.

References

Ajileye, A. B., Esan, E. O., & Adeyemi, O. A. (2018). Human embalming techniques: a review. American Journal of Biomedical Sciences, 10(2), 82-95. https://doi.org/10.5099/aj180200082

Alsharif, M. H. K., Musthafa, M., Elamin, A. Y., Ibnouf, E. O., Taha, K. M., Alfaki, M. A., ... & 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(3), 73–83. https://doi.org/10.4236/fmar.2017.53003

Anderson, S. D. (2006). Practical light embalming technique for use in the surgical fresh tissue dissection laboratory. Clinical Anatomy, 19(1), 8-11. https://doi.org/10.1002/ca.20216

Balta, J. Y., Cronin, M., Cryan, J. F., & O'mahony, S. M. (2015a). Human preservation techniques in anatomy: a 21st century medical education perspective. Clinical Anatomy, 28(6), 725-734. https://doi.org/10.1002/ca.22585

Balta, J. Y., Lamb, C., & Soames, R. W. (2015b). A pilot study comparing the use of Thiel‐and formalin‐embalmed cadavers in the teaching of human anatomy. Anatomical Sciences Education, 8(1), 86-91. https://doi.org/10.1002/ase.1470

Barton, D. P., Davies, D. C., Mahadevan, V., Dennis, L., Adib, T., Mudan, S., ... & Ellis, H. (2009). Dissection of soft-preserved cadavers in the training of gynaecological oncologists: report of the first UK workshop. Gynecologic Oncology, 113(3), 352-356. https://doi.org/10.1016/j.ygyno.2009.02.012

Batra, A. P. S., Khurana, B. S., Mahajan, A., & Kaur, N. (2010). Embalming and other methods of dead body preservation. International Journal of Medical Toxicology and Legal Medicine, 12(3), 15–19.

Bertone, V. H., Blasi, E., Ottone, N. E., & Dominguez, M. L. (2011). Walther Thiel method for the preservation of corpses with maintenance of the main physical properties of vivo. Revista Argentina de Anatomía, 2(3), 71–100.

Bradbury, S. A., & Hoshino, K. (1978). An improved embalming procedure for long-lasting preservation of the cadaver for anatomical study. Cells Tissues Organs, 101(2), 97-103. https://doi.org/10.1159/000144954

Brenner, E. (2014). Human body preservation–old and new techniques. Journal of anatomy, 224(3), 316-344. https://doi.org/10.1111/joa.12160

Burn, C. G. (1934). Experimental studies of postmortem bacterial invasion in animals. The Journal of Infectious Diseases, 54(3), 388-394. https://doi.org/10.1093/infdis/54.3.388

Chen, Y., Bundy, D. S., & Hoff, S. J. (1999). Using olfactometry to measure intensity and threshold dilution ratio for evaluating swine odor. Journal of the Air & Waste Management Association, 49(7), 847-853. https://doi.org/10.1080/10473289.1999.10463855

De Varrimento, E. (2013). Improvement of the embalming perfusion method: The innovation and the results by light and scanning electron microscopy. Acta Médica Portuguesa, 26(3), 188–194.

Durongphan, A., Chongkolwatana, W., Ngamskulrungroj, P., Pochnasomboon, T., Pinkaew, J., Pamornpol, B., ... & Ongsiriporn, M. (2022). A pilot comparative study of submerged vs. non-submerged saturated salt solution human cadavers embalming method by gross, histological, and microbiological evaluation. Siriraj Medical Journal, 74(7), 431–439. https://doi.org/10.33192/Smj.2022.52

Eisma, R., Lamb, C., & Soames, R. W. (2013). From formalin to Thiel embalming: What changes? One anatomy department's experiences. Clinical Anatomy, 26(5), 564–571. https://doi.org/10.1002/ca.22222

Eisma, R., Lamb, C., & Soames, R. W. (2013). From formalin to thiel embalming: what changes? one anatomy department's experiences. Clinical Anatomy, 26(5), 564-571. https://doi.org/10.1002/ca.22222

Fox, C. H., Johnson, F. B., Whiting, J., & Roller, P. P. (1985). Formaldehyde fixation. Journal of Histochemistry and Cytochemistry, 33(8), 845–853. https://doi.org/10.1177/33.8.3894502

Hammer, N., Löffler, S., Bechmann, I., Steinke, H., Hädrich, C., & Feja, C. (2015). Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques. Anatomical Sciences Education, 8(1), 74-85. https://doi.org/10.1002/ase.1450

Hammer, N., Löffler, S., Feja, C., Sandrock, M., Schmidt, W., Bechmann, I., & Steinke, H. (2012). Ethanol‐glycerin fixation with thymol conservation: a potential alternative to formaldehyde and phenol embalming. Anatomical Sciences Education, 5(4), 225-233. https://doi.org/10.1002/ase.1270

Hayashi, S., Homma, H., Naito, M., Oda, J., Nishiyama, T., Kawamoto, A., ... & Itoh, M. (2014). Saturated salt solution method: a useful cadaver embalming for surgical skills training. Medicine, 93(27), Article e196. https://doi.org/10.1097/MD.0000000000000196

Healy, S. E., Rai, B. P., Biyani, C. S., Eisma, R., Soames, R. W., & Nabi, G. (2015). Thiel embalming method for cadaver preservation: a review of new training model for urologic skills training. Urology, 85(3), 499-504. https://doi.org/10.1016/j.urology.2014.11.009

Heimesaat, M. M., Boelke, S., Fischer, A., Haag, L. M., Loddenkemper, C., Kühl, A. A., ... & Bereswill, S. (2012). Comprehensive postmortem analyses of intestinal microbiota changes and bacterial translocation in human flora associated mice. PLoS One, 7(7), Article e40758. https://doi.org/10.1371/journal.pone.0040758

Kaliappan, A., Motwani, R., Gupta, T., & Chandrupatla, M. (2023). Innovative cadaver preservation techniques: a systematic review. Maedica, 18(1), 127-135. https://doi.org/10.26574/maedica.2023.18.1.127

Kellerma, G. D., Waterman, N. G., & Scharfenberger, L. F. (1976). Demonstration in vitro of postmortem bacterial transmigration. American Journal of Clinical Pathology, 66(5), 911-915. https://doi.org/10.1093/ajcp/66.5.911

Kerckaert, I., Van Hoof, T., Pattyn, P., & D’Herde, K. (2008). Endogent: Centre for anatomy and invasive techniques. Anatomy, 2(1), 28–33.

Mayer, R. G. (2011). Embalming: History, theory, and practice (5th ed.). New York, NY: McGraw-Hill.

Mills, P. R. (2010). Preparation and presentation of anatomical specimens at the University of Sydney. Anatomy Department, University of Sydney. http://fliphtml5.com/mlay/rbhb/basic

Natekar, P. E., & Desouza, F. M. (2012). A new embalming fluid for preserving cadavers. Journal of Krishna Institute of Medical Sciences University, 1(2), 76-80.

Riedel, S. (2014). The value of postmortem microbiology cultures. Journal of Clinical Microbiology, 52(4), 1028-1033. https://doi.org/10.1128/jcm.03102-13

Sugata, Y., Miyaso, H., Odaka, Y., Komiyama, M., Sakamoto, N., Mori, C., & Matsuno, Y. (2016). Levels of formaldehyde vapor released from embalmed cadavers in each dissection stage. Environmental Science and Pollution Research, 23, 16176-16182. https://doi.org/10.1007/s11356-016-6744-8

Thavarajah, R., Mudimbaimannar, V. K., Elizabeth, J., Rao, U. K., & Ranganathan, K. (2012). Chemical and physical basics of routine formaldehyde fixation. Journal of Oral and Maxillofacial Pathology, 16(3), 400-405. https://doi.org/10.4103/0973-029X.102496

Thaweekhotr, P., Thongsopha, C., Tanprawate, S., Sudwan, P., Bumroongkit, K., & Quiggins, R. (2022). Incidence of death from stroke and brains of stroke victim cadavers in Northern Thailand. Chiang Mai University Journal of Natural Sciences, 21(2), e2022028.

Thaweekhotr, P., Thongsopha, C., Sudwan, P., Bumroongkit, K., Seeharach, K., Jaiyen, C., Suannahoy, P., Phasukdee, N., & Quiggins, R. (2023). Histological features of cerebral arteries and brain parenchyma in cadavers who had died from hemorrhagic stroke. Journal of Current Science and Technology, 13(3), 574–583. https://doi.org/10.59796/jcst.V13N3.2023.768

Theeuwes, H. P., van Riel, M. P. J. M., Lange, J. F., & Kleinrensink, G. J. (2017). A new model for training on human specimens in surgical-anatomical skills labs. Anatomy Physiology and Biochemistry International Journal, 3(1), 1–5. https://doi.org/10.19080/APBIJ.2017.03.555604

Thiel, W. (1992). Die Konservierung ganzer Leichen in natürlichen Farben. Annals of Anatomy – Anatomischer Anzeiger, 174(3), 185–195. https://doi.org/10.1016/S0940-9602(11)80346-8

Thiel, W. (2002). Ergänzung für die Konservierung ganzer Leichen nach W. Thiel. Annals of Anatomy – Anatomischer Anzeiger, 184(3), 267–269. https://doi.org/10.1016/S0940-9602(02)80121-2

Tolhurst, D. E., & Hart, J. (1990). Cadaver preservation and dissection. European Journal of Plastic Surgery, 13, 75-78. https://doi.org/10.1007/BF00177811

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Published

2025-06-15

How to Cite

Suwannahoy , P. . ., Boonsong , A. . . . ., Harnsiriwattanakit, K. . ., Pangjaidee, N. . ., & Quiggins, R. (2025). The Six-Point Injection Technique: A Non-Immersion Method for Enhancing Cadaveric Tissue Quality. Journal of Current Science and Technology, 15(3), 116. https://doi.org/10.59796/jcst.V15N3.2025.116

Issue

Vol. 15 No. 3 (2025): July-September

Section

Research Article

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