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      Phenoxyethanol‐Based Embalming for Anatomy Teaching: An 18 Years' Experience with Crosado Embalming at the University of Otago in New Zealand

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          Abstract

          Embalming fixatives such as formaldehyde and phenol have been associated with occupational health hazards. While anatomists aim at replacing these chemicals, this seems presently unfeasible in particular for formaldehyde. Furthermore, fixation protocols usually require well‐equipped facilities with highly experienced staff to achieve good fixation results in spite of only a minimal use of formaldehyde. Combining these aspects, a technique robust enough to be carried out by morticians is presented, resulting in durable tissues with minimal formaldehyde use. An embalming protocol involving phenoxyethanol was established, using concentrations of 7 and 1.5 Vol% of phenoxyethanol in the fixative and the conservation fluid, respectively. Visual, haptic, histological, and biomechanical properties and their perceived potential to positively influence student learning outcomes were compared to standard embalming techniques. The phenoxyethanol technique provides esthetic, durable, and odorless tissues. Bleaching is less pronounced compared to ethanol‐ or formaldehyde‐based protocols. The tissues remain pliable following the phenoxyethanol‐based embalming and can be used for biomechanical experiments to some extent. Phenoxyethanol‐fixed tissues are well suited for undergraduate teaching with perceived positive learning outcomes and partly for postgraduate training. Phenoxyethanol tissues provide the option to obtain well‐preserved histology samples, similar to those derived from formaldehyde. The provided protocol helps replace the use of phenol and formaldehyde for conservation purposes and minimizes the use of formaldehyde for the initial injection fixation. Phenoxyethanol‐based embalming forms an effective alternative to standard embalming techniques for human cadavers. It is simple to use, allowing fixation procedures to be carried out in less sophisticated facilities with non‐anatomy staff.

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          Medical education in the anatomical sciences: the winds of change continue to blow.

          At most institutions, education in the anatomical sciences has undergone several changes over the last decade. To identify the changes that have occurred in gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses, directors of these courses were asked to respond to a survey with questions pertaining to total course hours, hours of lecture, and hours of laboratory, whether the course was part of an integrated program or existed as a stand-alone course, and what type of laboratory experience occurred in the course. These data were compared to data obtained from a similar survey in 2002. Comparison between the data sets suggests several key points some of which include: decreased total hours in gross anatomy and neuroscience/neuroanatomy courses, increased use of virtual microscopy in microscopic anatomy courses, and decreased laboratory hours in embryology courses.
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            Effect of formalin tissue fixation and processing on immunohistochemistry.

            Although immunohistochemistry is routinely performed by many pathology laboratories, its standardization still lags behind. A major cause of variation in the reproducibility of immunohistochemical staining is induced by tissue fixation and, to a lesser degree, tissue processing. This report, stemming from the first meeting of the International Consensus Group on Standardization and Quality Control (ICGSQC) in Nice, France, summarizes the problem and suggests solutions to begin to achieve standardization of fixation and processing. Most laboratories use neutral-buffered formalin (10%) for tissue fixation which introduces cross-links, whereas coagulative fixatives are less popular. Problems with formalin fixation comprise delay of fixation and variations in the duration of the fixation mainly. Solutions to these problems could be to start fixation soon ( 24-48 hrs). For tissue processing, the most important problem is inadequate tissue dehydration prior to paraffin embedding. This can be prevented by preparing all solutions freshly every week, depending on the volume of tissue processed. If consistently applied, these procedures could eliminate some of the sources of variation in immunohistochemical stains.
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              Human body preservation - old and new techniques.

              This review deals with the art of (anatomical) embalming. The first part contains a brief historical review of the history of embalming, starting with ancient cultures such as the Egyptians and the lesser known Chinchorro culture, then going down the centuries and describing the anatomical techniques developed over the last two centuries. The second part deals in detail with the chemicals used for embalming purposes. The third part deals with several approaches to evaluating embalming methods, their suitability for biomechanical testing, antimicrobial properties, histological appearance, and usability. The fourth and final part analyze the European Biocidal Products Directive (98/8/EC) in the light of embalming. © 2014 Anatomical Society.
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                Author and article information

                Contributors
                nlshammer@googlemail.com , niels.hammer@medunigraz.at
                Journal
                Anat Sci Educ
                Anat Sci Educ
                10.1002/(ISSN)1935-9780
                ASE
                Anatomical Sciences Education
                John Wiley and Sons Inc. (Hoboken )
                1935-9772
                1935-9780
                21 January 2020
                Nov-Dec 2020
                : 13
                : 6 ( doiID: 10.1002/ase.v13.6 )
                : 778-793
                Affiliations
                [ 1 ] Department of Anatomy University of Otago Dunedin New Zealand
                [ 2 ] Department of Anatomy University of Leipzig Leipzig Germany
                [ 3 ] Institute of Legal Medicine University of Leipzig Leipzig Germany
                [ 4 ] Department of Clinical and Macroscopic Anatomy Medical University of Graz Graz Austria
                [ 5 ] Department of Trauma, Orthopedic and Plastic Surgery University Hospital of Leipzig Leipzig Germany
                [ 6 ] Fraunhofer Institute for Machine Tools and Forming Technology Dresden Germany
                Author notes
                [*] [* ] Correspondence to: Niels Hammer, M.D., Department of Clinical and Macroscopic Anatomy, Medical University of Graz, Harrachgasse 21, 8010 Graz, Austria. E‐mail: nlshammer@ 123456googlemail.com , niels.hammer@ 123456medunigraz.at

                Author information
                https://orcid.org/0000-0001-8230-9383
                Article
                ASE1933
                10.1002/ase.1933
                7687111
                31758863
                9508aff5-e924-4d84-8d25-fcc00b356c92
                © 2019 The Authors. Anatomical Sciences Education published by Wiley Periodicals, Inc. on behalf of American Association of Anatomy

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 05 April 2019
                : 28 October 2019
                : 19 November 2019
                Page count
                Figures: 5, Tables: 3, Pages: 10, Words: 23775
                Funding
                Funded by: Deutscher Akademischer Austauschdienst , open-funder-registry 10.13039/501100001655;
                Categories
                Descriptive Article
                Regular Articles
                Descriptive Articles
                Custom metadata
                2.0
                November/December 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.4 mode:remove_FC converted:25.11.2020

                cadaver embalming,cadaver fixation,dissection room teaching,formaldehyde reduction,gross anatomy education,laboratory teaching,learning outcomes,phenol replacement,phenoxyethanol

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