The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting

Abstract

The purpose of this study was to assess the usefulness of saturated salt solution‐embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half‐day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self‐confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed‐rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self‐assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution‐embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well‐preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution‐embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.

Swine viscera preservation in hypersaturated salt solution after alcohol fixation as a preparation method for educational purposes

“…In the following preservation periods at 30% SCHS (7, 14 and 21 days), no malodour, that could indicate putrefaction, was observed during the viscera manipulation in any of the analysed groups, a characteristic also reported by Burns et al (2018). This is probably related to the fact that SCHS at 30% has antiseptic and antibacterial properties (Brun et al, 2002;Hayashi et al, 2014;Oliveira, 2014;Watanabe et al, 2019). Another possibly relevant factor for the maintenance of the excellent viscera quality was the complete submersion of the organs due to the circular EVA plates placed over them during the periods in the solution containers.…”

“…Studies that aim to develop alternative cadaver preservation methods for research and teaching and that do not cause academic or scientific losses are essential and have been carried out worldwide (Beger et al, 2020;Burns et al, 2018;Gosomji et al, 2018;Homma et al, 2019;Kathapillai, 2019;Lombardero et al, 2017;Oliveira, 2014;Rocha et al, 2019;Watanabe et al, 2019). Features of some of these studies regarding the solution composition, embalming process and cadaver's storage can be accessed in Table 3.…”

“…Formaldehyde continues to be used in most of today's saturated saline preservation methods (Beger et al, 2020;Burns et al, 2018;Gosomji et al, 2018;Hayashi et al, 2014;Kathapillai, 2019;Oliveira, 2014;Watanabe et al, 2019). Its presence in the solutions, even if in low concentrations, requires several precautions related to its use, exposes the staff to the risks of its handle and demands care related to its proper disposal.…”

“…TA B L E 1 Physical evaluation of urinary bladders (Teams 1, 2 and 3) after EA fixation for 30 days and different preservation periods in 30% SCHS: 7 days (D7), 14 days (D14) and 21 days (D21) presented required a convoluted and time-consuming embalming process requiring specific materials and trained staff (Beger et al, 2020;Burns et al, 2018;Gosomji et al, 2018;Homma et al, 2019;Kathapillai, 2019;Lombardero et al, 2017;Oliveira, 2014;Rocha et al, 2019;Watanabe et al, 2019). Ultimately, in most of the studies described in Table 3, the embalmed specimens require storage under refrigeration or solution tanks large enough for the size of the cadaver (Beger et al, 2020;Burns et al, 2018;Gosomji et al, 2018;Lombardero et al, 2017;Oliveira, 2014;Rocha et al, 2019).…”

The Unintentional Effects on Body Donation Programs of a Competency‐Based Curriculum in Postgraduate Medical Education

“…The Thiel fixation, also known as Graz fixation, for example, was developed in 1992 and has been shown to provide excellent surgical training models (Thiel, 1992; Anderhuber, 2012). Less expensive soft‐embalming solutions based on saturated salt (Hayashi et al, 2014, 2016; Watanabe et al, 2020), soap‐ and ethanol‐based fixing solution (SEFS) (Turan et al, 2017) or phenol‐based, also known as the “floppy,” “soft‐preserved,” or Imperial College London Soft Preservation (ICL‐SP), (Barton et al, 2009; Balta et al, 2018a; Tomalty et al, 2019) are also being used by some programs (Eisma et al, 2013).…”