title: Saturated salt solution method: a useful cadaver embalming for surgical skills training.
abstract: This article evaluates the suitability of cadavers embalmed by the saturated salt solution (SSS) method for surgical skills training (SST). SST courses using cadavers have been performed to advance a surgeon's techniques without any risk to patients. One important factor for improving SST is the suitability of specimens, which depends on the embalming method. In addition, the infectious risk and cost involved in using cadavers are problems that need to be solved. Six cadavers were embalmed by 3 methods: formalin solution, Thiel solution (TS), and SSS methods. Bacterial and fungal culture tests and measurement of ranges of motion were conducted for each cadaver. Fourteen surgeons evaluated the 3 embalming methods and 9 SST instructors (7 trauma surgeons and 2 orthopedists) operated the cadavers by 21 procedures. In addition, ultrasonography, central venous catheterization, and incision with cauterization followed by autosuture stapling were performed in some cadavers. The SSS method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for SST. The surgeons evaluated the cadavers embalmed by the SSS method to be highly equal to those embalmed by the TS method. Ultrasound images were clear in the cadavers embalmed by both the methods. Central venous catheterization could be performed in a cadaver embalmed by the SSS method and then be affirmed by x-ray. Lungs and intestines could be incised with cauterization and autosuture stapling in the cadavers embalmed by TS and SSS methods. Cadavers embalmed by the SSS method are sufficiently useful for SST. This method is simple, carries a low infectious risk, and is relatively of low cost, enabling a wider use of cadavers for SST.
authors.affiliation: From the Department of Anatomy (SH, SK, TS, NQ, NH, SH, MI); Department of Emergency and Critical Care Medicine (HH, JO, KK, TS, TY); Department of Anesthesiology (TN, HF, KO), Tokyo Medical University, Tokyo, Japan; Department of Anatomy (MN), Aichi Medical University School of Medicine, Aichi, Japan; Department of Diagnostic Radiology/Division of Ultrasound (AK), Tokyo Medical University Hospital, Tokyo, Japan; Department of Primary Care and Emergency Medicine (NS), Graduate School of Medicine and University School of Medicine, Kyoto University, Kyoto, Japan; Advanced Disaster Medical and Emergency Critical Care Center (TF), Niigata University Medical and Dental Hospital, Niigata, Japan; Department of Emergency and Critical Care Medicine (HT), Kinki University School of Medicine, Osaka, Japan; Shock and Trauma Center (KM), Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan; Department of Emergency and Critical Care Medicine (TA), Nihon University School of Medicine Itabashi Hospital, Tokyo, Japan; Department of Orthopaedic Surgery (MI), Niigata City General Hospital, Niigata, Japan; Department of Colorectal Surgery (YN), National Cancer Center Hospital East, Chiba, Japan; Department of Plastic Surgery (JA), University of Tokyo Graduate School of Medicine, Tokyo, Japan; and Division of Gastroenterological and General Surgery (NM), Asahikawa Medical University School of Medicine, Hokkaido, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Hayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Homma
authors.forename: Munekazu
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authors.lastname: Naito
authors.forename: Jun
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authors.lastname: Oda
authors.forename: Takahisa
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authors.lastname: Nishiyama
authors.forename: Atsuo
authors.initials: A
authors.lastname: Kawamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kawata
authors.forename: Norio
authors.initials: N
authors.lastname: Sato
authors.forename: Tomomi
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taguchi
authors.forename: Kazuki
authors.initials: K
authors.lastname: Mashiko
authors.forename: Takeo
authors.initials: T
authors.lastname: Azuhata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ito
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kawai
authors.forename: Tomoya
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authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Naoto
authors.initials: N
authors.lastname: Matsuno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shirai
authors.forename: Ning
authors.initials: N
authors.lastname: Qu
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hatayama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hirai
authors.forename: Hidekimi
authors.initials: H
authors.lastname: Fukui
authors.forename: Kiyoshige
authors.initials: K
authors.lastname: Ohseto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yukioka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000369:Aged, 80 and over; D002102:Cadaver; D004203:Disinfection; D004615:Embalming / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D019188:Organ Preservation Solutions; D058996:Quality Improvement; D016059:Range of Motion, Articular; D012965:Sodium Chloride
chemical_list: D019188:Organ Preservation Solutions; D012965:Sodium Chloride