Shogo Hayashi , MD, PhD, Hiroshi Homma , MD, PhD, Munekazu Naito , MD, PhD, Jun Oda , MD, PhD, Takahisa Nishiyama , MD, PhD, Atsuo Kawamoto , RT, MHS, Shinichi Kawata , BHS, Norio Sato , MD, PhD, Tomomi Fukuhara , MD, Hirokazu Taguchi , MD, PhD, Kazuki Mashiko , MD, Takeo Azuhata , MD, PhD, Masayuki Ito , MD, PhD, Kentaro Kawai , MD, PhD, Tomoya Suzuki , MD, Yuji Nishizawa , MD, PhD, Jun Araki , MD, Naoto Matsuno , MD, PhD, Takayuki Shirai , MD, Ning Qu , MD, PhD, Naoyuki Hatayama , BS, Shuichi Hirai , MD, PhD, Hidekimi Fukui , MD, PhD, Kiyoshige Ohseto , MD, PhD, Tetsuo Yukioka , MD, PhD, FACS, Masahiro Itoh , MD, PhD
12 December 2014
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.