Preparation of Soft Embalmed Cadavers by the Modified Thiel Embalming Technique for Surgical Skill Training and Development of a Universal Quantitative Scoring System to Assess the Suitability of Soft Embalmed Cadavers for Such Training Purposes.

Background Cadaver dissection plays an important role in learning anatomy. A surgeon must have a thorough knowledge of anatomy of the operating region to perform safe surgery. Skill laboratories give opportunities to surgeons to practice on cadavers before venturing onto real patients. The most common method of cadaver preservation is through formalin fixation. In the process of fixation, formalin destroys the tissue characteristics and also has issues such as smell, eye irritation, hardening of tissue, and risk of carcinogenesis. The Thiel embalming technique and its modifications were developed to address those issues. Our primary objective was to find the benefits of soft embalmed cadavers over formalin-fixed bodies and, secondly, to find out microbial flora in soft embalmed cadavers. Study design This is a basic study. Methods Four cadavers were prepared for the soft embalming purpose for our workshop for surgeons on spine fixation. Due to unavailability, we replaced 4-chloro-3-methylphenol 1% with phenol 1%. The bodies were preserved in refrigerators at 4° C before being used for the workshop purpose. The delegates and faculties were given a questionnaire to assess their experience of the cadavers in terms of odor, irritation, tissue characteristics, joint mobility, and imaging characteristics. The results were calculated using statistical analysis. Swabs were taken from a few of the cadavers for culture to find the organisms. Results There were 14 questions in the questionnaire, and the data collected were divided into two groups, faculties, and delegates. JASP software was used to analyze the data. The questions addressed various aspects of cadavers such as color, odor, tissue pliability, joint flexibility, imaging characteristics, mucosal irritation, and earlier experience in working with cadavers. Cronbach α was used to find the correlation between the various characteristics analyzed. The authors intend to name the domains being measured: surgical suitability (scores of items 8 to 12), imaging suitability (scores of items 5 and 6), and smell score (scores of items 5 and 6). It can be a guide to constructing and refining a better quantitative scale to measure the "quality of soft-embalmed cadavers for surgical training." Conclusions Skill laboratories give opportunities to young surgeons and trainees to learn and improve their skills before applying them to real patients. This was our first attempt to develop soft embalmed cadavers at our center and our state. We used the parent solution with some variations as per the availability of chemicals at our place and found that the features of the preserved cadavers were good and well-suited to address our purpose. Therefore, with some variations in the parent formulations, centers situated in remote and less developed places can formulate their own solution to develop soft embalmed cadavers and establish cadaver skill laboratories. This will benefit the local surgeons and trainees. The authors tried to develop a few domains through statistical analysis, which can be used to assess and compare the quality of cadavers prepared at various centers.