Thiel Soft-Embalmed Cadavers and Ultrasonography

Noel T. Boaz, Ph.D., M.D.

Integrative Centers for Science and Medicine

Virginia Commonwealth University

The Thiel Method

Soft embalming (Thiel, W. Annals of Anatomy(1992) 174:185-195; (2002) 184:267-269) is a technique which relies on a mixture of salt compounds and very low amounts of volatile formaldehyde and formalin to effect fixation of tissue with a number of unique properties.

Thiel Method

Canula is set in superiorsagittal sinus for infusion

of 3 liters of Intestine FormulaInfusion pressure is 0.2- 0.4 bar

With body on the right side, dissect external iliac artery and place two canulae in the artery

Precise mixing of the “wet-salz” chemicals

Cadavers preserved with the ThielMethod have

• no detectable odor• a lifelike flexibility of body parts• excellent color preservation of muscle, viscera, and vasculature• superior antimicrobial preservation properties.

Chemicals Used

• Ethylene glycol• Ammonium nitrate• Potassium nitrate• Boric acid• 4-chloro 3-methyl

phenol• Sodium sulphite• Morpholine• Formalin• Ethyl alcohol

Accurate Measurement of Chemical Constituents by Weight

• Solids (ammonium nitrate, potassium nitrate, sodium sulphite, boric acid, and phenol) are measured out by weight to be added to solution

• Here sodium sulphite is weighed for the embalming solution

Accurate Measurement of Chemical Constituents by Volume

• Liquids (ethylene glycol, water, morpholine, formalin, and ethyl alcohol) are measured out by volume in a graduated cylinder to be added to solution

• Stem Solution A is made of accurately measured amounts of boric acid, ethylene glycol, ammonium nitrate, potassium nitrate, and water

• Stem Solution B is made of accurately measured amounts of ethlylene glycol and 4-chloro 3-methyl phenol

Mixing Stem Solution A

• Dissolving the salts in water and ethylene glycol to make Stem Solution A

• 44.4 liters of Stem Solution A were made

Addition of Stem Solution B

• 8.8 liters of Stem Solution B were made from ethlyleneglycol and 4-chloro 3-methyl phenol

Mixed Embalming Solution is Added to Embalming Machine

• Measured amounts of Stem Solution A and Stem Solution B were mixed with

• Measured amounts of sodium suphite, morpholine, formalin, and ethyl alcohol to yield

• 15.75 liters of Embalming Solution

Cadaver is Prepared for Injection of Embalming Fluid

Single Port Made in Right Common Carotid Artery

Exit of Fluid Via Right Internal Jugular Vein

Injection and Gravity Feed of Embalming Solution

• Embalming solution injected under pressure of 15 psi

• Embalming was completed overnight by gravity feed

Body Perfused with Fluid

Some “Burning” of Tissues Noted

• Areas of brownish discoloration in malar areas (“burning”) noted due to interaction of tissues with embalming fluids

Superficial Epidermal Desquamation and Bulla Formation

Desquamation occurs between stratum corneumand “stratum malpighii”

Didactic Advantages of Soft Embalming

• Because of the more lifelike texture and color of structures students’ dissections are of high quality, improving learning in the laboratory.

• Appreciating the actions of muscles at joints, especially in the extremities, is facilitated by the flexibility of the cadaver.

• Soft-embalmed cadavers offer advantages over unembalmed cadavers or simulators in teaching clinical procedures, such as intubation, lumbar puncture, central line placement, thoracocentesis, and surgery.

• The flexibility of the peritoneal membrane and internal viscera allows soft-embalmed cadavers to be especially useful in teaching laparoscopic surgical anatomy.

Thiel-Embalming Allows Excellent Visualization of Anatomical Structures Via Ultrasonography

Ultrasound imaging of the left carpal tunnel in a Thiel-embalmed elderly female

Visualization of the Carpal Tunnel in a Thiel-Embalmed Cadaver

Visualization of the Renal Pelvis in a Thiel-Embalmed Cadaver