The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries

Alexander Michael Kerner; Uta Biedermann; Lars Bräuer; Svenja Caspers; Sara Doll; Maren Engelhardt; Timm J Filler; Estifanos Ghebremedhin; Stefanie Gundlach; Gregor U Hayn-Leichsenring; Stephan Heermann; Ingrid Hettwer-Steeger; Laura Hiepe; Bernhard Hirt; Lena Hirtler; Romed Hörmann; Christoph Kulisch; Tobias Lange; Rudolf Leube; Annika Hela Meuser; Magdalena Müller-Gerbl; Christina Nassenstein; Peter H Neckel; Ute Nimtschke; Friedrich Paulsen; Andreas Prescher; Michael Pretterklieber; Stefanie Schliwa; Katja Schmidt; Andreas Schmiedl; Christof Schomerus; Gundula Schulze-Tanzil; Udo Schumacher; Sven Schumann; Volker Spindler; Johannes Streicher; Thomas Tschernig; Axel Unverzagt; Ursula Valentiner; Christoph Viebahn; Thilo Wedel; Janet Weigner; Wolfgang J Weninger; Jürgen Westermann; Imke Weyers; Jens Waschke; Niels Hammer

doi:10.1002/ase.2285

The chemicals between us-First results of the cluster analyses on anatomy embalming procedures in the German-speaking countries

Anat Sci Educ. 2023 Sep-Oct;16(5):814-829. doi: 10.1002/ase.2285. Epub 2023 May 15.

Authors

Alexander Michael Kerner¹, Uta Biedermann², Lars Bräuer³, Svenja Caspers⁴, Sara Doll⁵, Maren Engelhardt⁶, Timm J Filler⁴, Estifanos Ghebremedhin⁷, Stefanie Gundlach⁸, Gregor U Hayn-Leichsenring², Stephan Heermann⁹, Ingrid Hettwer-Steeger¹⁰, Laura Hiepe¹¹, Bernhard Hirt¹², Lena Hirtler¹³, Romed Hörmann¹⁴, Christoph Kulisch¹⁵, Tobias Lange^{2

16}, Rudolf Leube¹⁷, Annika Hela Meuser¹, Magdalena Müller-Gerbl¹⁸, Christina Nassenstein¹⁹, Peter H Neckel¹², Ute Nimtschke²⁰, Friedrich Paulsen³, Andreas Prescher¹⁷, Michael Pretterklieber¹, Stefanie Schliwa²¹, Katja Schmidt²², Andreas Schmiedl²³, Christof Schomerus⁷, Gundula Schulze-Tanzil²⁴, Udo Schumacher¹⁶, Sven Schumann²⁵, Volker Spindler¹⁸, Johannes Streicher²⁶, Thomas Tschernig²⁷, Axel Unverzagt²⁸, Ursula Valentiner¹⁶, Christoph Viebahn¹⁰, Thilo Wedel⁸, Janet Weigner²⁹, Wolfgang J Weninger¹³, Jürgen Westermann³⁰, Imke Weyers³⁰, Jens Waschke²⁸, Niels Hammer^{1

31

32}

Affiliations

¹ Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria.
² Institute of Anatomy I, University Hospital Jena, Jena, Germany.
³ Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
⁴ Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
⁵ Department of Anatomy and Cell Biology, Heidelberg University, Heidelberg, Germany.
⁶ Institute of Anatomy and Cell Biology, Johannes Kepler University, Linz, Austria.
⁷ Institute of Anatomy, Goethe University Frankfurt, Frankfurt am Main, Germany.
⁸ Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
⁹ Institute for Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
¹⁰ Center of Anatomy, University of Göttingen, Göttingen, Germany.
¹¹ Institute of Anatomy, Rostock University Medical Center, Rostock, Germany.
¹² Institute of Clinical Anatomy and Cell Analysis, University of Tübingen, Tübingen, Germany.
¹³ Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
¹⁴ Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria.
¹⁵ Institute of Functional Anatomy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹⁶ Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁷ Department of Anatomy and Cell Biology, University Hospital RWTH Aachen University, Aachen, Germany.
¹⁸ Department of Biomedicine, University of Basel, Basel, Switzerland.
¹⁹ Institute of Anatomy and Cell Biology, Justus-Liebig-University, Giessen, Germany.
²⁰ Institute of Anatomy, Technical University Carl Gustav Carus Dresden, Dresden, Germany.
²¹ Institute of Anatomy, Anatomy and Cell Biology, University of Bonn, Bonn, Germany.
²² Institute of Anatomy, University of Leipzig, Leipzig, Germany.
²³ Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany.
²⁴ Institute of Anatomy and Cell Biology, Paracelsus Medical University, Nuremberg and Salzburg, Nuremberg, Germany.
²⁵ Institute of Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
²⁶ Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria.
²⁷ Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany.
²⁸ Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany.
²⁹ Institute of Veterinary Anatomy, Freie Universität Berlin, Berlin, Germany.
³⁰ Institute of Anatomy, University of Lübeck, Lübeck, Germany.
³¹ Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.
³² Division of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology Dresden, Dresden, Germany.

PMID: 37183973
DOI: 10.1002/ase.2285

Abstract

Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes ≤1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.

Keywords: body donor; cadaver; conservation; embalming; fixation; formaldehyde; human tissue; occupational exposure limit the value.

MeSH terms

Anatomy* / education
Cadaver
Embalming / methods
Ethanol
Fixatives
Formaldehyde / chemistry
Humans

Substances

Fixatives
Formaldehyde
Ethanol