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Morphological changes in striated muscle fibres caused by components of the Thiel embalming method
Affiliations- Institute of Anatomy, University of Bern, Switzerland
open access
Abstract
Background: Thiel-fixed body donors are highly valued for surgical training courses. The pronounced flexibility of Thiel-fixed tissue has been postulated to be caused by histologically visible fragmentation of striated muscle. The aim of this study was to analyse whether a specific ingredient, pH, decay, or autolysis could cause this fragmentation in order to modulate the Thiel solution to adapt specimen flexibility specifically to the needs of different courses.
Materials and methods: Striated muscle of the mouse was fixed for different time periods in formalin, Thiel solution, and its individual ingredients, and analysed by light microscopy. Further, pH-values of Thiel solution and its ingredients were measured. In addition, unfixed muscle tissue was histologically analysed including Gram staining to investigate a relationship between autolysis, decomposition, and fragmentation.
Results: Muscle fixed with Thiel solution for 3 months was slightly more fragmentated than muscle fixed for 1 day. Fragmentation was more pronounced after 1 year of immersion. Three individual salt ingredients showed slight fragmentation. Decay and autolysis had no effect on fragmentation, which occurred regardless of the pH of all solutions.
Conclusions: Fragmentation of Thiel-fixed muscle is dependent on fixation time and most likely occurs due to salts present in the Thiel solution. Adjustment of the salt composition in the Thiel solution with verification of the influence on the fixation effect, fragmentation and flexibility of the cadavers could be performed in further studies.
Abstract
Background: Thiel-fixed body donors are highly valued for surgical training courses. The pronounced flexibility of Thiel-fixed tissue has been postulated to be caused by histologically visible fragmentation of striated muscle. The aim of this study was to analyse whether a specific ingredient, pH, decay, or autolysis could cause this fragmentation in order to modulate the Thiel solution to adapt specimen flexibility specifically to the needs of different courses.
Materials and methods: Striated muscle of the mouse was fixed for different time periods in formalin, Thiel solution, and its individual ingredients, and analysed by light microscopy. Further, pH-values of Thiel solution and its ingredients were measured. In addition, unfixed muscle tissue was histologically analysed including Gram staining to investigate a relationship between autolysis, decomposition, and fragmentation.
Results: Muscle fixed with Thiel solution for 3 months was slightly more fragmentated than muscle fixed for 1 day. Fragmentation was more pronounced after 1 year of immersion. Three individual salt ingredients showed slight fragmentation. Decay and autolysis had no effect on fragmentation, which occurred regardless of the pH of all solutions.
Conclusions: Fragmentation of Thiel-fixed muscle is dependent on fixation time and most likely occurs due to salts present in the Thiel solution. Adjustment of the salt composition in the Thiel solution with verification of the influence on the fixation effect, fragmentation and flexibility of the cadavers could be performed in further studies.
Keywords
tissue fixation, skeletal muscle, light microscopy, fragmentation, saturated salt solution, formalin, boric acid, pH
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About this articleTitle
Morphological changes in striated muscle fibres caused by components of the Thiel embalming method
Journal
Issue
Vol 83, No 1 (2024): Folia Morphologica
Article type
Original article
Pages
83-91
Published online
2023-02-16
Page views
533
Article views/downloads
509
DOI
Pubmed
Bibliographic record
Folia Morphol 2024;83(1):83-91.
Keywords
tissue fixation
skeletal muscle
light microscopy
fragmentation
saturated salt solution
formalin
boric acid
pH
Authors
Dea Aaldijk
Adrian Reusser
Elisabeth Eppler
Eveline Yao
Valentin Djonov
Sebastian Halm
References (47)- Astruc T, Desfrétières A, Vénien A. Histological study of ultrastructural changes in muscle exposed to various concentrations of nacl brine. J Food Sci. 2018; 83(5): 1221–1228.
- Balta JY, Lamb C, Soames RW. A pilot study comparing the use of Thiel- and formalin-embalmed cadavers in the teaching of human anatomy. Anat Sci Educ. 2015; 8(1): 86–91.
- Bauer DR, Otter M, Chafin DR. A new paradigm for tissue diagnostics: tools and techniques to standardize tissue collection, transport, and fixation. Curr Pathobiol Rep. 2018; 6(2): 135–143.
- Beger O, Karagül Mİ, Koç T, et al. Effects of different cadaver preservation methods on muscles and tendons: a morphometric, biomechanical and histological study. Anat Sci Int. 2020; 95(2): 174–189.
- Benkhadra M, Bouchot A, Gérard J, et al. Flexibility of Thiel's embalmed cadavers: the explanation is probably in the muscles. Surg Radiol Anat. 2011; 33(4): 365–368.
- Brenner E. Human body preservation - old and new techniques. J Anat. 2014; 224(3): 316–344.
- Cocariu EA, Mageriu V, Stăniceanu F, et al. Correlations between the autolytic changes and postmortem interval in refrigerated cadavers. Rom J Intern Med. 2016; 54(2): 105–112.
- Desmond E. Reducing salt: A challenge for the meat industry. Meat Sci. 2006; 74(1): 188–196.
- Eisma R, Wilkinson T. From "silent teachers" to models. PLoS Biol. 2014; 12(10): e1001971.
- Estermann SJ, Förster-Streffleur S, Hirtler L, et al. Comparison of Thiel preserved, fresh human, and animal liver tissue in terms of mechanical properties. Ann Anat. 2021; 236: 151717.
- Fessel G, Frey K, Schweizer A, et al. Suitability of Thiel embalmed tendons for biomechanical investigation. Ann Anat. 2011; 193(3): 237–241.
- Gatt A, Schembri-Wismayer P, Chockalingam N, et al. Kinematic and kinetic comparison of fresh frozen and thiel-embalmed human feet for suitability for biomechanical educational and research settings. J Am Podiatr Med Assoc. 2019; 109(2): 113–121.
- Giger U, Frésard I, Häfliger A, et al. Laparoscopic training on Thiel human cadavers: a model to teach advanced laparoscopic procedures. Surg Endosc. 2008; 22(4): 901–906.
- Groscurth P, Eggli P, Kapfhammer J, et al. Gross anatomy in the surgical curriculum in Switzerland: improved cadaver preservation, anatomical models, and course development. Anat Rec. 2001; 265(6): 254–256.
- Halm S, Fairhurst PG, Tschanz S, et al. Effect of lateral sliding calcaneus osteotomy on tarsal tunnel pressure. Foot Ankle Orthop. 2020; 5(3): 2473011420931015.
- Hammer N, Löffler S, Bechmann I, et al. Comparison of modified Thiel embalming and ethanol-glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques. Anat Sci Educ. 2015; 8(1): 74–85.
- Hammer N, Schröder C, Schleifenbaum S. On the suitability of Thiel-fixed samples for biomechanical purposes: Critical considerations on the articles of Liao et al. "Elastic Properties of Thiel-Embalmed Human Ankle Tendon and Ligament" and Verstraete et al. "Impact of Drying and Thiel Embalming on Mechanical Properties of Achilles Tendons". Clin Anat. 2016; 29(4): 424–425.
- Hassan S, Eisma R, Malhas A, et al. Surgical simulation flexor tendon repair using Thiel cadavers: a comparison with formalin embalmed cadavers and porcine models. J Hand Surg Eur Vol. 2015; 40(3): 246–249.
- Hayashi S, Naito M, Kawata S, et al. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method. Anat Sci Int. 2016; 91(1): 1–7.
- Healy SE, Rai BP, Biyani CS, et al. Thiel embalming method for cadaver preservation: a review of new training model for urologic skills training. Urology. 2015; 85(3): 499–504.
- Hohmann E, Keough N, Glatt V, et al. The mechanical properties of fresh versus fresh/frozen and preserved (Thiel and Formalin) long head of biceps tendons: A cadaveric investigation. Ann Anat. 2019; 221: 186–191.
- Huff-Lonergan E, Lonergan SM. Mechanisms of water-holding capacity of meat: The role of postmortem biochemical and structural changes. Meat Sci. 2005; 71(1): 194–204.
- Jaung R, Cook P, Blyth P. A comparison of embalming fluids for use in surgical workshops. Clin Anat. 2011; 24(2): 155–161.
- Kennel L, Martin DMA, Shaw H, et al. Learning anatomy through Thiel- vs. formalin-embalmed cadavers: Student perceptions of embalming methods and effect on functional anatomy knowledge. Anat Sci Educ. 2018; 11(2): 166–174.
- Kerdok AE, Ottensmeyer MP, Howe RD. Effects of perfusion on the viscoelastic characteristics of liver. J Biomech. 2006; 39(12): 2221–2231.
- Liao X, Kemp S, Corner G, et al. Elastic properties of Thiel-embalmed human ankle tendon and ligament. Clin Anat. 2015; 28(7): 917–924.
- McDougall S, Soames R, Felts P. Thiel embalming: Quantifying histological changes in skeletal muscle and tendon and investigating the role of boric acid. Clin Anat. 2020; 33(5): 696–704.
- Nicolle S, Palierne JF. Dehydration effect on the mechanical behaviour of biological soft tissues: observations on kidney tissues. J Mech Behav Biomed Mater. 2010; 3(8): 630–635.
- Offer G, Knight P, Jeacocke R. The structural basis of the water-holding, appearance and toughness of meat and meat products. Food Structure. 1989; 8(1): Article 17.
- Porzionato A, Polese L, Lezoche E, et al. On the suitability of Thiel cadavers for natural orifice transluminal endoscopic surgery (NOTES): surgical training, feasibility studies, and anatomical education. Surg Endosc. 2015; 29(3): 737–746.
- Prasad Rai B, Tang B, Eisma R, et al. A qualitative assessment of human cadavers embalmed by Thiel's method used in laparoscopic training for renal resection. Anat Sci Educ. 2012; 5(3): 182–186.
- Rakuša M, Kocbek Šaherl L. Thiel embalming method used for anatomy dissection as an educational tool in teaching human anatomy, in research, and in training in comparison of different methods for long term preservation. Folia Morphol. 2023; 82(3): 449–456.
- Ruiz-Tovar J, Prieto-Nieto I, García-Olmo D, et al. Training courses in laparoscopic bariatric surgery on cadaver Thiel: results of a satisfaction survey on students and professors. Obes Surg. 2019; 29(11): 3465–3470.
- Saetan J, Nopparat J, Tipbunjong C. Modified Thiel and saturated salt solutions for rabbit soft cadaveric embalming: a preliminary study. Sonklanakarin J Sci Technol. 2021; 43(5): 1435–1442.
- Stouthandel MEJ, Vanhove C, Devriendt W, et al. Biomechanical comparison of Thiel embalmed and fresh frozen nerve tissue. Anat Sci Int. 2020; 95(3): 399–407.
- Tavichakorntrakool R, Prasongwattana V, Sriboonlue P, et al. Serial analyses of postmortem changes in human skeletal muscle: A case study of alterations in proteome profile, histology, electrolyte contents, water composition, and enzyme activity. Proteomics Clin Appl. 2008; 2(9): 1255–1264.
- Thiel W. The preservation of the whole corpse with natural color]. Ann Anat. 1992; 174(3): 185–195.
- Türkmen RD, Akarca G, Akosman MS. The investigation of potential preservative effect of boric acid on formalin fixed striated muscle tissues. Kocatepe Vet J. 2017; 10(4): 317–321.
- Unger S, Blauth M, Schmoelz W. Effects of three different preservation methods on the mechanical properties of human and bovine cortical bone. Bone. 2010; 47(6): 1048–1053.
- Usami T, Fujioka T, Yoshida A, et al. Assessment of laparoscopic training for gynecological malignancies using Thiel-embalmed human cadavers. Mol Clin Oncol. 2018; 9(5): 511–514.
- Verstraete MA, Van Der Straeten C, De Lepeleere B, et al. Impact of drying and thiel embalming on mechanical properties of achilles tendons. Clin Anat. 2015; 28(8): 994–1001.
- Villacorta P, Hernando H, Abdulla A, et al. A comparative study of Thiel soft-embalmed and formalin preserved cadavers for anatomy dissection. Acta Medica Philippina. 2019; 53(1).
- Völlner F, Pilsl U, Craiovan B, et al. Stability of knee ligament complex of Thiel-embalmed cadaver compared to in vivo knee. J Mech Behav Biomed Mater. 2017; 71: 392–396.
- Waerlop F, Rashidian N, Marrannes S, et al. Thiel embalmed human cadavers in surgical education: Optimizing realism and long-term application. Am J Surg. 2021; 221(6): 1300–1302.
- Wilke HJ, Werner K, Häussler K, et al. Thiel-fixation preserves the non-linear load-deformation characteristic of spinal motion segments, but increases their flexibility. J Mech Behav Biomed Mater. 2011; 4(8): 2133–2137.
- Yiasemidou M, Roberts D, Glassman D, et al. A multispecialty evaluation of Thiel cadavers for surgical training: reply. World J Surg. 2017; 41(12): 3230–3231.
- Zwirner J, Scholze M, Ondruschka B, et al. Tissue biomechanics of the human head are altered by Thiel embalming, restricting its use for biomechanical validation. Clin Anat. 2019; 32(7): 903–913.
