KADAVRA TESPİT SOLÜSYONLARININ KARŞILAŞTIRILARAK İNCELENMESİ

Yıl 2019, Cilt: 6 Sayı: 2, 21 - 25, 15.12.2019

Rümeysa Gamze Taşkın , Nazire Kiliç Şafak , Ahmet Hilmi Yücel

Öz

Kadavra
diseksiyonu ile dokular veya yapılar cerrahi olarak açığa çıkarılarak
incelemeye uygun hale getirilir, literatürde bu uygulamanın diğer adı
anatomizasyon olarak da geçer. Kadavra diseksiyonunun tıp ve veteriner hekimlik
eğitiminde önemli bir yeri bulunur. Öğrencilerin görerek ve dokunarak
deneyimledikleri en kapsamlı tecrübedir. Bu deneyimin nesiller boyu devam
edebilmesi için kadavra tespiti amaca en uygun fiksasyon yöntemi ile
yapılmalıdır. Kadavra tespitinde amaç, dekompozisyon ve putrifikasyonu
geciktirerek yapıların uzun süre muhafaza edilmesini ve özellikle bakteriyel ve
fungal üremenin engellenmesini sağlamaktır. Tespitin kalitesini etkileyen faktörler,
hidrojen iyonu konsantrasyonu ve tamponlar, sıcaklık, fiksatiflerin
penetrasyonu, osmolalitesi, konsantrasyonu ve tespitin süresidir. Dünyada
kadavra tespiti için en yaygın kullanılan solüsyon formaldehittir. İkinci
sırada ise fenol bulunur. Kadavra tespitinde sıklıkla tercih edilen
solüsyonlar; thiel solüsyonu, larssen solüsyonu, modifiye larssen solüsyonu,
logan solüsyonu, modifiye logan solüsyonu, etanol-gliserin, doymuş tuz
çözeltisi solüsyonudur. Çalışmamızda literatür taraması yapılarak solüsyonların
içerikleri, avantajları ve dezavantajları karşılaştırılmıştır. Bu çalışmanın
amacı, kadavralarda yaygın olarak kullanılan fiksatif solüsyonları incelemektir.

Anahtar Kelimeler

Kadavra, Fiksatif, Diseksiyon, Solüsyon

COMPARATIVE EXAMINATION OF CADAVER FIXATION SOLUTIONS

Öz

Dissecting
the tissues or structures by cadaveric dissection is made suitable for
examination and the other name of this application in the literature is also
referred to as anatomization. Cadaver dissection has an important role in
medicine and veterinary medicine education. It is the most comprehensive
experience that students get by seeing and touching. In order for this
experience to continue for generations, cadaver fixation should be done with
the most appropriate fixation method. The aim of cadaver fixation is to delay
the decomposition and putrification and to maintain the structures for a long
time and to prevent bacterial and fungal growth. Factors affecting the quality
of fixation, hydrogen ion concentration and buffers, temperature, penetration of
fixatives, osmolality, concentration and the duration of fixation. The most
commonly used solution for cadaver fixation in the world is formaldehyde. The
second order is phenol. Cadaver fixation is often the preferred solution; thiel
solution, larssen solution, modified larssen solution, logan solution, modified
logan solution, ethanol-glycerin, saturated saline solution. In our study, the
advantages and disadvantages of the contents of the solutions were compared by
literature review. The aim of this study is to investigate the fixative
solutions and application methods used in cadavers.

Anahtar Kelimeler

Cadaver, Fixative, Dissection, Solution

Kaynakça

• 1. Gunther Von Hagens. Body worlds: The original exhibition of real human bodies [Gunther Von Hagens’in Body Worlds Orijinal Vücut Dünyası Sergisi]. Whalley A, translator. İstanbul: Art and Sciences Yayınevi; 2010.
• 2. Brenner E. Human body preservation–old and new techniques. J Anat 2014; 224 (3): 316-344.
• 3. Onyije FM, Avwioro OG. Excruciating effects of formaldehyde exposure to students in gross anatomy dissection laboratory. Int J Occup Environ Med 2012; 3 (2): 92-95.
• 4. 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.
• 5. Kalanjati VP, Prasetiowati L, Alimsardjono H. The use of lower formalin-containing embalming solution for anatomy cadaver preparation. Med J Indones 2013; 21 (4): 203-207.
• 6. Silva RM, Matera JM, Ribeiro AA. New alternative methods to teach surgical techniques for veterinary medicine students despite the absence of living animals. Is that an academic paradox?. Anat Histol Embryol 2007; 36 (3): 220-224.
• 7. Thiel W. The preservation of the whole corpse with natural color. Ann Anat 1992; 174: 185–195.
• 8. Thiel W. Supplement to the conservation of an entire cadaver according to W. Thiel. Ann Anat 2002; 184: 267–269.
• 9. 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: 1–7.
• 10. Balta JY, Cronin M, Cryan JF, et al. Human preservation techniques in anatomy: A 21st century medical education perspective. Clin Anat 2015; 28: 725–734.
• 11. Ottone NE, Vargas CA, Fuentes R, et al. Walter Thiel’s embalming method. Review of solutions and applications in different fields of biomedical research. Int. J. Morphol 2016; 34 (4): 1442-1454.
• 12. Silva RMG, Matera JM, Ribeiro AACM. Preservation of cadavers for surgical technique training. Vet Surg 2014; 33: 606–608.
• 13. Bilge O, Çelik S. Cadaver embalming fluid for surgical training courses: modified Larssen solution. Surg Radiol Anat 2017; 39: 1263–1272.
• 14. Beger O. Kadavra saklama ve doku koruma tekniklerinin tendonlar üzerindeki biyomekanik ve histolojik etkileri [doktora tezi]. Mersin: Mersin Üniversitesi, Sağlık Bilimleri Enstitüsü: 2019.
• 15. Logan B. The long-term preservation of whole human cadavers destined for anatomical study. Ann R Coll Surg Engl 1983; 65: 333.
• 16. Ellis, H., Logan B. Topographical anatomy-the cambridge experiment. Clin Anat 1991; 4 (3): 212-215.
• 17. Choi D, Carroll N, Abrahams P. Spinal cord diameters in cadaveric specimens and magnetic resonance scans, to assess embalming artefacts. Surg Radiol Anat 1996; 18: 133-135.
• 18. Hayashi S, Homma H, Naito M, et al. Saturated salt solution method: a useful cadaver embalming for surgical skills training. Medicine (Baltimore) 2014; 93 (27): e196.
• 19. 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.
• 20. Lombardero M, Yllera MM, Costa-E-Silva A, et al. Saturated salt solution: a further step to a formaldehyde-free embalming method for veterinary gross anatomy. J Anat 2017; 231: 309-317.
• 21. Burns DM, Bell I, Katchky R, et al. Saturated salt solution cadaver embalming method improves orthopaedic surgical skills training. J Bone Joint Surg Am 2018; 100-104.