EMBALMINGDIAGNOSIS AND M.L ASPECT

Dr. Faiz ahmadForensic medicine

JNMC,A.M.U Aligarh

Freezing

Embalming

Texidermy

Ancient egyptian method(mummification)

Formalin preservation

Paraffin impregnation

Plastination

Artificially

• At very low temperature.

• At very high temperature.

• Shallow moist clay soiled

grave,or submerged in water.

• In water or soil containing

antiseptic substance

like,,arsenic,lime etc.

Naturally

Preservation of Dead Body

Definition: It is a process of preservation of dead body by treating it with antiseptic and preservatives to prevent putrifection.

By this process,1. Protein are coagulated

2. Tissues are fixed

3. Organs are bleached and hardened

4. Blood is coagulated and transformed into a pinkish brown mass

EMBALMING

• Embalming produce a chemical stiffening similar to rigor mortis but

normal rigor does not develop.

• Rigidity in case of embalming is permanent.

• To get desired effect- embalming to be done within 6 hrs of death.

• If done several hrs of death,the body will show mixture of bacterial

decomposition and mummification and will disintigrate in few months.

Embalming is done in:

• Medical College to preserve dead body for the purpose of

education and dissection.

• When the dead body has to be taken from one country to

other or in same state for last rituals.

Embalming is done by injecting embalming fluid in the

body.

• 1.5 liters• 600grms• 900grm

• 600ml• 800gm• 30ml• 90ml• Upto10 lit

Proportion• Formaline(preservstive)• Sodium borate(buffer)• Sodium citrate(antocoagulant)• Glycerine(wetting agent)• Sodium chloride(controle ph)• Eosin(1%)(cosmetic)• Soluble winter green(perfume)• Water(vehicle)

Ingredient

Composition of an ideal embalming fluid

Embalming Room

Embalming Fluid

• Sodium borate and sodium citrate should be dissolve in hot

water and allow to cool.

• Add rest of the component and dilute with water to make up

ten liters.

• Allow to stand for few hours and filter.

• A dead body of 70 kg weight requires 10 liters of embalming

fluid of which 10% will be lost through various drain and

purging.

1. Formalin _ 60%

2. Methenol _25%

3. Phenol _ 10%

4. Sodium lauryl sulphate _ 1%

5. Mercuric chloride _1%

6. Eucalyptus oil _1%

For cavity embalming the fluid having the following composition

Types of embalming

1. Arterial embalming

2. Cavity embalming

3. Hypodermic embalming

4. Surface embalming

5. Embalminf of autopsied body

6. Embalming of AIDS body

Arterial embalming

• Place body supine on table.

• Remove clothing and surgical dressing if any and the body

washed withan antiseptic soap and warm water.

• Rigor mortis,if present should be broken by

bending,massaging,rotating the head etc.

• The nostrils are cleaned and plugged with a wad of cotton

soaked in arterial solution.

Arterial Embalming Conti..

• The cheek may be filled out with cotton soaked in arterial

solution.

• The mouth and eyelid shoud be closed.

• If eyebal is sunken arterial solution should be injected into the

orbit and eyeball.

• The head should be elevated 8to10cm and placed on head rest

and feet raised to facilitate drainage.

• Anal orifice and vagina plugged similarly.

Arterial Embalming

Choice of vessels

• The nearer the vessel to the heart ,the better the

result specially for drainage.

• Single point injection leave the patches of area

unfixed by embalming fluid.

• Multiple site injection used in,,traumatic

death,autopsised case and postmortem mutilation.

• Six point injection involve , R/L common

carotid A for head and neck, R/L axillary A for

upper limb ,and R/L femoral A for lower limb.

• On completion the vessel should be ligated to

prevent leakage of embalming fluid.

• Each side of face injected separately to prevent

distortion of face due to over injection

• After injection of one artery it should be

ligated before injecting to other artery,

• All drainage point should be ligated after

completion to prevent leak.

Instrument used for injecting the embalming fluid

a) Hand/ foot pump

b) Stirrup pump

c) Bulb syringe:

• This is a manual pump similar to Higginson's syringe.

• Bulb type rubber syringe and rubber tubing at either end.

• Valves,allow suction on one side and ejection on other side

d. Gravity injector:

• It is the simplest,safest,slowest of the injection method.

• Gravity bottle or percolator should hold 10 lit of fluid and raised above body .

• A rise of 1 m gives a fluid pressure of 0.6kg/sq.cm and 2m about 1kg/sq.cm

• Take longer time and distribution of fluid is uneven.

Instruments

Gravity Injector

e)Motorised injectors:

• Fluid from injection tank is forced into the vascular

system using air from a compression tank.

• Prassure and flow rate are controled by device

• 10 litres of arterial solution injected within 30 min.

• Injection prassure is about 2kg/sq.cm

Motorized Injector

Method of injection

1.Continuous injection and drainage

• The arterial injection is given continuously

• Vein tube kept open throughout injection

• Embalming time much shorter

• Venous drainage and tissue saturation is poor

• Least satisfactory

2. Continuous injection with disrupted drainage

• The injection is continuous with vein tube closed.

• The blood in the vein build up a resistance for arterial

flow which help in better diffusion of fluid.

• Thick blood is discharged when drain tube is opened.

• Bettrer than continuous discharge and drainage.

3.Alternate injection and drainage

• The arterial fluid is injected for some time with drain tube

closed.

• The injection is stopped when superficial veins swell, and

drain is opened.

• When the flow of blood from the drain tube stop, it is closed

and injection started.

• This process repeated several time.

4. Discontinuous injection and drainage:

• This consist of repeated arterial injection of small quantities at

two hrs interval.

• The total quantiti of injection fluid is in exces of ordinary

injection done at a time.

• Injection is continued for three or four time.

• The venous drain tube which is closed is opened a little before

and open a little after starting another dose of injection.

• This is the best method.

b)cavity embalming(closed cavity treatment)

• Cavity treatment should be done after half to one

hrs,Which allow for the hardening of the viscera

and facilitate piercing of the gut.

• A motorised aspirator if available is better.

• A 30cm long trocar is inserted into the abdomen

throug small incision 5to6cm above umbilicus in

mid line.

Cavity Embalming

• The trocar is first directed upward, backward

and to the left to pierce and aspirate the stomach.

• Then trocar is slightly withdrawn and pushed up

toward right to pierce right side of heart.

• Next the right and left pleural sacs are reached

by piercing diaphragm and aspirated.

• Next several puncture are made in small

intestine , caecum , colon to suck out content.

• The urinary bladder, sigmoid colon and rectum

should be aspirated.

• One liter of cavity fluid should be injected

distributing it evenly throughout the cavity.

c)Hypodermic embalming

• Suitable for embalming isolated limbs,body parts

followimg bomb blast,air crush,railway injuries

• Embalming fluid injected subcutaneously.

d) Surface embalming:

• Suitable for burn injury cases.

• Whole body is packed with cotton soaked in embalming

fluid.

e)Embalming of autopsied body:

• Before stitching up ,thoraco-abdominal and cranial

cavity is sponged with embalming fluid

• Then viscera properly treated with embalming

fluid,covering and packing with embalming fluid soaked

cotton

• Placed within the body cavity and stitched up.

• If body is already stitched up,removed and re -stitched.

f)Embalming of AIDS bodies:

• Concentration of arterial and cavity

embalming fluid is increased.

• Recomended precaution to be taken during

handling the body.

Legal aspects of practice of embalming

• Proper identification of body by near relative is done before

procedure.

• Concent for the procedure should be obtained.

• No objection certificate from police should be obtained.

• Death certificate should be referred before embalming.

• In case of foreigner, Embassy clearance should be obtained

in addition.

• In medicolegal cases, it should be done after autopsy.

• Death certificate/P.M report should be accompanied with the

dead body.

• On completion of embalming,embalmer/competent authority

should issue certificate(for local transport 3copies ,and for

international transport 5 copies.

• In case of embalming of dead body who suffered from

noticeable

disease(cholera,rabis,plague,tetanus ,HepB,AIDS,TB

etc)concern authority is informed.

MEDICOLEGAL ASPECTS OF EMBALMING

1. Embalming should never be allowed before autopsy, it

may induce artifact and poses difficultu in interpreting

the finding.

2. Embalming provides chemical stiffening similar to

rigor mortis, so difficulty arise in estimating time since

death.

3. Embalming alter the appearence of body so

interpretation of injuries become difficult.

4.Embalming destroys cyanide,alcohol,opiates, carbon monoxide

thus toxicological analysis become useless or difficult.

5.Embalming kills bacteria so bacteriologic evaluation become

useless.

6. Due to embalming blood group cannot be made out.

7.Detection of thrombus or embolism are not possible.

8.The dimentions of wounds may be modified by the embalmer

or new wounds may be produced due to use of trocher.

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