인체 해부 교육에서 에탄올-글리세린 방부 처리 시신의 유용성
Suitability of Ethanol-Glycerin Embalming Cadavers for the Training of Human Anatomy
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초록
에탄올-글리세린 방부 처리 시신이 현재 인체 해부실습 교육과 실제 해부 교육에 사용되는 포르말린 고정시신을 대체할 수 있는지를 알아보기 위해, 이 두 가지 방법으로 각각 처리된 시신 5구를 이용하여 물리화학적 특성을 비교 평가하고 생물학적 분석 및 초음파 검사를 시행하였다. 에탄올-글리세린 고정 시신 (3구)은 색깔, 질감, 탄력성, 축축함 (부드러움), 피부 절개와 봉합, 혈관 매듭과 봉합, 박리의 용이함, 냄새, 자극성 등 조사한 물리화학적 특성에서 피부 봉합을 제외한 모든 항목의 평가점수가 포르말린-페놀 고정 시신 (2구)에 비해 높았다. 관절의 유연성 검사 결과 팔꿉관절의 폄운동을 제외한 어깨관절, 팔꿉관절, 손목관절의 운동에서 에탄올-글리세린 고정 시신이 통계적으로 유의하게 큰 운동 범위를 보였다. 8주째 시행한 생물학적 분석에서 에탄올-글리세린 고정 시신 1구에서 세균 1종이 검출된 데 비해, 포르말린-페놀 고정액으로 방부 처리한 모든시신에서 세균과 곰팡이가 배양되었다. 초음파 검사 결과 포르말린-페놀 고정 시신에 비해 에탄올-글리세린 고정 시신의 간 일부에서 관찰되는 혈관 구조와 간 실질 음영이 뚜렷했으며, 넓적다리 근육 구조를 관찰하는 데 더 좋은 해상도를 보였다. 이상의 연구 결과 에탄올-글리세린 고정 시신이 해부에 적합한 물렁조직의 질과 관절의 유연성 그리고 감염으로부터의 충분한 보호력을 갖는 것으로 평가되었으며, 초음파 검사에서도 깨끗한 영상을 얻을 수 있었다. 이는 학생의 해부실습과 임상의사를 대상으로 하는 다양한 실제 해부 교육에 에탄올-글리세린 고정 시신이 활용될 수 있음을 시사한다.
Abstract
This study evaluates the suitability of cadavers embalmed by the ethanol-glycerin fixative for the dissection course of medical students and the hands-on dissection workshop of clinicians. Five cadavers were embalmed by two different methods: two formalin-phenol fixation (FPF) and three ethanol-glycerin fixation (EGF) cadavers. The measurement of physical and chemical characteristics including ranges of motion (ROM), bacterial and fungal culture tests, and ultrasonography were performed for each cadaver. The EGF cadavers were evaluated to be significantly more suitable than FPF cadavers for the physical and chemical characteristics including color, texture, elasticity, wetness (softness), skin incision, vessel ligation and suture, decollement, odor, and irritant. In shoulder, elbow, and wrist joints, ROMs of the EGF cadavers were statistically more than those of the FPF except for elbow extension. On bacterial and fungal culture tests at 8 weeks after carrying out of refrigerator, one bacteria were detected in one EGF cadaver; however, some bacteria and fungi could be detected in all FPF cadavers. The ultrasound images of abdominal organ and thigh musculature could be more clearly detected in the EGF cadavers than those of FPF cadavers. These results indicate that the EGF method had a sufficient antibiotic effect and produced cadavers with flexible joints and a high tissue quality suitable for various cadaveric dissection courses.
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