Thiel Soft-Embalmed Cadavers and Ultrasonography

Thiel Soft-Embalmed Cadavers
and Ultrasonography

Noel T. Boaz, Ph.D., M.D.

Integrative Centers for Science and Medicine
Virginia Commonwealth University

The Thiel Method

Soft embalming (Thiel, W. Annals of Anatomy
(1992) 174:185-195; (2002) 184:267-269) is a
technique which relies on a mixture of salt
compounds and very low amounts of volatile
formaldehyde and formalin to effect fixation
of tissue with a number of unique properties.

Thiel Method

Precise mixing of With body on the right side, dissect external iliac
the “wet-salz” artery and place two canulae in the artery
chemicals

Canula is set in superior Infusion pressure is 0.2- 0.4 bar
sagittal sinus for infusion
of 3 liters of Intestine Formula

Cadavers preserved with the Thiel
Method have

• no detectable odor
• a lifelike flexibility of body parts
• excellent color preservation of muscle, viscera,
and vasculature
• superior antimicrobial preservation properties.

Chemicals Used

• Ethylene glycol
• Ammonium nitrate
• Potassium nitrate
• Boric acid
• 4-chloro 3-methyl

phenol
• Sodium sulphite
• Morpholine
• Formalin
• Ethyl alcohol

Accurate Measurement of Chemical
Constituents by Weight

• Solids (ammonium
nitrate, potassium
nitrate, sodium
sulphite, boric acid, and
phenol) are measured
out by weight to be
added to solution

• Here sodium sulphite is
weighed for the
embalming solution

Accurate Measurement of Chemical
Constituents by Volume

• Liquids (ethylene glycol, water,
morpholine, formalin, and
ethyl alcohol) are measured
out by volume in a graduated
cylinder to be added to
solution

• Stem Solution A is made of
accurately measured amounts
of boric acid, ethylene glycol,
ammonium nitrate, potassium
nitrate, and water

• Stem Solution B is made of
accurately measured amounts
of ethlylene glycol and 4-
chloro 3-methyl phenol

Mixing Stem Solution A

• Dissolving the salts
in water and
ethylene glycol to
make Stem Solution
A

• 44.4 liters of Stem
Solution A were
made

Addition of Stem Solution B

• 8.8 liters of Stem
Solution B were
made from ethlylene
glycol and 4-chloro
3-methyl phenol

Mixed Embalming Solution is Added to
Embalming Machine

• Measured amounts of
Stem Solution A and
Stem Solution B were
mixed with

• Measured amounts of
sodium suphite,
morpholine, formalin,
and ethyl alcohol to
yield

• 15.75 liters of
Embalming Solution

Cadaver is Prepared for Injection of
Embalming Fluid

Single Port Made in Right Common
Carotid Artery

Exit of Fluid Via Right Internal Jugular
Vein

Injection and Gravity Feed of
Embalming Solution

• Embalming solution
injected under
pressure of 15 psi

• Embalming was
completed overnight
by gravity feed

Body Perfused with Fluid

Some “Burning” of Tissues Noted

• Areas of brownish
discoloration in
malar areas
(“burning”) noted
due to interaction of
tissues with
embalming fluids

Superficial Epidermal Desquamation
and Bulla Formation

Desquamation occurs
between stratum corneum
and “stratum malpighii”

Didactic Advantages of Soft

Embalming

• Because of the more lifelike texture and color of structures
students’ dissections are of high quality, improving learning
in the laboratory.

• Appreciating the actions of muscles at joints, especially in
the extremities, is facilitated by the flexibility of the
cadaver.

• Soft-embalmed cadavers offer advantages over
unembalmed cadavers or simulators in teaching clinical
procedures, such as intubation, lumbar puncture, central
line placement, thoracocentesis, and surgery.

• The flexibility of the peritoneal membrane and internal
viscera allows soft-embalmed cadavers to be especially
useful in teaching laparoscopic surgical anatomy.

Thiel-Embalming Allows Excellent Visualization
of Anatomical Structures Via Ultrasonography

Ultrasound imaging of the
left carpal tunnel in a Thiel-
embalmed elderly female

Visualization of the Carpal Tunnel in a
Thiel-Embalmed Cadaver

Visualization of the Renal Pelvis in a
Thiel-Embalmed Cadaver