Wax, wax treatments, and attachment methods RA I

What are the indications of a good wax?

• Adheres well to tissue.

• Is pliable at room temperature.

• Is able to take cosmetics.

• Reflects light in a manner similar to normal skin.

What are the types of wax?

• Firm Wax (Wound Filler)

• Medium Wax (Derma Surgery)

• Soft Wax (Surface Restorer)

• Lip Wax

What wax has these characteristics:

• Used to recreate or model features.

• Used to fill large cavities.

  • Used to fill the cavity to within about a ¼” from the surface.

• Characteristics:

  • Holds its shape once its molded

  • Is the least adhesive of any of the waxes

  • Best when anchored with a basket-weave suture

Firm Wax or Wound Filler

What wax has these characteristics:

• Often used in place of firm wax to recreate or model features.

• Can “top-off” firm wax in a deep wound restoration.

  • Used to complete the top ¼” and surface areas.

• Characteristics:

  • Softer than firm wax and often used as a substitute for firm wax.

  • Adheres to the tissue.

  • Holds its shape once molded.

  • Easily manipulated or softened.

  • Can be smoothed to a very fine layer, thus suitable for surface restoration.

Medium Wax or Derma Surgery

What wax has these characteristics:

• Used for surface restorations:

  • Minor abrasions

  • Razor burn

  • Suture Incisions

  • Surface layer of deep cavity repair

  • Lip waxing

  • Seals puncture sites from hypodermic treatment

• Characteristics:

  • Readily accepts cosmetics

  • “Pore Effect” can be recreated w/o damaging the wax

  • Comes in various skin colors

Soft Wax or Surface Restorer

What wax has these characteristics:

• The most adhesive of all the waxes

• Used for:

  • lip waxing

  • recreating the surface contours of the lips

  • correcting lip separation from dehydration

  • corrective “cosmetics” (can shorten lip line)

• Characteristics:

  • Rather translucent

  • Typically tinted in various warm hues

  • Takes cosmetics easily

Lip Wax

What are the prerequisites for successful wax restoration?

• The underlying tissue must be thoroughly embalmed.

• Surface treatment may be necessary to further dry damaged or traumatized tissue prior to wax restoration.

• The key to success is firm, dry tissue.

• The ideal waiting time between embalming and wax application is 8 to10 hours.

What is the general restoration guidelines for severe head trauma that requires wax restoration?

• Restricted cervical injection is recommended

• Head freeze and/or waterless embalming may also need to be considered

• An astringent fluid (strong) arterial solution should be used.

• Hypodermic treatment of phenol or cavity fluid can treat small areas:

  • Abrasions

  • Fever blisters

  • Skin slip areas

  • Second-degree burns

• Surface packs can be added where needed

  • Phenol or cavity packs dry tissue

• A combination of arterial injection, hypo injection and surface pack’s may be necessary to thoroughly prepare the tissue for wax application.

After embalming someone requiring wax reconstruction for severe head trauma what should you do after the drying techniques?

Application of an adhesive can provide additional protection from further leakage:

• Quick drying liquid-sealer

  • Super Glue

  • Aron Alpha

  • Pore Closer

• Hobby Cement

• Clear Nail Polish

• Rubber Cement

After embalming someone requiring wax reconstruction for severe head trauma what should you do following the sealer?

• Apply a thin layer of wax and feather out the edges onto the surrounding tissue.

• Create the “pore-effect”

  • Stipple Brush

  • Damp Paper Towel

  • Damp Gauze

  • Damp Terry Cloth

  • foil ball

• ~Experiment to develop your own stippling effect

What are the three most commonly used methods of using wax and cosmetics?

1. Cosmetics under wax

2. Cosmetics mixed with wax

3. Cosmetics over wax

When are cosmetics under wax used?

to cover deep discolorations:

• Liquid (least effective)

• Spray (most effective)

• Water-based cream

All should eventually dry sufficiently to allow wax application to adhere (you may have to “set” the cream and liquid bases with powder).

~Oil-based creams must be avoided as they will NOT dry sufficiently enough to allow wax application.

How should you apply cosmetics under wax?

• Once the undercoat is dry apply wax working from the center toward the sides, feathering the wax onto the surrounding tissue.

  • Trichloroethylene (dry wash)

  • Acetone

• Recreate the skin texture

• Finish with a liquid cosmetic applied over the wax to match the surrounding skin tone.

What does mixing cosmetics into the wax do?

It softens the wax

How should you apply cosmetics mixed with wax?

• Add cream or liquid cosmetic and work into wax until distributed evenly (Start light).

• Recreate skin texture.

• Apply a thin coat of opaque cosmetic to blend the wax to the skin, matching the complexion color.

What is the most common wax and cosmetic technique used?

Cosmetic Over Wax

How should you apply cosmetics over wax?

• Apply wax first.

• Recreate texture, pores, wrinkles etc…

• Add cosmetics.

• Stipple-blend into the surrounding tissue.

• Typically a cream cosmetic will work well but liquids can be used, too. You may need to “set” the cosmetic with powder.

What are some ways to soften wax?

• Manipulate or knead the wax in your hand

• Add a cream cosmetic

• Add massage cream

• Place the wax in warm water (in its container).

• Hold the wax under a blow dryer.

What are some methods to firm wax?

• Place the wax in the refrigerator

• Mix the wax with cornstarch

• Mix the wax with talcum powder

What is the key to wax application and why?

• Firm, dry, well-preserved tissue is necessary.

• Why?

  • Moist tissue inhibits the ability of the wax to adhere to the tissue - The effectiveness of the restoration is then compromised.

What must you determine when modeling wax features for a restoration?

The feature location, size and form.

The size of a feature involved what three dimensions?

• Length

  • The length of a feature is its vertical measurement.

• Width

  • The width of a feature is its horizontal measurement.

• Projection

What is typically the most difficult part of the feature to recreate?

The amount of projection

What are wax attachment techniques for the mouth?

• Basket-Weave Suture

• Wax

What are wax attachment techniques for the nose?

• Basket-Weave Suture

• Wire Armature

• Cardboard Armature

• Wire Screen

• Plaster of Paris and Cotton

• Wax

What are wax attachment techniques for the eye?

• Basket-weave Suture

• Wax

What are wax attachment techniques for the Ear?

• Basket-weave Suture

• Loop stitch

• Bent wire armature

• Wax