Restorative Art I - MSFS 245

Go from the known to the unknown

Restorative Art

Care of the deceased to create natural form, color, and texture; limited to visible parts of remains (start w/ underneath base structures); form refers to shape of surface structure, recognizable by its outline and surface

Restorative Art (cont.)

Scientific thinking (understanding anatomy and color), community engagement (technique learning and conversations w/ fellow embalmers), be willing to try new things

Incentives for achieving proficiency

Psychological effect on family and friends, professional responsibility (our goal), develop a following (reputation, pushing the envelope w/ materials, problem solve and apply other fields to ours)

Laboratory procedures

Analyze situation, excise and clear damage area, clean off bone fragments and foundation, start from known and work toward unknown, top or bottom (if crushed inside out), put puzzle together, dry/suture/wax lacerations and avulsions, restore any missing features

Case considerations and types of RA

Major vs Minor restorations, pathology, aging, postmortem changes, effects of embalming, trauma

Building a base

Anatomical planes and directions, Latin vocab, bones/muscles/skin (facial features - ear, nose, mouth, eye)

Everybody is different

Alignment of facial features, profiles, facial shapes, division of face into zones

Two sides of same coin

Embalming and RA closely intermingled, RA part of EVERY embalming, washing body (gives better picture of what they looked like), setting features, vessel selection (fluid distribution, incision visibility), fluids and solutions (disinfection + preservation = restoration), monitoring injection process, appropriate incision closure (set up for waxing and cosmetics), wash body again, post-embalming restorative techniques, cosmetics, dressing body, placement in casket

Preservative art

Proteins and formaldehyde, pH, bacterial activity, temp, balancing moisture

Embalming chemicals

Buffers, humectants, surfactants, anticoagulants, other preservatives

Prep room detective

Case analysis, long term care, decomp, pathology

Pleasantry

Closing the mouth and eyes, grooming/positioning of the hands

Keeping an eye on things

Identify and respond to dehydration, swelling, other problems

Autopsy preparation

Disruptive process to head and torso, can affect the way people appear in casket

Organ and tissue donation

Disruptive process, tissue to be preserved, limbs to be restored

What comes after

Tissue building, compresses, waxes, tissue damage

Tissue building

Equipment necessary (syringe and tissue fluid), how to do it (hidden points of entry)

Waxes and their application

Types of waxes and uses, heating and cooling, hardening and softening

Tissue damage

Addressing trauma, pathology, skin disorders, communication w/ family; case studies

Final piece of the puzzle

Photography, color theory, lighting, cosmetics, dressing and casketing, preparation of unembalmed body

Can you make them look like this again?

Photographic viewpoints and lighting, types of photos

Lighting

Types of light fixtures, color theory application, lighting in FH, outcomes of colored lighting

Color theory

Basics, how we see color, application to RA

Cosmetics

Color theory application, types, natural skin tone recreation, brushes, contouring

Hair care and replacement

Caring for hair, wigs, replacement of hair, types of artificial/natural hair, coloring hair

Dressing and casketing

Difference between men’s and women’s clothing, cutting/not cutting clothes, placement in casket, finishing touches

Preparation of an unembalmed body

Safe handling, dressing, cosmetizing, following family’s wishes

Permission for restoration

Secured from someone in authority before making incisions/excisions, necessary for major restorations (can legally be described as mutilation), not needed for those incurred in prep of remains (setting features, distention, leakage, tissue discoloration)

Excision

The act/procedure of removing by/as if by cutting out

Incision

Surgical cut made in skin/flesh

Minor restorations

Day-to-day procedures such as setting features, tissue building, swelling reduction, discolorations, realignment of fracture, cosmetics, dressing and casketing

Major restorations

Time consuming/skill (ask permission) such as soft tissue repair, deep wound prep, bone reconstruction, hair restoration, sub-tissue surgery, modeling of facial features, dental fixes, recoloring discolored face

Causes of RA - Injuries

Fractures, contusions, swelling, torn tissue, abrasions, discolorations, loss of hair, damage to facial features

Causes of RA - Pathology

Swelling, torn tissues, discolorations, hair, tumors, medical devices, lesions, addiction

Causes of RA - Age

Discoloration, changes in mouth, weight loss, hair loss, hygiene

Causes of RA - Postmortem time period

Movement of body fluids, decomp (desquamation, discoloration, gases, odor, purge), subcutaneous emphysema, contact pressure, autopsy, tissue donation, dehydration

Desquamation

The sloughing off of epidermis that occurs as skin cells decompose

Effects of embalming

Dehydration, discolorations, swelling, poor preservation

Adhesives (glue)

Adhere tissues together, secure incisions, create ‘tacky” surface for cosmetics; cyanoacrylates (Super glue/Kragle) are in applicator, spray, adhesive strips, or brush; polyethylene glycol polymers are in brushes

Aneurysm hook

Blunt dissection, raising vessels, setting features, face measurement, securing calvarium clamps, facial markings, can have regular/cradle handle

Aneurysm needle

Blunt dissection, raising vessels, setting features, face measurement, securing calvarium clamps, facial markings, has “eye” in hook portion which could be used for passing ligatures around vessel (similar to hook, but has sharp pointed tip)

Armatures

Used as a base for wax/cosmetic (wire, styrofoam, plastic)

Calvarium clamps

Secure calvarium after autopsy

Compresses

Soaked cotton/gauze (bleaching, pressure, preservation, moisture retention), cranial cap absorbent pads are perforated 8”x15” lint free cotton sheet that absorbs 10x its weight in liquid

Cotton

Soft, white, fibrous substance; absorb chemicals for compresses, absorbs moisture, support

Electric spatula

Tissue dryer, heating element, reduce swelling, dehydrates and cauterizes; keep it lubed and keep it moving w/ massage cream

Massage cream

Retains moisture/prevents dehydration, cosmetic removal, don’t use sparingly (glob it on), useful at end of embalming before cosmetics

Needle injector

Used to insert a “barb” into mandible and maxilla to hold lower jaw in closed position, several types of handles available which can make device easier to use, electric version also available; stay parallel to gums

Eye caps

Creates form, secures eye, plastic (most common - flesh/clear colored) metal, cloth

Mouth formers

Restore contour to mouth, curved/flat, serrated side for security, holes for threading ligature

Feature builder

Regular (cellulose and alcohol, react w/ moisture to gel), firming (same reaction as regular, contains formaldehyde); feature builder solvent (solution of alcohol and some water, used to dissolve feature builder of both types)

Hypodermic needle

Hollow tube w/ a pointed opening at end, tissue building, hypodermic injection for preservation, thickness measured in gauge, length selection based on delicacy of operation

Forceps

Spring forceps (angular/drainage, straight, dissector), clamping and occluding, gathering, fixation

Incision spreader

Holds open incision

Scissors

Used for cutting and opening arteries/veins; vary in length but may be straight, curved, pointed, blunt

Grooved director

Expands to help guide drain tube/device into vein for drainage; Mickey Mouse tool

Hair dryer

Drying hair and nail polish, heating hair for coloring purposes, melting wax, extension cord

Hypovalve trocar

Injects tissue hypodermically, small gauge trocar, one-way handle activated by button, attached to embalming machine; push button going in, release button pulling out

Trocar button

Threaded plastic screw used for closing trocar punctures, may also be used to close small punctures/surgical drain openings/intravenous line punctures; available in several sizes, use liquid sealer after

Trocar button applicator

Used to insert trocar button

Ligature

Filament used to bind tissue, linen/cotton/polyester, waxed/unwaxed, different thicknesses available, selection based on operation

Mortuary mastic/putty

Used to restore contour to features (mouth, eyes, autopsy, incisions), applicator/spatula

Nasal aspirator

Attached to aspirator hose, nasal passages and throat, tracheostomies

Autopsy aspirator

Attaches to aspirator hose, removes fluid from cavity and viscera bag; listen for changes in suction

Hydro aspirator

Creates vacuum when water is run through mechanism; friend and enemy

Plastic garments

Worn on deceased to protect clothing and contain moisture, different sizes, secure; unionalls, coveralls, capri pants, pants, stockings, sleeves, shirt

Plastic wrap

Rolled plastic on dispenser, place under autopsied heads over pillow on casket, secure long incisions, prevent leakage

Stay Cream

Seal-N-Form (fills and seals wet tissue, helps hold dentures in place and fills out emaciated cheeks), Kalip Stay Cream (fully workable and easily applied, can be used on delicate tissues of eyes/lips/nostrils, smooths unsightly wrinkles and folds in place, useful for filling tiny separation which can occur between lips as well as small fissures on lip)

Positioning devices

Adjustable/styrofoam head blocks, head rest, body rests, extremities positioners, arm and hand rests consist of 2 curved metal arm holders attached by adjustable strap

Scalpel

Small knife, detachable/permanent blade, incisions and excisions

Suture needles

Half curved, double curved (“S” curve), circle curved, loopuyt double curve/back curve, L shaped; all come in multiple gauges and lengths

Waxes

Beeswax/paraffin/petroleum, types (lip wax, surface restorer/soft wax, modeling wax, wound filler/firm wax - large holes), multiple tones

Anatomical position

Standing upright, facing forward, feet flat, palms out

Anterior

Before/towards front; opposite is posterior

Deep

Away from surface; opposite is superficial

Distal

Away from center of body/point of attachment; opposite is proximal

Intermediate

Between 2 structures

Lateral

To side of/away from middle; opposite is medial

Medial

Towards middle; opposite is lateral

Superior

Top of head/above, opposite is inferior

Inferior

Feet/below; opposite is superior

Posterior

Back/towards rear; opposite is anterior

Oblique

Deviation from parallel/perpendicular angles

Proximal

Nearer the center of body/point of attachment; opposite is distal

Superficial

Closer to surface; opposite is deep

Coronal body plane

Division of body from Anterior → Posterior

Transverse body plane

Division of body from Superior → Inferior

Sagittal body plane

Division of body from Left → Right; can be done anywhere on body, called midsagittal if divided directly in middle

Anguli

Corner/bend

Labii

Lip

Lacrimal

Weeping/tears

Maxilla

Jaw

Nuchal

Nape of neck

Occipital (location)

Back of head

Oculi

Eye

Oris

Mouth/speech/expression

Palatine

Roof of mouth

Palpebrae

Eyelid

Parietal (location)

Wall of hollow cavity/organ

Ciliary

Lashes/eyebrow