discolorations, bleaching and stain removers

Abrasion

Resulting from friction of the skin against a firm object causing removal of the epidermis (outermost layer of skin).

Laceration

A wound or irregular tear to the flesh.

Incision

A clean cut into the tissue.

Excision

An area from which something has been cut out.

Excise

To remove by cutting

Mastic Compound

Putty-like substance; absorbent sealing adhesive that can be injected under the skin or applied to the surface tissues to establish skin contour.

Abrasions

Vary in size and depth

Small and shallow, as from a fall

Deeper and extensive, as from dragging during a car crash, and may also contain lacerations within the abrasion.

Abrasions

The length of the time between abrasion and death affects:

The amount of dehydration

The color of the abrasion

The amount of scabbing

Treatment of Non-Viewable Abrasions

Embalm

Seal abrasion with a sealer

Cover with cotton

Determine if plastic wrap or plastic garments is necessary

- Abrasions are typically very dry wounds

Treatment of Viewable Abrasions

Before embalming, cover area surrounding abrasion with massage cream (but not to the abrasion itself)

Embalm

Remove scabs after embalming

Dry the area using a cauterizing agent

Seal with a liquid sealer

Add wax, recreating pores and facial markings

Cosmetize - Abrasions are often very dark and may need cosmetic treatment prior to applying wax

Laceration - Irregularly torn/jagged wound

Vary in length, depth, width and tissue damage

Typically caused by blunt-force trauma

Incision - Cleanly cut (even margins) wound

Vary in length and width

Typically caused by a sharp object such as a scalpel blade or a piece of glass or sharp metal.

Treatment of Lacerations and Incisions

Prior to embalming determine if bridge sutures are necessary

Tissue below the skin's surface may include drying, packing, suturing and sealing the wounds

Tissue at or near the skin's surface will dictate further treatment:

Laceration - Worm suture in visible areas

Incision - Intradermal suture in visible areas

Recommended Treatments to Viewable Areas

•Dry inside of wound with cauterant

•Add massage cream to surrounding areas

•Bridge stitch where necessary

•Embalm

•Dry wound, re-treat with cauterant pack if necessary and add sealer internally to deep tissues.

•Pack with drying/incision powders

•Excise dried and dehydrated edges of wound

•Suture appropriately

•Wax, if needed, recreating pores and facial markings•Cosmetize as needed

Penetrating Wounds

Wounds entering the interior of an organ or cavity.

Penetrating Wounds:

Wounds entering the interior of an organ or cavity.

Bullet entry or exit

Medical devices (feeding tubes)

Punctures

Stab wounds

Punctures:

a hole from a piercing injury.

Punctures: Pre-embalming

Remove scabs using a sharp instrument

Cover the area with an emollient

Punctures: Post-embalming

Excise dehydrated margins

Ensure firm, dry tissue

Close the opening appropriately (Is it viewable?)Trocar button, Purse-string suture, or simply a dot of glue

Wax if necessary

Cosmetize if necessary

Pistol and Rifle Wounds: velocity difference

A rifle is a high velocity weapon

Longer barrels create faster moving bullets

A pistol is low(er) velocity

Pistol and Rifle Wounds: Close range wounds

Wounds from close range are typically more severe than those from a distance.

Pistol and Rifle Wounds: entrance and exit wounds

Entrance - smaller, cleaner

Exit - larger, lacerated

Restoration Procedures: Abrasions, Lacerations

pre-embalming

Face is covered with an emollient (lanolin spray/massage cream)

Surface bleach ecchymosis around the eyes

Cold compresses for swelling

Restoration Procedures: Abrasions, Lacerations

embalming

Leave wounds open and observe distribution

Restoration Procedures: Abrasions, Lacerations

post-embalming

• Excise dehydrated margins

• Ensure firm, dry tissue

• Large, deep wounds are treated as large cavity restorations

• Small wounds may be sutured

• Some wounds may need waxing, done over firm dry tissue.

• Treat remaining discolorations (such as powder burns and black eyes

Discoloration

Any abnormal color in or on the body.

Stain

To discolor with foreign matter; an area so discolored.

Disease

Any deviation from, or interruption of, the normal structure or function of a body part, organ, or system.

Trauma

Physical injury or wound caused by external force or violence.

Decomposition

Separation of compounds into simpler substances by the action of microbes and/or autolytic enzymes.

Lividity (Livor Mortis)

Postmortem intravascular red-blue discoloration resulting from hypostasis of blood.

Hypostasis

Settling of the blood and/or other fluids to dependent portions of the body.

Bleaching agent

Chemicals that lighten or blanch skin discolorations.

Bleaching

The act of lightening a discoloration (Hypodermic injection & Surface compress/pack

Hemolysis

The destruction of red blood cells that liberates hemoglobin

Blanch

To whiten by removing color; to make pale.

Phenol (Carbolic acid)

Antiseptic/disinfectant employed to dry moist tissues and to bleach discolored tissues.

Considerations: discoloration vs stain

•A discoloration CAN be removed with embalming techniques.

•A stain CANNOT be removed

Considerations: precautions

•Pre-embalming analysis, via digital pressure, can determine a discoloration from a stain.

•If blanching (clearing) occurs, it is a discoloration.

•If blanching does not occur, the blood has hemolyzed, released hematin into the tissues, causing a post-mortem stain.

Causes of Discolorations & Stains:

Pre-embalming Color Changes

- Disease- Decomposition

- Medical Treatment

- Trauma

- Lividity

- Postmortem Stain

Causes of Discolorations & Stains:

Embalming Color Changes

- Too strong an arterial injection

- Inadequate drainage

- Formaldehyde/jaundice reactions

Causes of Discolorations & Stains: Post-embalming Color Changes

- Razor burn

- Graying

- Post-embalming decomposition

-Dehydration

Discolorations & Stain Treatments

- Bleaching

- Cosmetics

- Both Bleaching and Cosmetics

Bleaching Agents

•Cavity fluid

•Phenol and/or alcohol

•Preservative gel

•Special-bleaching fluid

Effects of Bleaching Agents

•Lightening of the stained area

•Lightening of the non-stained area

•Possible dehydration

•Fixation of tissue

Bleaching Techniques

Surface Compress/Pack

A cotton pack soaked in bleaching agent is applied to the discolored area (topical)

•Apply massage cream to surrounding tissues

•Cover the compress with plastic

•Check at intervals to monitor effectiveness

•Remove once stain is adequately lessened or removed

Hypodermic Injection

•A syringe and needle are used to inject bleaching agent under the skin

•Apply massage cream•Inject bleaching agent to entire stained area, superficially

•Seal the injection site with adhesive or sealer to prevent leakage

Caution about phenol and alcohol

•Phenol can over-bleach and dehydrate an area of discoloration.

•Alcohol should be available to "neutralize" the phenol.

•If over-bleaching begins to occur, brush the area with alcohol to stop the process.

Surface Stain Removers

Surface stains (non-tissue stains) include dirt, grease and grime Always try soap and water first!

Types of Surface Stain Removers

•Adhesive tape - rubbing alcohol, ether

•Blood - cold water, ammonia (peroxide if fresh blood)•Paint - turpentine, paint thinner

•Nicotine - lemon juice, household bleach

•Tar; varnish - acetone, commercial remover, liquid shampoo

•Iodine - alcohol

•Grease - ether, acetone, gasoline, liquid shampoo

•Oil - ether, gasoline

•Wax - ether

•Urine - ammonia

•Ink - lemon juice, petroleum jelly

•Glue - white vinegar, glue solvent

•Lipstick - Dry cleaning solvent