Chapter 7: Tissue Prep and Wax

• Major restoration requires written permission

• Enables incisions and excisions

• Indemnifies funeral home

• Get current photo if possible

Restorative Preliminary Procedures

Most incisions and excisions are made ___________________ so the circulation is not disrupted

after embalming

If tumors or growths distort the facial features excisions may be made…

before embalming

• surrounding tissues are temporarily sutured to keep them in a normal position

• loop stitch is used

procedure for excisions made before embalming

• Align features

• Set fractured bones

• Suture loose flaps of skin

• Support depressed tissues

• Shave all areas of the face

• Remove stains and foreign matter

• Apply a heavy layer of massage cream

• Cotton may be saturated with high index fluid and placed in deep wounds.

• It may be necessary to plug small punctures as well as the nose and ears

tissue preparation for restorative work before embalming

Arterial injection by restricted cervical injection is the preferred method anytime there is head or facial trauma. This controls head swelling and allows for different solution strengths in the face vs. body

tissue preparation for restorative work during embalming

• Reduce swelling

• Bleach discolorations

• Hypodermically inject areas not embalmed

• Excise damaged or diseased tissues.

• Suture incisions

tissue preparation for restorative work after embalming

• After embalming, any compresses, padding, plugs, and temporary sutures are removed.

• Diseased tissue is completely excised, as well as and any hard dehydrated tissue at the margins of large wounds.

• The margins of the involved area should be undercut at this time

Large Cavity and Excision Considerations

This is ideal for large wounds where skin needs to be anchored across a gap. It creates a foundation for wax restoration

Basket-Weave Suture

If the wound is less severe, hidden sutures like the single or double intradermal stitch can be used to pull tissues together

Intradermal Sutures

Useful for pulling together deeper muscle tissue before working on surface layers

Loop Stitch

• Dry chemically with cavity pack or cotton soaked in full strength arterial solution OR Deep tissues may be injected with full strength arterial or cavity fluid (Phenol works faster than formaldehyde).

• Before anchoring, ensure the tissues are completely dry to prevent further slippage or separation. Use a cavity fluid pack, drying powder, or chemical cauterant

• Loop Stitch suture, Intradermal sutures, & basket weave suture recommended

Deep Tissue and Anchoring

• pack the area with cotton or mortuary putty before suturing to provide support

• use adhesives before applying wax

Deep Tissue and Anchoring with a significant amount of missing tissue

• Arterial Embalming

• Hypodermic Injection

• Surface Compress

• Cauterizing Agents

• Electric Spatula

• Sealer

Methods to Achieve Firm & Dry Tissue

When was a special wax developed for mortuary purposes?

the 1920s

an early term for Restorative Art

Demi-Surgery

Firm wax, Medium wax, soft wax, & lip wax

The Four Types of Waxes Used

Used for wound filling, as well as for filling large cavities and modeling features. It will hold its shape one modeled but is the least adhesive of all mortuary waxes. When restoring deep cavities, the wax is used to fill within ¼" from the surface where a softer wax is then used. Basket Weave Suture used as a base for reconstruction.

Firm Wax or Wound Filler

Often used as a substitute for firm wax. Ideal for feature restoration. Will adhere to tissue and hold its shape once molded. Can be softened by hand or blow dryer. When warmed can be smoothed to a fine layer. Also used for shallow surface restoration.

Medium Wax or Derma-Surgery Wax

Used to fill shallow depressions. Very pliable. Can be applied in a very thin layer. Ideal for abrasions, razor burn, and suture incisions. Readily accepts cosmetics. Pores can be created without cracking the wax. Can also be used to hide puncture sides and dehydrated inner canthus's.

Soft Wax or Surface Restorer

A soft wax that is usually tinted. Used to correct lip separations and surface the mucous membranes. The most adhesive of the waxes. Tinted in a variety of warm hues.

Lip Wax

1.Applied under wax

2.Mixed with wax

3.Applied over wax

the three ways cosmetics are applied when using wax

Once undercoat is dry, wax is applied. Wax should be worked from the center and feathered outward. Dry wash can be applied with a brush to smooth out the edges.

Wax under cosmetics technique

What type of cosmetic is most suitable for using cosmetics under wax?

Must be liquid, spray* or water-based cream* (*preferred over liquid)

The choice of what type of cosmetic to use under wax depends on what?

the type of discoloration being covered up

Oil-based cosmetics are applied ______ wax.

over

the three general steps to mixing cosmetics with wax

Mix, Small Amount, Blend

Liquid or cream cosmetics can be mixed with wax to Mix match a person's complexion

The first step to mixing cosmetics with wax

Begin with a lighter color and add a small amount at a time until desired color is reached.

the second step to mixing cosmetics with wax

After placing wax on skin and modeling it, an opaque cosmetic can be applied over the wax to blend it in and match the surround skin complexion

The third step to mixing cosmetics with wax

• Manipulation by kneading in the palm of the hand.

• Adding cream cosmetic or massage cream.

• Adding White Petroleum Jelly (will also increase adhesiveness)

• Placing the wax in warm water.

• Holding the wax under a blow dryer

how to soften wax

• Place in refrigerator

• Mix with cornstarch

• Mix the wax with talcum or pigment powder

how to make wax firmer

Tissue MUST be _____________ before wax can be applied.

firm and dry

_______________ tissue will inhibit the ability of the wax to adhere to tissue and impair the effectiveness of restoration

moist or underembalmed

hypodermic injection or a surface compress of cavity fluid, arterial fluid, or phenol may be used…

when additional tissue firming is needed

typically oil-based for restoration; usually gray

Clay

calcium sulfate; a white powdery substance which forms a quick-setting paste when mixed with water

Plaster of Paris

a clear syrup-like liquid which evaporates, leaving a contractile, white film; a liquid sealer (scar wax)

Collodion

• Clay

• Latex

• Silicone

• Plaster of Paris

• Cotton

• Collodion

Other Modeling Materials Besides Wax