Advanced Embalming Quiz #3

What is decomposition?

The process where complex organic compounds are broken down into simpler substances through the action of microbial and/or autolytic enzymes.

What is proteolysis?

The process of breaking proteins down into smaller peptides or amino acids.

What is autolysis?

The breakdown of self by self by its own enzymes.

What is lipolysis?

The metabolic process of breaking down stored fat (triglycerides) into glycerol and free fatty acids.

What is fermentation?

The anaerobic breakdown of carbohydrates, like glucose, into simpler molecules such as organic acids or alcohol.

What is saccharolytic?

The breakdown of sugars.

What are the five signs of decomposition?

1. Color

2. Purge

3. Gas

4. Odor

5. Skin slip

What does color refer to in decomposition?

Trunk:

- Green discoloration in the lower right quadrant of the abdomen.

- Large intestine will be identifiable.

- The color change, in time, can be seen up to the neck and chin.

Vascular:

- Marbling (occurs in almost all superficial vessels)

- Postmortem staining (stains, pose a major concern if the body is found face down)

What does purge refer to in decomposition?

Putrefactive body fluids becoming forced out of the body orifices.

What does gas refer to in decomposition?

Gases produced by chemical or microbial activity during the decomposition of solid waste (If Clostridium Perfringens causes gas build-up, you can expect: blistering, stomach purge, and rectal purge). If heat or humidity are present (favor gas production), the gas will cause the body to swell and bloat and cause the eyes and tongue to protrude (if this distends the abdominal cavity, this can cause: lung purge, stomach purge, and rectal purge).

What does odor refer to in decomposition?

When autolysis and putrefaction occur, their products will emit a foul odor (cadaverine and putrescine). Things such as Clostridium Perfringens can also produce a gas that can emit a pungent odor.

How do extrinsic (outside) factors affect decomposition?

- Temperature: higher speeds up decomposition, lower slows decomposition

- Moisture: humidity increases decomposition, dry air dehydrates

- Access of air

- Animal activity

- Pressure (due to clothing or earth)

- Bacteria

How do intrinsic (internal) factors affect decomposition?

- Internal moisture

- Febrile diseases (infections)

- Gas gangrene, moist gangrene

- Bacteria in the body

Can mode of death affect decomposition?

Yes, especially in cases of:

- Drowning

- Suicide (hanging, gunshot, the time before being found)

- Accidental death (from trauma)

What is the tissue order for decomposition?

1. Liquid tissues (blood and lymph)

2. Soft tissues (parenchyma of organs, or the functional tissue that performs the organ's specific work)

3. Firm tissues (muscle and stroma of organs)

4. Hard tissues (cartilage and bone)

What are the five stages of decomposition?

Stage 1: Fresh (1-2 days)

Stage 2: Bloated (2-6 days)

Stage 3: Decay (5-11 days)

Stage 4: Post-Decay (10-25 days)

Stage 5: Dry (25+ days)

How can color pose a problem for the embalmer?

- There can be a green discoloration, especially on the abdomen

- Livor mortis

- Postmortem staining and hemolysis are major concerns when the body is found face down since they can cause petechiae; can, at best, be bleached

How can gas pose a problem for the embalmer?

- Distention caused by excess moisture (edema) and tissue gas

- Bacteria growth, be sure to stop things like Clostridium Perfringens via cavity work

- Can only be managed through trocar puncturing or continuous drainage

- If still present, requires additional channeling or an air/water collar

How can desquamation pose a problem for the embalmer?

- Weakening of the superficial layer of skin, can result in gas moving into the skin layers

- The affected area must be sprayed with a topical disinfectant (dis-pray or tri-san)

- Cotton or cauterant such as basic/penetrating dryene can be saturated and applied to the area

How can maggots pose a problem for the embalmer?

- They can be found if the body is found in 50 degrees Fahrenheit or warmer, but not under 50 degrees Fahrenheit

- They'll be in parts of the skin (alongside items such as eggs) and in skin folds

What embalming complications can decomposition cause?

- Poor fluid distribution (coagula present)

- Drainage is poor due to decomposed blood elements and vessels

- Swelling of tissues due to broken down or torn capillaries, so pushing of fluid can cause distention

- Ammonia and nitrogenous products in the tissues will result in increased formaldehyde or preservative demand

What are some protocols for a decomposition case?

- Multi-point injection or restricted cervical injections will be ace in controlling facial distention

- A strong solution or, as recommended by Champion, a near-anhydrous arterial injection (or, by Dodge, "waterless")

- Hypo-injecting areas with poor distribution

- Perfuming agents or Kitty litter for poor smell

- Sometimes a cauterizing or drying agent may be used on areas needing waxing or cosmetizing

What are the key points to hit?

1. Evaluate the body before beginning

2. Use appropriate PPE and ventilation

3. Select the appropriate preservative

4. Control injection pressure and rate

5. Assess circulation and drainage

6. Manage gas formation and distention

7. Give special attention to cavity treatment

8. Anticipate purge and leakage

9. Protect fragile tissue and address skin slippage

10. Reassess preservation and viewing potential