MAMC Journal of Medical Sciences

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 2  |  Issue : 1  |  Page : 38--42

Plastination: An innovative method of preservation of dead body for teaching and learning anatomy


Anita Mahajan, Shilpi Agarwal, Swati Tiwari, Neelam Vasudeva 
 Department of Anatomy, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Neelam Vasudeva
Department of Anatomy, Maulana Azad Medical College, New Delhi
India

Abstract

Background: Plastination is the process to preserve the perishable biological tissues for long time using curable polymers. This technique was invented by Gunther Von Hagens, a German anatomist, in 1977. Since then, there have been many modifi cations according to the need and availability of infrastructure in various institutions. Many deviations from the standard plastination procedure have been suggested and used successfully. Methods: Modified short plastination protocol using epoxy resin has been adopted and standardized by the Department of Anatomy, Maulana Azad Medical College. Results and Conclusion: This technique provides dry, odorless, durable, nontoxic specimens that are easy to handle and can be stored at room temperature indefi nitely. This can be performed in a short period of time with limited and less expensive infrastructure. Our department organizes regular national workshops on “body preservation techniques” to train young anatomists.



How to cite this article:
Mahajan A, Agarwal S, Tiwari S, Vasudeva N. Plastination: An innovative method of preservation of dead body for teaching and learning anatomy.MAMC J Med Sci 2016;2:38-42


How to cite this URL:
Mahajan A, Agarwal S, Tiwari S, Vasudeva N. Plastination: An innovative method of preservation of dead body for teaching and learning anatomy. MAMC J Med Sci [serial online] 2016 [cited 2019 Sep 22 ];2:38-42
Available from: http://www.mamcjms.in/text.asp?2016/2/1/38/174836


Full Text

 Introduction



Plastination is a pioneering invention of Gunther Von Hagens to preserve body after death and to use it as didactic tool. Plastination is a technique for long-term preservation of perishable biological tissues using curable polymers. This technique yields dry, odorless, durable, nontoxic specimens that are easy to handle and can be stored at room temperature indefinitely. The plastinated specimens retain their original color and consistency and remain dry and free of formalin fumes, thus obtaining many advantages over the routine formalin-fixed specimens. This is a promising and upcoming method for producing natural looking, nontoxic specimens to facilitate teaching and learning when there is a paucity of cadavers and dissected materials.

In the process of plastination, the water and lipids in the biological tissues are replaced with curable polymers such as silicone, epoxy, and polyester resin by forced vacuum impregnation. The type of polymer used determines the optical (transparent or opaque) and mechanical (flexible or firm) properties of the impregnated specimen. Silicone is used for whole specimens and thick body and organ slices to obtain a natural look. Epoxy resins are used for thin, transparent body, and organ slices. Polyester-copolymer is exclusively used for brain slices to gain an excellent distinction of gray and white matter.

There are many methods of plastination techniques in current use. The Department of Anatomy has devised a modified short protocol of plastination, which has proven to be cost effective, needs minimal infrastructure, and provides remarkably well preserved specimens.

 Background



Plastination technique was invented by Gunther Von Hagens in 1977 in Germany. He developed the basis of plastination method after trial and error on many tissues and organs using various polymers and patented it between 1977 and 1982. The S10 technique developed by Gunther Von Hagens (1986–1987), got approval of many researchers and it is the gold standard for plastination of the whole body, organs, small tissues, and brain sections. This technique yields most exquisite specimens with great surface detail and little flexibility. This technique involved dehydration of formalin-fixed specimens in acetone at −20°C for 3 weeks followed by immersion in a mixture of S10/S3 (ratio 100:1) at −20°C for 1 week. After this, forced impregnation was performed at −20°C in vacuum followed by gas curing using S6 vapors.[1],[2]

Later, polyester polymers came into use for plastination, namely P35 and P40. P35 was introduced first and yielded brain slices of unparalleled beauty, clarity, and good definition of white and gray matter. P40 was introduced later and needs shorter and less cumbersome technique. Several modifications of these techniques have been devised by various authors yielding good results.[1],[3],[4],[5]

Plastination using epoxy resin yields in good quality of plastinates for thin 2–5 mm transparent slices.[1],[6],[7] For ultra-thin slices, high temperature and proportion of resin hardener and accelerator are crucial for better penetration.[8]

According to Musumeci et al. in the S10 method, fine structures become more resistant to damage and more rigid, which may influence exploratory anatomy using endoscopic procedures.[9]

By sheet plastination, thin slices of organs, extremities, brain, or even whole in situ sections may be specially processed and encapsulated within a clear, smooth resin sheet. Sections may vary in thickness from 2 mm to 6 mm depending upon the region, type of tissue, and the desired result. Sheet plastination has proven to be a vital tool in the enhancement and clarification of anatomical concepts and relationships, previously often difficult to appreciate.[10]

Studies have been conducted by changing the sequence in which the basic plastination chemicals were added such that the impregnation mixture is stable at room temperature.[11]

Many authors have followed the same principle and compared the cold silicon impregnation with ambient temperature silicon impregnation and have found similar comparable results.[12]

Light plastination is a cost-effective method producing lightweight, rigid, good quality, and durable specimens using mixture of silicon and xylene at different compositions according to the tissue to reduce the weight of the plastinated specimen.[13]

By using trial and error method, the above-mentioned techniques are being used to preserve a variety of body tissues. It has been reported that good plastinated specimens of heart can be obtained by hydrostatic dilation. In addition, by avoiding fixation, more flexible specimens can be obtained.[14],[15] Baptista and Conran presented a plastination technique for preparation of the heart for better visualization of the cardiac valves and adjacent structures.[16] Plastination techniques have been used in studies of anatomical organization in the female urethra,[17] esophageal muscles,[18] the carpal tunnel,[19] and skin ligaments.[20] Ultra-thin plastinated slices have been used to construct precise three-dimensional computer models of anatomical structures.[21] Magiros et al. have generated magnetic resonance imaging scanned images of the head and then generated plastinated sections using polymerized emulsion 11 (PEM). They correlated the plastinates to the scans and found better differentiation of musculature in the plastinated sections.[22] Sora et al. developed cross sections from plastinated specimens of pelvis and then used them to form computerized three-dimensional images.[23]

Von Hagens established the Institute of Plastination in 1993 in Heidelberg and created an original exhibition of real human bodies, the Body Worlds in Mannheim in 1997.[24] Von Hagens also has organized an exhibition cum workshop known as Plastinarium in Germany in 2006. He also established the company Biodur ® which supplies wide variety of materials required for plastination to many medical institutions. Dr. Sui Hongjin founded a museum to display plastinated human fetuses of various gestational age in China in 2011. He has successfully organized a display of plastinated human bodies and body parts in Chengdu city in China in 2014.

 Present Modification



The standard procedure of plastination is carried out in four steps, i.e., fixation, dehydration, impregnation and curing.

Each specimen requires its own unique, carefully and precisely planned plastination protocol, if it is to be preserved perfectly. Polymer to be used varies according to the type of specimen, type of tissue, and its consistency. The standard plastination technique requires stringent steps and expensive sophisticated equipment such as large vacuum chambers. Considering these limitations, an innovation in the protocol of plastination has been performed at the Plastination Unit, Department of Anatomy, Maulana Azad Medical College in 2006. The protocol for plastination was introduced in our department by Dr. Neelam Vasudeva in a thesis work during 2006–2008. The plastination procedure used initially was in accordance with the technique devised by Janakiram et al. in 1993.[25] According to this technique, the specimens were immersed in equal parts of quickfix and amyl acetate. We, at the Department of Anatomy, Maulana Azad Medical College, are using a curable polymer epoxy resin to satisfactorily plastinate small parts of the limbs [Figure 1] and [Figure 2] and transverse sections [Figure 3].{Figure 1}{Figure 2}{Figure 3}

Regular annual workshops are conducted by our department to train the postgraduate students and faculty from all over India and to encourage them to introduce this technique at their own institutes [Figure 4]a and [Figure 4]b.{Figure 4}

 Short Plastination Protocol



Proper choice of the corpses is the foremost step of plastination. The corpse with shortest possible postmortem interval (2–10 days) is desirable so as to avoid the effects of the autolytic degeneration.

The standard procedure of plastination is carried out in 4 steps, i.e., fixation, dehydration, impregnation and curing [Figure 5]: flowchart].{Figure 5}

Fixation

For fixation, the selected bodies are embalmed by perfusion technique. Formalin is the commonly used preservative in the embalming fluid to arrest decomposition and to inactivate saprophytic bacteria thus preventing putrefaction. Fixation converts proteins of the body to a longer lasting substance by forming cross linkages between adjacent protein molecules. The formation of this high molecular cross linked lattice causes loss of ability to retain water, thus preventing decomposition.[26]

The embalmed cadaver is dissected carefully to obtain the desirable specimen. For cross-sectional study, sections of the head (cross, coronal, or sagittal) and transverse sections of limbs and trunk are obtained.

Dehydration

The sections are dehydrated using organic solvent acetone of a grade between 96% and 100% purity. It is miscible with water and thus replaces the water and soluble fat of the section/tissue. The amount of the dehydrating solvent used is 10 times the weight of the specimen immersed. The specimens are completely immersed in acetone in glass jars and then covered with glass lids and sealed with glue to prevent evaporation of acetone. Sections may vary in thickness from 2 mm to 6 mm depending upon the region, type of tissue, and the desired result.[10] The specimens remain immersed in acetone for at least a period of 3 weeks at room temperature along with change of acetone after every week.

After a period of 3 weeks, the specimens are kept outside for 24 h so that the residual acetone evaporates.

Impregnation

Impregnation is performed by a variety of curable polymers which replace the acetone, taking advantage of difference in their chemical properties.

In the standard technique, the specimen is placed in a vacuum chamber and the pressure is reduced to the point where the dehydrating solvent boils. The acetone is suctioned out of the tissue at the moment it vaporizes and the resulting vacuum causes the polymer to permeate the tissue. This exchange process is allowed to continue until all the tissues have been completely saturated which may take days to week. Silicon S10 technique is the standard procedure in plastination which results in opaque, more or less/relatively flexible, and natural looking specimen.[1] The epoxy E12 procedure is utilized for their body and organ slices. The polyester P35 and P40 procedures yield good results for brain slices with remarkable differentiation of white and gray matter.[27] Use of Biodur ® S10 (Silicon rubber) is sometimes linked to specimens of the brain tissue and also for specimens to be used by students for self-instruction. Biodur ® PEM27 provides good novel appearance with clear surface details.[28]

In our short protocol, the specimen to be plastinated is immersed in the epoxy resin in a glass container for variable time up to 2 days depending on the size of the specimen. The specimen is taken out and the extra resin is wiped off. Hundred ml of epoxy resin and 10 ml of hardener is mixed in a plastic measuring chamber. The specimen is painted with the mixture. It takes around 30–35 min for polymerization of the resin. Application of the resin should be completed within the stipulated time as the mixture may get hardened. The specimen is transferred on a meshwork over a tray and left to dry.

Curing

Finally, curing of the polymerized specimen is performed. Depending on the polymer used, this is performed with gas, ultraviolet light, or heat. The resulting plastinates assume rigidity and permanence.[29] Curing of the specimen in our plastination unit is performed by exposing it to sunlight for 24 h. The specimens are then mounted on a stand and kept for display.

 Discussion/conclusion



The short protocol for plastination is cost-effective, less time-consuming, nontedious, and can be easily performed with a simple setup without using costly equipment such as vacuum chambers and deep freezer. The plastinated specimens, obtained over the period of 5 years in our department, have retained their life-like appearance without any decay. They are resistant to fungal growth and atmospheric variations in temperature and moisture. These specimens have been displayed in the museum and are useful as self-study instructional modules. Using plastination, a library of specimens can be created displaying normal, variant, and pathological anatomy. Such libraries will benefit various scholars from disciplines such as anthropology, anatomy, and pathology.[30] The computerized reconstruction of pelvic floor plastinates has proven useful for various medical specialists such as gynecologists, urosurgeons, and radiologists.[23] Reiderer found that for better differentiation of gray and white matter, the Prussian blue staining procedure can be used as described by Barnett et al.[3],[31] Further research is in the line to innovate protocols for plastination of brain slices. Customized vacuum chambers instead of currently available expensive industrial vacuum chambers are being considered for upcoming research work on plastination.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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