OF THE TRADE”
You probably already know that Clostridium perfringens, better known as “true” tissue gas, is one of the biggest nightmares for all embalmers. I would say most embalmers are never sure if they have a case with tissue gas or not, but the wise thing to do is to treat each case as if it may have Clostridium perfringens.
There are five types of gases that cause distension in the tissues of a dead human body:
air from the embalming apparatus
See TABLE below for further clarification.
According to well-known textbook author and long-time embalmer Robert G. Mayer, the predisposing conditions to tissue gas are the following:
(The above was taken from Mr. Mayer’s textbook, Embalming History, Theory, & Practice.)
When you have a tissue gas case, you are going into battle with the C. perfringens, because, if you don't win the battle, they can destroy all other cases you work on later, not to mention the case you were working on in the first place. So, if and when you get a case with tissue gas, be prepared for a battle. Equip yourself to win. The necessary “weapons” are San-Veino, Metracide or Dis-Spray.
When I embalm a case with tissue gas, I use sectional embalming (at least six points). The more points you inject, the better off you are. Using restricted drainage will also help, but, when going up the head, be very careful not to distend or swell the face and facial features. A little more pressure than normal pushes the fluid into the capillaries better, and will help force out some of the gases. I use a very strong fluid mixture and, depending on the severity of the tissue gas, I might even inject straight 100% fluid (waterless embalming) to the area which has the most crepitation.
My mixture (recipe) I like, and have found works best for me, is Champion Hiform or Specialist, combined with some Omega (has 19 fast acting ingredients to kill Clostridium perfringens and the odor) if you do not have Omega then add Trisan and HAR; I then add some soap and (the secret ingredient) San-Veino. Not too many mortuaries carry Omega or San-Veino, but I always buy it on my own and carry it with me; when you need it, you do not want to be caught without it. If at all possible after injecting, I like to leave all my incisions open after I have channeled each incision site (so the gases can escape overnight; then, if need be, I can always reinject more the next day. Also, after aspirating, I use a couple of bottles of Champion Cavity 48 (an awesome cavity fluid - it is 100% pure chemical, and less likely to allow the case to purge) and also add about 8 ounces or so of San-Veino to the abdominal cavity treatment. Of course, I hypodermically inject the necessary areas and follow all other embalming techniques required for the case. And cavity packs are usually necessary also (do not pack with Champion’s Cavity 48). If you do not have any San-Veino, Metricide by Champion or Dodge’s Dis-Spray will also help.
Lastly, and this is really as important as the care taken with the embalming of tissue gas cases, you must not forget to completely disinfect your instruments and the area in which you worked. If you neglect this, it could set off a chain reaction of tissue gas cases.
GASES THAT CAUSE DISTENSION
|Subcutaneous emphysema||Puncture of lung or pleural sac; seen after CPR; puncture wounds to thorax, rib fractures; tracheotomy||No odor; no skin-slip; no blebs; gas can reach distal points, even toes; can create intense swelling; rises to highest body areas||Gas escape through incisions; establishment of good arterial preservation; channeling of tissues after arterial injection to release gasses|
|"True" tissue gas||Anaerobic bacteria (gas gangrene), Clostiridium perfringens||Very strong odor of decomposition; skin-slip; skin blebs; increase in intensity and amount of gas; possible transfer of spore-forming bacterium via cutting instruments to other bodies||Special "tissue gas" arterial solutions; localized hypodermic injection of cavity fluid; channeling of tissues to release gases.|
|Gas gangrene||Anaerobic bacteria, C. perfringens||Foul odor, infection||Strong arterial solutions; local hypodermic injection of cavity chemical|
|Decompostion||Bacterial breakdown of body tissues; autolytic breakdown of body tissues||Possible odor; skin-slip in time; color changes; purging||Arterial injection of sufficient amount of the appropriate strong chemical; hypodermic and surface treatments; channeling to release gases|
|Air from embalming apparatus||Air injected by embalming machine (air pressure machines and hand pumps are in limited use today)||First evidence in eyelids; no odors; no skin-slip; amount depends on injection, time||If distension is present, channeling after arterial injection to release gases|
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