144 - More Than a Feeling: Evaluating Subjective Interpretations of Embalmed Tissues with Quantitative Testing

Poster Board Number: 144
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Co-authors:

Esa Ahmad, BHSc (Hon.) - Master’s Student, Biomedical Innovation, McMaster University; Athena Li, BHSc (Hon.) - Undergraduate student, Faculty of Health Sciences, McMaster University; Austine Wang, BHSc - Medical Student, DeGroote School of Medicine, McMaster University; Betty Zhang, BHSc - Medical Student, Queen's University's School of Medicine, Queens University; Andrew Palombella, MSc - Anatomical Technician and Demonstrator, Education Program in Anatomy, McMaster University; Jasmine Rockarts, MSc - Anatomical Technician and Demonstrator, Education Program in Anatomy, McMaster University; Brooke DeCarlo, MSc - Anatomical Technician and Demonstrator, Education Program in Anatomy, McMaster University; Laura Nguyen, MD, FRCSC, BSc, - Urologist, Surgery, Juravinski Hospital; Darren de SA, MBA(c),MD FRCSC - Assistant Professor, Orthopedic Surgery, McMaster University; Gregory Wohl, PhD - Chair, Dept of Mechanical Engineering, McMaster University; Bruce Wainman, PhD - Director, Education Program in Anatomy, McMaster University; Danielle Brewer-Deluce, PhD - Assistant Professor, Education Program in Anatomy, McMaster University

Abstract Body : Introduction/Objective

Soft-preserved human donors are the highest fidelity model for surgical skills training, yet embalming procedures are not standardized and comparisons of tissue fidelity across solutions are scarce. Our previous research evaluated the effect of embalming solutions on subjective domains of tissue fidelity (color, texture, force, similarity, and suitability) using the McMaster Embalming Scale (MES). The current study aims to corroborate these qualitative findings with quantitative biomechanical measures to compare tissue fidelity across four embalming solutions to further determine the MES' construct validity.



Methods

MES data was drawn from a previous study where 25 surgical residents evaluated four human donors embalmed with either Saturated Salt Solution (SSS), Imperial College London (ICL), Ethanol-Phenol (EP), or Surgical Reality Fluid (SRF). Tissue samples from the same donors underwent mechanical stress testing using the Instron 5967. Scalpel incision, puncture, tensile loading, fluid dehydration, and electroconductivity tests were conducted on skin samples. Bone saw tests were performed on femoral cortical bone, and chest tube insertion tests were conducted on intercostal muscles/pleura.




Results

MES qualitative scores significantly differed (2-way MANOVA, p< 0.05) across skills and solutions, without interaction. Solution performance varied across MES domains: ICL demonstrated worse color and texture, and EP had better suitability in comparison to other solutions.



Throughout mechanical testing, SRF consistently required more force to cut, puncture, and tear, and had less fluid content (ANOVAs, all p< 0.05). ICL had higher fluid content and required more force during chest tube insertion. No significant differences were found between solutions for electroconductivity and bone saw tests.



Conclusion/Significance

Variability in qualitative and quantitative measures suggests differential degrees of discrimination between MES (coarse) and mechanical (fine) testing, a distinction which better defines the scope and validity of MES use.



In terms of solution optimization: ICL consistently ranked the lowest across MES domains and had the highest fluid content, suggesting tissue edema may influence trainee’s experience. EP ranked highest on MES-suitability and maintained mid-ranking performance throughout testing, suggesting that EP is suitable for a variety of applications – a valuable outcome for standardizing time-sensitive embalming procedures and optimizing tissue use.



Together, these qualitative and quantitative results refine our understanding of tissue characteristics critical to surgical skills training and offer a clear path towards optimizing tissue preparation for surgical training.