Name: vacuum-sealed hot water bath immersion for the preparation of anatomical and surgical cadaveric bone models
Uploaded: 2022-12-02T14:50:00
Description: Watch this Scientific Journal Video about Vacuum-Sealed Hot Water Bath Immersion for the Preparation of Anatomical and Surgical Cadaveric Bone Models at JoVE.com

Lumbar spines were harvested from 4-year-old Merino cross adult ewes (Ovis aries) following the ethical guidelines of the Animal Care and Ethics Committee of the Surgical and Orthopaedic Research Laboratories. Following the institutionally approved method of humane euthanasia, the lumbar spines were harvested using a sharp dissection tool, first incising through the skin and subcutaneous tissues, followed by fascia and musculature prior to disarticulation at the thoracolumbar and lumbosacral junctions. A harvest...

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This technical note aims to describe a simple, safe, and low-cost method to produce an anatomical bone model for the benefit of veterinary and medical education and for use in anatomical education and surgical planning. 
Pilot testing found that a bath temperature of 70 &#176;C provided the fastest processing time without causing damage to the samples. Higher temperatures caused an extensive breakdown of collagen within the bone, resulting in brittle samples with a chalky texture. The hot bath...

Removing soft tissue and cleaning bones are required for forensics, medical and biological research, and veterinary and medical education. Most techniques have been developed for forensic purposes, minimizing damage to the bone to preserve as much detail as possible. This can provide an accurate, tangible bone model for preoperative surgical planning, as well as intraoperative decision-making to help minimize complications1,2,3. This is beneficial in surgery by reducing operation times and blood loss and improving communication between surgeons, compared to planning with 2D images4. The use of these models may also reduce the reliance on intraoperative imaging, such as fluoroscopy, which may reduce radiation exposure to personnel.
Skeletal bone from cadavers has historically been used for these models; however, technological advances have pushed toward the use of manufactured models and, more recently, three-dimensional (3D) printed models. Bone models rely on the availability of cadaveric samples and the efficiency of processing these samples into usable models. 3D printing has the advantage of creative freedom, allowing for anatomical and patient-specific models, especially when anatomical abnormalities or neoplasms are present, or if the hardware needs to be manufactured or augmented to fit the patient1. These samples are also able to be sterilized and manipulated by surgeons during a procedure. However, this freedom comes with a cost, as it requires computed tomography (CT) scans, the materials and equipment required can be expensive, and expertise is essential to create the models in the required software1,4. Additionally, these factors can limit the precision and quality of the model, and hence the surgical planning and success1. 3D printed models may not be the best choice for cases where there is no need for patient-specific anatomy and where there is an immediate requirement for the model.
Commonly applied methods for the removal of soft tissue from cadaveric bone include manual cleaning, bacterial maceration, chemical maceration, cooking, and insect maceration5,6. The success of these methods is generally based on the cost, time, labor, equipment, safety, and quality of the final product5,7. Manual cleaning requires the most labor and a significant amount of time, but involves minimal equipment5. Bacterial maceration consists of leaving the sample in a cold or warm water bath for long periods of time, often up to 3 weeks, allowing bacteria to decompose the tissue6. This creates unpleasant odors, requires additional equipment to treat the bacteria, and creates a biosecurity hazard for the user5,6. The use of dermestid beetles is very effective with minimal labor, but requires the acquisition of a colony and husbandry of the animals, and is not considered an economic investment if used infrequently6,7. Chemical maceration usually involves the use of enzymes such as trypsin, pepsin, and papain, or commercial detergents containing substances such as surfactants and enzymes5,8. Although this method provides faster results, the chemicals used, such as sodium hydroxide, ammonia, bleach, and gasoline, may represent a health and safety risk and produce noxious odors that require personal protective equipment (PPE) and a fume hood5,7,8,9. Finally, extended heating provides another minimally intensive method but may produce odors requiring ventilation10.
A simple, safe, and low-cost method for the preparation of anatomical bone models would provide a useful tool for surgeons, students, educators, and researchers. This article describes a novel method for preparing skeletal bone models that avoids unpleasant odors and noxious chemicals, and produces a detailed surgical model with minimal equipment and labor.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Dimension Elite 3D printer</td>
			<td>Stratasys, Eden Prairie, MN, United States</td>
			<td></td>
			<td>3D printer for production of surgical bone models based on reconstructed CT scans</td>
		</tr>
		<tr>
			<td>Mimics Innovation Suite</td>
			<td>Materialise NV, Leuven, Belgium</td>
			<td>Suite 24</td>
			<td>Software to create 3D models from imaging scans</td>
		</tr>
		<tr>
			<td>Nylon cable ties</td>
			<td>4Cabling, Alexandria, NSW, Australia</td>
			<td>011.060.1042/011.060.1039</td>
			<td>Used to maintain connection between vertebral bodies</td>
		</tr>
		<tr>
			<td>Orthopaedic wire</td>
			<td>B Braun, Bella Vista, NSW, Australia</td>
			<td></td>
			<td>Used to maintain connection between vertebral bodies</td>
		</tr>
		<tr>
			<td>Support Cleaning Apparatus</td>
			<td>Phoenix Analysis and Design Technologies, Tempe, AZ, United States</td>
			<td>SCA-1200</td>
			<td>Hot water bath for immersion of the sealed sample.</td>
		</tr>
		<tr>
			<td>Ultra Strength Original Dishwashing Liquid</td>
			<td>Colgate-Palmolive, New York, NY, United States</td>
			<td></td>
			<td>Dishwashing liquid added to sealed bag with sample for cleaning of the bone model.</td>
		</tr>
		<tr>
			<td>Vacuum bags</td>
			<td>Pacfood PTY LTD</td>
			<td></td>
			<td>Heat safe, sealable plastic bags</td>
		</tr>
		<tr>
			<td>Vacuum Food sealer</td>
			<td>Tempoo (Aust) PTY LTD</td>
			<td></td>
			<td>Vacuum food sealer to seal vacuum bags prior to bath immersion</td>
		</tr>
	</tbody>
</table>

vacuum-sealed hot water bath immersion for the preparation of anatomical and surgical cadaveric bone models

Bone models serve many purposes, including improving anatomical understanding, preoperative surgical planning, and intraoperative referencing. Several techniques for the maceration of soft tissues have been described, mainly for forensic analysis. For clinical research and medical use, these methods have been superseded by three-dimensional (3D) printed models, which require substantial equipment and expertise, and are costly. Here, cadaveric sheep vertebral bone was cleaned by vacuum sealing the specimen with commercial dishwashing detergent, immersing in a hot water bath, and subsequently manually removing the soft tissue. This eliminated the disadvantages of the previously existing maceration methods, such as the existence of foul odors, usage of hazardous chemicals, substantial equipment, and high costs. The described technique produced clean, dry samples while maintaining anatomical detail and structure to accurately model the osseous structures that can be useful for preoperative planning and intraoperative referencing. The method is simple, low-cost, and effective for bone model preparation for education and surgical planning in veterinary and human medicine.

Following this protocol, clean and dry sheep lumbar vertebral column models were created for surgical planning and reference. Samples consisting of seven lumbar vertebrae were processed within 4 days using this method, with one initial bath to remove the bulk of the muscle and three subsequent baths. Completion of the baths was indicated by the ease at which cartilage and connective tissue were removed from the bone. This varied based on the type and location of cartilage; thin layers were easily removed after one or two...

Watch this Scientific Journal Video about Vacuum-Sealed Hot Water Bath Immersion for the Preparation of Anatomical and Surgical Cadaveric Bone Models at JoVE.com

Vacuum-Sealed Hot Water Bath Immersion for the Preparation of Anatomical and Surgical Cadaveric Bone Models

The present protocol describes the maceration and cleaning of cadaveric bone with a vacuum-sealed, hot water bath immersion technique. This is a low-cost, safe, and effective method to produce anatomical specimens for surgical planning and medical education as an alternative to three-dimensional (3D) printed models.

Bone models serve many purposes, including improving anatomical understanding, preoperative surgical planning, and intraoperative referencing. Several ...

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