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

腰椎是从4岁的美利奴杂交成年母羊 （Ovis aries） 中收获的，遵循外科和骨科研究实验室动物护理和伦理委员会的伦理准则。按照机构认可的人道安乐死方法，使用锋利的解剖工具收获腰椎，首先切开皮肤和皮下组织，然后在胸腰椎和腰骶交界处进行筋膜和肌肉组织。收获的样品如图 1A所示。
1. 初始入浴的准备
<ol><li>在进一步处理之...

<ol>
	<li>Leary, O. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+printed+anatomic+modeling+for+surgical+planning+and+real-time+operative+guidance+in+complex+primary+spinal+column+tumors:+single-center+experience+and+case+series.">Three-dimensional printed anatomic modeling for surgical planning and real-time operative guidance in complex primary spinal column tumors: single-center experience and case series.</a> World Neurosurgery. 145, 116-126 (2021).</li><li>Tack, P., Victor, J., Gemmel, P., Annemans, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=3D-printing+techniques+in+a+medical+setting:+a+systematic+literature+review.">3D-printing techniques in a medical setting: a systematic literature review.</a> BioMedical Engineering OnLine. 15 (1), 115 (2016).</li><li>Ventola, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Medical+applications+for+3D+printing:+current+and+projected+uses.">Medical applications for 3D printing: current and projected uses.</a> Pharmacy and Therapeutics. 39 (10), 704-711 (2014).</li><li>Wilcox, B., Mobbs, R. J., Wu, A. M., Phan, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+review+of+3D+printing+in+spinal+surgery:+the+current+state+of+play.">Systematic review of 3D printing in spinal surgery: the current state of play.</a> Journal of Spinal Surgery. 3 (3), 433-443 (2017).</li><li>Mairs, S., Swift, B., Rutty, G. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detergent:+an+alternative+approach+to+traditional+bone+cleaning+methods+for+forensic+practice.">Detergent: an alternative approach to traditional bone cleaning methods for forensic practice.</a> The American Journal of Forensic Medicine and Pathology. 25 (4), 276-284 (2004).</li><li>Husch, C., Berner, M., Goldammer, H., Lichtscheidl-Schultz, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technical+note:+A+novel+method+for+gentle+and+non-destructive+removal+of+flesh+from+bones.">Technical note: A novel method for gentle and non-destructive removal of flesh from bones.</a> Forensic Science International. 323, 110778 (2021).</li><li>Couse, T., Connor, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+maceration+techniques+for+use+in+forensic+skeletal+preparations.">A comparison of maceration techniques for use in forensic skeletal preparations.</a> Journal of Forensic Investigation. 3, 1-6 (2015).</li><li>Mahon, T. J., Maboke, N., Myburgh, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+different+detergents+in+skeletal+preparations.">The use of different detergents in skeletal preparations.</a> Forensic Science International. 327, 110967 (2021).</li><li>Hussain, M., Hussain, N., Zainab, H., Qaiser, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Skeletal+preservation+techniques+to+enhance+veterinary+anatomy+teaching.">Skeletal preservation techniques to enhance veterinary anatomy teaching.</a> IJAVMS. 1, 21-23 (2007).</li><li>Simonsen, K. P., Rasmussen, A. R., Mathisen, P., Petersen, H., Borup, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+fast+preparation+of+skeletal+materials+using+enzyme+maceration.">A fast preparation of skeletal materials using enzyme maceration.</a> Journal of Forensic Science. 56 (2), 480-484 (2011).</li><li>Burkhard, M., Furnstahl, P., Farshad, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensionally+printed+vertebrae+with+different+bone+densities+for+surgical+training.">Three-dimensionally printed vertebrae with different bone densities for surgical training.</a> European Spine Journal. 28 (4), 798-806 (2019).</li><li>Rose, A. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multi-material+3D+models+for+temporal+bone+surgical+simulation.">Multi-material 3D models for temporal bone surgical simulation.</a> The Annals of Otology, Rhinology, and Laryngology. 124 (7), 528-536 (2015).</li><li>Werz, S. M., Zeichner, S. J., Berg, B. I., Zeilhofer, H. F., Thieringer, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=3D+printed+surgical+simulation+models+as+educational+tool+by+maxillofacial+surgeons.">3D printed surgical simulation models as educational tool by maxillofacial surgeons.</a> European Journal of Dental Education. 22 (3), 500-505 (2018).</li></ol>

本技术说明旨在描述一种简单、安全且低成本的方法来生成解剖骨骼模型，以有益于兽医和医学教育，并用于解剖学教育和手术计划。 
初步测试发现，70°C的浴温提供了最快的处理时间，而不会对样品造成损坏。较高的温度导致骨骼内的胶原蛋白广泛分解，导致具有白垩质地的脆性样品。该实验中的热水浴专门用于处理3D打印样品，并因其方便而使用;但是，其他较便宜的商?...

去除软组织和清洁骨骼是法医、医学和生物学研究以及兽医和医学教育所必需的。大多数技术都是为法医目的而开发的，最大限度地减少对骨骼的损害，以保留尽可能多的细节。这可以为术前手术计划以及术中决策提供准确、有形的骨骼模型，以帮助最大限度地减少并发症1，2，3。与使用 2D 图像进行规划相比，这有利于手术，因为它可以减少手术时间和失血量，并改善外科医生之间的沟通4.使用这些模型还可以减少对术中成像（如透视）的依赖，这可以减少对人员的辐射暴露。
尸体的骨骼骨历来被用于这些模型;然而，技术进步已经推动了制造模型的使用，以及最近的三维（3D）打印模型。骨骼模型依赖于尸体样本的可用性以及将这些样本处理成可用模型的效率。3D打印具有创作自由的优势，允许解剖学和患者特定的模型，特别是当存在解剖异常或肿瘤时，或者如果硬件需要制造或增强以适应患者1。这些样本也可以在手术过程中由外科医生进行消毒和操作。然而，这种自由是有代价的，因为它需要计算机断层扫描（CT），所需的材料和设备可能很昂贵，并且专业知识对于在所需的软件中创建模型至关重要1，4。此外，这些因素会限制模型的精度和质量，从而限制手术计划和成功1.对于不需要患者特定的解剖结构并且对模型有直接需求的情况，3D打印模型可能不是最佳选择。
从尸体骨中去除软组织的常用方法包括手动清洁，细菌浸渍，化学浸渍，烹饪和昆虫浸渍5，6。这些方法的成功通常基于最终产品的成本、时间、劳动力、设备、安全性和质量5，7。手动清洁需要最多的劳动力和大量时间，但涉及的设备最少5.细菌浸渍包括将样品长时间留在冷水浴或温水浴中，通常长达 3 周，让细菌分解组织6.这会产生难闻的气味，需要额外的设备来处理细菌，并对用户造成生物安全危害5，6。使用真皮甲虫非常有效，劳动力最少，但需要获得动物的殖民地和饲养，如果不经常使用，则不被视为经济投资6，7。化学浸渍通常涉及使用胰蛋白酶、胃蛋白酶和木瓜蛋白酶等酶，或含有表面活性剂和酶5，8 等物质的商业洗涤剂。虽然这种方法提供了更快的结果，但使用的化学品，如氢氧化钠、氨、漂白剂和汽油，可能会带来健康和安全风险，并产生有毒气味，需要个人防护装备 （PPE） 和通风橱5，7，8，9。最后，扩展加热提供了另一种最低强度的方法，但可能会产生需要通风的气味10。
一种简单、安全且低成本的解剖骨骼模型制备方法将为外科医生、学生、教育工作者和研究人员提供有用的工具。本文介绍了一种制备骨骼模型的新方法，该方法避免了难闻的气味和有毒化学物质，并以最少的设备和劳动力生成了详细的手术模型。

<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

骨骼模型有多种用途，包括提高解剖学理解、术前手术计划和术中参考。已经描述了几种用于软组织浸渍的技术，主要用于法医分析。对于临床研究和医疗用途，这些方法已被三维（3D）打印模型所取代，这些模型需要大量的设备和专业知识，而且成本高昂。在这里，尸体羊椎骨通过用商业洗碗剂真空密封标本，浸入热水浴中，然后手动去除软组织来清洁。这消除了以前存在的浸渍方法的缺点，例如存在恶臭，使用危险化学品，大量设备和高成本。所描述的技术产生了干净、干燥的样本，同时保持解剖细节和结构，以准确模拟可用于术前计划和术中参考的骨结构。该方法简单、成本低，对兽医和人类医学教育和手术计划的骨模型制备有效。

按照该协议，创建了清洁干燥的绵羊腰椎柱模型，以供手术计划和参考。使用这种方法在4天内处理由7块腰椎组成的样本，其中1次初始浴以去除大部分肌肉，随后进行3次浴。浴的完成是通过从骨头中去除软骨和结缔组织的难易程度来表示的。这根据软骨的类型和位置而变化;洗一两次澡后很容易去除薄层，但被其他组织包围的厚材料，如椎间盘，需要三到四次洗澡。干燥48小时后，预计骨骼的颜色...

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

本协议描述了用真空密封的热水浴浸泡技术浸渍和清洁尸体骨。这是一种低成本、安全且有效的方法，用于生产用于手术计划和医学教育的解剖标本，可替代三维 （3D） 打印模型。

真空密封热水浴浸泡用于制备解剖和外科尸体骨骼模型

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

这种方法产生准确的解剖骨骼模型，描绘了原生解剖结构，有助于指导研究人员、临床医生和外科医生进行手术方法和植入物放置，以及其他好处。这种方法产生干净卫生的解剖骨骼模型，这很重要，例如，考虑到将这些模型放在床边或手术室中。与3D打印的解剖骨骼模型相比，我们的模型成本低，安全且有效，并且与这些3D模型相比，这些手术骨骼模型更好地代表了骨骼的结构和原生解剖结构。所描述的技术是为脊柱生成准确的解剖骨骼模型，但该技术可以很容易地外推到身体的其他骨结构。该方法更好地告知外科医生，研究人员和临床医生如何计划和执行手术技术，并告知他们什么是正常的骨解剖结构，这将有助于他们识别病理。但该技术可以很容易地推断到一系列不同物种的一系列其他骨结构。首先，使用锋利的解剖工具从骨样本中手动去除软组织，例如肌肉，结缔组织，脂肪等，并在去除空气后将样品密封在热安全的可密封塑料袋中。将密封的样品完全浸入70摄氏度的水浴中24小时，然后将袋子从浴中取出，打开袋子，让样品冷却至可处理。根据需要使用锋利的手术刀和流水从骨头上去除尽可能多的软组织。要断开任何关节以暴露软骨组织，请使用矫形电线或电缆扎带等材料将断开的碎片保持在原位，以保持解剖位置。将样品与10毫升洗洁精和10毫升自来水一起密封在真空袋中，并将密封的样品浸入70摄氏度的水浴中24小时。从浴槽中取出袋子后，重复前面显示的步骤，尽可能多地去除软组织，直到骨骼没有软组织材料。最后，让样品干燥约48小时。这里提供了3D打印和尸体骨骼模型之间的定性比较。这些图像表明，3D打印模型不能准确地详细说明尸体标本的精细骨质细节，丢失了更精细的细节，例如骨骼的轮廓，特别是在横向过程中。此处显示了在同一处理步骤中使用和不使用洗涤剂处理的绵羊腰椎模型。从这两张图像中，可以注意到颜色和纹理的明显差异。为了重现这种方法，个人或研究小组确实需要获得解剖标本，热水浴和真空密封设备。热水浴前后的软组织解剖在技术上要求不高，但它确实需要一些精细的运动技能和一些使用锋利解剖设备和其他手术设备的经验。

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可调节刚度，外固定支架的大鼠股骨截骨和节段性骨缺损模型

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Multiple surgical procedures have been reported to induce gastroesophageal reflux in animals. Herein, we report three surgical models with mice aiming to ...

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The oculomotor system involves a large number of brain areas including parts of the basal ganglia, and various neurodegenerative diseases including ...

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Cadaveric fracture testing is routinely used to understand factors that affect proximal femur strength.  Because ex vivo biological tissues are prone to ...