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Cluster Analyses of Contemporary Embalming Protocols in Central European Anatomy Institutions: A Collaborative Effort to Minimize Chemical Exposure.

Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft

Authors: Sara Mohebimoushaei, Veronica Antipova, Uta Biedermann, Beate Brand-Saberi, Lars Bräuer, Svenja Caspers, Sara Doll, Maren Engelhardt, Timm J Filler, Martin Gericke, Yakup Gümüsalan, Stefanie Gundlach, Gregor U Hayn-Leichsenring, Stephan Heermann, Laura Hiepe, Bernhard Hirt, Lena Hirtler, Christoph Kulisch, Marko Konschake, Stefanie Kürten, Tobias Lange, Mario Lorenz, Christina Nassenstein, Peter H Neckel, Ute Nimtschke, Friedrich Paulsen, Andreas Prescher, Michael L Pretterklieber, Andreas Schmiedl, Sven Schumann, Volker Spindler, Gundula Schulze-Tanzil, Thomas Tschernig, Axel Unverzagt, Ursula Valentiner, Ivan Varga, Thilo Wedel, Janet Weigner, Wolfgang J Weninger, Jürgen Westermann, Monika Wimmer-Roell, Jens Waschke, Niels Hammer

BACKGROUND: Anatomical embalming forms a mainstay in the provision of teaching materials based on human post-mortem tissues. As a consequence of regulations worldwide to minimize the use of formaldehyde due to its harmful nature, effective measures must be taken to minimize its application in the anatomy laboratory. This study aimed to identify commonalities among embalming protocols used in Austrian, German and Swiss anatomies to reduce formaldehyde usage and provide a foundation for joint accreditation.

METHODS: Survey data on all procedures, technologies and chemicals related to embalming were collected from 28 participating institutions and analyzed using an automated clustering approach. Special attention was given to chemicals, explosion-proof facilities, and air ventilation technology. After conducting principal component analyses, the data was evaluated using an unsupervised K-means learning algorithm.

RESULTS: Six distinct clusters of common chemical usage were identified, namely (1) Thiel embalming with explosion-proof facilities, (2) potassium- and sodium salt-based embalming with downdraft ventilation, (3) ethanol/glycerin/glutaraldehyde/sodium alkyl ether sulphate-based embalming, (4) ethanol-based embalming, (5) formaldehyde-based embalming, and (6) ethanol/phenoxyethanol/alkyl (C12-16) dimethylbenzyl ammoniumchloride-based embalming. All clusters included the use of formaldehyde to varying extent. These clusters demonstrated high stability for fixation, combined fixation and conservation, as well as the incorporation of explosion-proof facilities and air ventilation technology. Moreover, a number of institutions used more than one similar protocol, so-called 'Superclusters', with Clusters (4) and (1) or Clusters (5) and (1) combined being the most common observation.

CONCLUSION: These findings provide a basis for optimizing, streamlining and sharing embalming protocols among central European anatomy institutions.

Copyright © 2025 The Author(s). Published by Elsevier GmbH.. All rights reserved.

PMID: 40118157

Participating cluster members