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Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys

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Title: Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys
Language: English
Authors: Skopnik-Chicago, Marianne, Poblete-Cordero, Katherine, Zamora, Natali, Bastías, Roberto, Lizana, Pablo A. (ORCID 0000-0002-9366-6930)
Source: Anatomical Sciences Education. Nov-Dec 2021 14(6):836-846.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 11
Publication Date: 2021
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Animals, Laboratory Procedures, Chemistry, Microbiology, Tactual Perception, Color, Student Attitudes, Health Sciences, Biology, Anatomy, College Students
DOI: 10.1002/ase.2042
ISSN: 1935-9772
Abstract: One of the most widely used solutions to fix and preserve organic tissues is formaldehyde, despite reservations regarding its toxicity and the fact that formaldehyde-embalmed bodies lose their original characteristics. Anatomy laboratories have been replacing formaldehyde with solutions that retain the characteristics of fresh tissue. For this purpose, alternative solutions with a very low concentration of formaldehyde or without any formaldehyde have been analyzed. The objective of this study was to compare biometry, coloration, haptic properties, and bacterial load on animal specimens (pig kidneys) embalmed with formaldehyde, and with Chilean Conservative Fixative Solution with and without formaldehyde (formaldehyde chCFS and formaldehyde-free chCFS). Also, the perception of health and biological science students toward specimens treated with different solutions was assessed. The results indicated that there were no significant differences in specimens' retraction, or bacterial load. Students showed a preference for organs embalmed in formaldehyde chCFS and formaldehyde-free chCFS; indicating that with these treatments they could better visualize structures and that the prosections had greater flexibility and the colors were more similar to those of fresh tissue. Additionally, students recommended the material embalmed in formaldehyde chCFS and formaldehyde-free chCFS for anatomy learning. In contrast, students indicated that formaldehyde-fixation negatively affected their practical experience. In conclusion, embalming with formaldehyde chCFS or formaldehyde-free chCFS provides an advantageous practical experience over the use of formaldehyde and may be an alternative to replace the use of formaldehyde in anatomy laboratories.
Abstractor: As Provided
Entry Date: 2021
Accession Number: EJ1318923
Database: ERIC
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  Value: <anid>AN0153983683;[8z8k]01nov.21;2021Dec08.07:36;v2.2.500</anid> <title id="AN0153983683-1">Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde Versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys </title> <p>One of the most widely used solutions to fix and preserve organic tissues is formaldehyde, despite reservations regarding its toxicity and the fact that formaldehyde‐embalmed bodies lose their original characteristics. Anatomy laboratories have been replacing formaldehyde with solutions that retain the characteristics of fresh tissue. For this purpose, alternative solutions with a very low concentration of formaldehyde or without any formaldehyde have been analyzed. The objective of this study was to compare biometry, coloration, haptic properties, and bacterial load on animal specimens (pig kidneys) embalmed with formaldehyde, and with Chilean Conservative Fixative Solution with and without formaldehyde (formaldehyde chCFS and formaldehyde‐free chCFS). Also, the perception of health and biological science students toward specimens treated with different solutions was assessed. The results indicated that there were no significant differences in specimens' retraction, or bacterial load. Students showed a preference for organs embalmed in formaldehyde chCFS and formaldehyde‐free chCFS; indicating that with these treatments they could better visualize structures and that the prosections had greater flexibility and the colors were more similar to those of fresh tissue. Additionally, students recommended the material embalmed in formaldehyde chCFS and formaldehyde‐free chCFS for anatomy learning. In contrast, students indicated that formaldehyde‐fixation negatively affected their practical experience. In conclusion, embalming with formaldehyde chCFS or formaldehyde‐free chCFS provides an advantageous practical experience over the use of formaldehyde and may be an alternative to replace the use of formaldehyde in anatomy laboratories.</p> <p>Keywords: Gross anatomy education; Undergraduate education; Fixation methods; Embalming procedures; Formaldehyde; Formaldehyde reduction; animal tissue; microbiological study</p> <hd id="AN0153983683-2">INTRODUCTION</hd> <p>A current concern in the field of anatomical techniques is to improve the quality of preserved specimens while ensuring the safety of those who handle them (Kennel et al., 2018). One of the most widely used solutions for embalming and preserving organic tissues and entire body is formaldehyde (Fox et al., 1985; Waschke et al., 2019). Exposure to formaldehyde solution has been reported to have harmful effects on human health because it is a toxic compound (Akbar‐Khanzadeh and Mlunek, 1997; İnci et al., 2013), causes irritation of skin and mucosa, damages the airways due to its volatility, and is a carcinogenic (Chia et al., 1992; Akbar‐Khanzadeh and Mlunek, 1997; Wolff et al., 2012; Kennel et al., 2018; Waschke et al., 2019) and teratogenic agent (Inzunza et al., 2003; Kim et al., 2011). Therefore, handling of anatomical specimens treated with formaldehyde solution requires the use of safety precautions (Dimenstein, 2009; Waschke et al., 2019). Formaldehyde‐embalmed bodies or specimens are widely used for anatomy teaching and are therefore handled by many people such as professors, students, and assistants (Lakchayapakorn and Watchalayarn, 2010; Onyije and Avwioro, 2012). In this regard, several studies describe that exposure to formaldehyde in anatomy laboratories is higher than that established by biosafety standards (Ohmichi et al., 2006; Takayanagi et al., 2007). The authors suggest that formaldehyde levels in anatomy laboratories should be measured regularly, adequate ventilation systems should be in place, as well as safeguards and a decrease in the amount of time students and teachers are exposed to the formaldehyde (Chia, 1992; Kurose et al., 2004; Ohmichi et al., 2006; Wei et al., 2007; Ahmed, 2011).</p> <p>It has been reported that the use of formaldehyde for fixing animal or human specimens changes the characteristics of the original tissues (Waschke et al., 2019), because it generates discoloration and induration (Kennel et al., 2018; Waschke et al., 2019). Despite this, formaldehyde is still widely used for the fixation of anatomical prosections and for embalming, mainly because it is more accessible and is less expensive than other less harmful solutions (Wolff et al., 2012).</p> <p>Exposure to formaldehyde occurs not only in research laboratories, but also in dissection and anatomy courses where both professors and students are exposed to the formaldehyde solution (Lakchayapakorn and Watchalayarn, 2010; Onyije and Avwioro, 2012). However, research indicates that in the methodologies of several investigations, 10% of formaldehyde solution is still used in Latin America as a fixation solution (Mariz et al., 2001; Condemayta et al., 2014; Duque‐Parra and Vélez, 2014; Pacheco et al., 2017; Viana et al., 2020). Chile is not an exception. For the fixation and conservation of cadaveric material, 75% of the laboratories studied use a formula with formaldehyde, of which 17% use a formula where formaldehyde is at high concentrations, although formaldehyde concentrations were not reported (Tiznado‐Matzer et al., 2019). In this context, it is essential to have conservative solutions either with a maximum concentration of 4% formaldehyde (Waschke et al., 2019) or with no formaldehyde at all (Hammer, 2011) to avoid any damage to health. Besides, it is also essential to include organizational and logistical measures in anatomy laboratories to reduce health risks through formaldehyde exposure (Ahmed, 2011; Wascke et al., 2019).</p> <p>Although anatomy teaching methods have changed over the years, the use of specimens, organs, and cadavers continues to be preferred (McLachlan and Patten, 2006; Gosh, 2015). This is supported by multiple authors who indicate that the use of cadavers in anatomy teaching is of great importance because it stimulates and motivates learning, generates respect for laboratory work with individual specimens (García‐Hernández, 2003; Gosh, 2015), and facilitates the real anatomical understanding of physiological structures (Inzunza et al., 2007; Waschke et al., 2019).</p> <p>In anatomical education, several alternatives have been used to working with fresh anatomical specimens, such as the use of software, anatomical models (Wright, 2012; Azer and Azer, 2016), and/or the use of fixed and preserved anatomical specimens (Gillingwater, 2008; Kennel et al., 2018). Prosections are not only useful for a competent education, but also because their use is not restricted to a single session (due to putrefaction or deterioration of fresh tissue) and they contribute to the biosecurity of those who handle them (Kennel et al., 2018). That is why, given the risks described above, study centers that use formaldehyde‐embalmed cadavers are in constant need to generate and use new methodologies for teaching anatomy such as images, software, and models, which should not be considered as substitutes for the use of cadavers, but rather as complements to teaching (Inzunza et al., 2003; Lizana et al., 2015; Waschke et al., 2019). Kennel et al. (2018) compared the perception of students regarding dissection experiences of cadaveric material preserved with Thiel as well as with formaldehyde, reporting that students preferred cadaveric material with Thiel solution over those preserved in a solution containing formaldehyde in aspects such as structure identification and dissection. In addition, tissue preserved in Thiel solution was more flexible, was easier to identify in terms of structure, and had less odor than that preserved with formaldehyde solution.</p> <p>In Chile, it has been reported that it is difficult to obtain human cadavers in universities, which has opened the search for new strategies for teaching human anatomy (García‐Hernández, 2003; Inzunza et al., 2003; Valdés et al., 2010; López et al., 2011). Recently, a study was carried out that reports the conditions of some Chilean universities' anatomy laboratories. From this study, 12 participating universities describe that they have cadaveric material for anatomy classes, but only three of them have enough cadaveric material to be able to carry out their practices, while the remaining nine universities use other complementary means in their classes, such as anatomical models and software (Tiznado‐Matzner et al., 2019).</p> <p>Due to the deficit of cadaveric material, some studies propose using animal organs as models for the study of human organs. In this sense, Salinas and Schwerter (2015) propose the use of canine kidneys as a surgical model in human studies, taking into consideration the anatomical variations of the renal artery, while Buys‐Gonçalves et al. (2016) propose that sheep kidneys can be used as a model for teaching practices on human kidneys, presenting several morphological aspects that resemble or differ from the human organ. Other studies propose that pig kidneys can be used as models for experimental surgical practices, due to their similarity to the human kidney (Sampaio et al., 1998; Pereira‐Sampaio et al., 2004; Bagetti Filho et al., 2008). Therefore, the work with cadaveric specimens of animal origin has been incorporated as a tool in the teaching and learning processes of human anatomy.</p> <p>Some Chilean universities have made progress in replacing formaldehyde as a solution for fixing and conserving cadaveric specimens. Nine of the universities surveyed in the study by Tiznado‐Matzner et al. (2019) use a solution whose description of the components coincide with chCFS. Dr. Alberto Rodriguez Torres from the University of Chile in Santiago de Chile created the chCFS; given the need for new solutions with a lower percentage of formaldehyde, the chCFS is composed of sodium chloride, sodium nitrate, glycerin, ethyl alcohol, benzalkonium chloride, formaldehyde, and eucalyptus essence (Franco, 2014; Ortega, 2014). The salts used in the solution conserve the tissue, while the disinfection properties are provided by benzalkonium chloride (Gainor et al., 1997) and 5% formaldehyde (Franco, 2014). The specific functions of each component are specified in Table 1. Variations of chCFS have been incorporated where formaldehyde has been replaced by ethyl alcohol (Villarroel and Troncoso, 2017), resulting in formaldehyde‐free chCFS.</p> <p>1 TableChilean Conservative Fixative Solution (chCFS) Components and their Main Functions</p> <p> <ephtml> <table><thead valign="top"><tr><th align="left">Component</th><th align="center">Function</th></tr></thead><tbody><tr><td align="left">Sodium chloride</td><td align="left"><list list-type="Bullet"><list-item><p>Preservation</p></list-item></list>(Coleman and Kogan, 1998; Franco, 2014; Ortega, 2014)</td></tr><tr><td align="left">Sodium nitrate</td><td align="left"><list list-type="Bullet"><list-item><p>Preservation, softening, inhibition of enzymatic activities</p></list-item></list>(Ortega, 2014; Franco, 2014; Brenner, 2014)</td></tr><tr><td align="left">Glycerin</td><td align="left"><list list-type="Bullet"><list-item><p>Preservation, softening, inhibition of enzymatic activities</p></list-item></list>(Franco, 2014; Ortega, 2014; Brenner, 2014);<list list-type="Bullet"><list-item><p>Maintaining flexibility and pliability</p></list-item></list>(Hammer et al., 2012)</td></tr><tr><td align="left">Ethyl alcohol</td><td align="left"><list list-type="Bullet"><list-item><p>Contribution to the degradation of fat, dehydration</p></list-item></list>(Brenner, 2014)</td></tr><tr><td align="left">Benzalkonium chloride</td><td align="left"><list list-type="Bullet"><list-item><p>Sporicidal action</p></list-item></list>(Brenner, 2014)</td></tr><tr><td align="left">Formaldehyde</td><td align="left"><list list-type="Bullet"><list-item><p>Fixation, conservation; antiseptic properties</p></list-item></list>(Brenner, 2014)</td></tr></tbody></table> </ephtml> </p> <p>As well as its other advantages, chCFS does not expel annoying or harmful odors (Villarroel and Troncoso, 2017). However, precautions should be taken with some components of chCFS. For example, benzalkonium chloride is harmful if ingested, produces irritation after prolonged contact, and can also generate injury to the respiratory tract and eyes (Isaac and Scheinman, 2017). Concerning ethyl alcohol, the United States National Institute for Occupational Safety and Health indicates that it can irritate the eyes, skin, and nose; and can cause headaches, drowsiness, and lethargy if adequate safety measures are not taken (NIOSH, 2007).</p> <p>Satisfactory results have been observed in different tissues with chCFS. Villarroel and Troncoso (2017) report good results in canine skeletal muscle, with a long duration of preservation of the cadaveric sample without constant immersion. Likewise, Franco (2014) presents good results in the fixation and preservation of pig hearts using chCFS. For his work on upper limbs, Ortega (2014) used different types of solutions including chCFS which gave positive results in the restoration process, and several investigations have shown that preservation with chCFS results in a lower rigidity in cadaveric specimens (Ortega, 2014; Franco, 2014; Villarroel and Troncoso, 2017).</p> <p>Currently, there are no comparative studies between chCFS and other preservative solutions. Therefore, this study describes the comparison of chCFS with formaldehyde solutions and the perceptions of undergraduate students when handling animal cadaveric material using both solutions.</p> <p>This research aims to compare the haptic characteristics, biometry, and bacterial load of three solutions used for the fixation and preservation of anatomical structures: formaldehyde chCFS, formaldehyde‐free chCFS, and 10% formaldehyde solution. Furthermore, the perception of university students toward samples fixed with the different solutions is evaluated.</p> <hd id="AN0153983683-3">MATERIALS AND METHODS</hd> <p></p> <hd id="AN0153983683-4">Comparison of the Fixing Solutions</hd> <p>The solutions were prepared according to the measurements shown in Table 2, following the steps presented by Ortega (2014) for the preparation of chCFS with formaldehyde, as well as the modifications presented by Villarroel and Troncoso (2017) for the preparation of the formaldehyde‐free chCFS: (<reflink idref="bib1" id="ref1">1</reflink>) Sodium chloride is dissolved in distilled water. (<reflink idref="bib2" id="ref2">2</reflink>) Sodium nitrate is dissolved in distilled water, in a separate container from step 1. (<reflink idref="bib3" id="ref3">3</reflink>) Glycerin is poured into another container of greater volume. (<reflink idref="bib4" id="ref4">4</reflink>) Add the sodium chloride solution (from step 1) to the glycerin, and then, the sodium nitrate solution (step 2). (<reflink idref="bib5" id="ref5">5</reflink>) Ethyl alcohol is added to the container (the amount of ethyl alcohol depends on whether the chCFS is with or without formaldehyde). (<reflink idref="bib6" id="ref6">6</reflink>) Add the benzalkonium chloride. (<reflink idref="bib7" id="ref7">7</reflink>) Add the formaldehyde (only if the preparation is of chCFS with formaldehyde). Formaldehyde was prepared from 37% commercial formaldehyde, which was diluted with water at a ratio of 1:9 to reach a concentration of 10% (DeJong and Henry, 2007).</p> <p>2 TableReagents Used for the Preparation of Fixative Solutions</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Reagent</th><th align="center">Chilean Conservative Fixative Solution</th><th align="center">Formaldehyde 10% solution</th></tr><tr><th align="center">With Formaldehyde</th><th align="center">Formaldehyde‐free</th></tr></thead><tbody><tr><td align="left">Sodium chloride</td><td align="center">375 g</td><td align="center">375 g</td><td align="center" /></tr><tr><td align="left">Sodium nitrate</td><td align="center">300 g</td><td align="center">300 g</td><td align="center" /></tr><tr><td align="left">Glycerin</td><td align="center">1.0 L</td><td align="center">1.0 L</td><td align="center" /></tr><tr><td align="left">Ethyl alcohol</td><td align="center">1.5 L</td><td align="center">1.625 L</td><td align="center" /></tr><tr><td align="left">Benzalkonium chloride</td><td align="center">0.5 L</td><td align="center">0.5 L</td><td align="center" /></tr><tr><td align="left">Distilled water</td><td align="center">3.0 L</td><td align="center">3.0 L</td><td align="center">5.4 L</td></tr><tr><td align="left">Formaldehyde</td><td align="center">0.125 L(5% solution)</td><td align="center" /><td align="center">0.6 L(37% solution)</td></tr><tr><td align="left">Total volume</td><td align="center">6.125 L</td><td align="center">6.125 L</td><td align="center">6.0 L</td></tr></tbody></table> </ephtml> </p> <p>1 Reagent are used for the preparation of 6.125 L of formaldehyde Chilean Conservative Fixative Solution (chCFS), formaldehyde‐free chCFS, and 6 L of 10% formaldehyde solution (Franco, 2014 and Ortega, 2014); L: Liters; g: Grams.</p> <p>Solutions were stored in airtight boxes in an area protected from sunlight and artificial light. The temperature of the laboratory where the boxes were placed was 21 ± 2°C.</p> <p>The cost of reagents varies according to the company and country where they are purchased. However, the quotation made with a Chilean company for the reagents used in this study's solutions were calculated at 6,125 liters for chCFS with formaldehyde; 6,125 liters for formaldehyde‐free chCFS; and 6.0 liters for formaldehyde at 10% concentration.</p> <p>Thirty‐nine fresh pig kidneys (<emph>Sus scrofa ssp. domestica</emph>) were washed for 2 minutes under continuous water flow. Specimens were labeled with numbers (Fig. 1), and photographed with a Nikon digital camera, model D5600 (Nikon Corporation, Tokyo, Japan) using an AF‐S DX Micro‐NIKKOR 40mm f/2.8G lens (Nikon Corporation, Tokyo, Japan). Kidneys were photographed on a millimeter background that allowed measurements of maximum length and width to be measured at three different time points: at the beginning, before immersing the kidneys in the solutions, and 7 and 14 days after being immersed in the solutions. Eight labeled kidneys were placed in each solution. Specimens used to measure bacterial load were unlabeled and five kidneys were stored per solution.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/8Z8K/01nov21/ase2042-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="ase2042-fig-0001.jpg" title="1 Tracing gross anatomy specimens of pig kidney (Sus scrofa ssp. domestica). A, Chilean Conservative Fixative Solution with formaldehyde; B, Chilean Conservative Fixative Solution without formaldehyde; C, 10% formaldehyde solution; chCFS, Chilean Conservative Fixative Solution." /> </p> <p></p> <hd id="AN0153983683-6">Bacterial Load Comparison in Tissues Treated with the Different Fixing Solutions</hd> <p>Tissues for measurement of bacterial load were kept at 4°C, and then, at room temperature, in an open petri dish and closed petri dish, for 1 week. To evaluate the bacterial load of the pig kidneys in the different solutions, specimens were taken at days 0, 1, and 7 to determine the variations in the bacterial load after 14 days, which were kept out of the solutions. For each bacterial load measurement, 5 g of kidney tissue was removed and homogenized in 50 ml of trypticase soy broth by vortexing. Then, serial dilutions were made in 0.85% of saline, and 0.1 ml was plated on trypticase soy agar plates. Plates were incubated at 30°C for 48 hours before bacterial colonies were counted.</p> <p>A total of 28 bacterial colonies were isolated from the cultured microorganisms, which were identified by 16S rRNA gene sequencing. To extract the DNA of each isolated bacterium, each colony was resuspended in 100 µl of TE buffer (1.0 mM EDTA, 10 mM Tris‐HCl, pH 8), incubated 10 minutes at −20°C, and then, for 15 minutes at 95°C. Samples were centrifuged at 11,000 g for 5 minutes to recover the supernatant containing the DNA. This supernatant was transferred to a new tube and the DNA amplified using PCR. The PCR primers used were 16S‐27F (5′‐AGAGTTTGATCMTGGCTCAG‐3′) and 16S‐1492R (5′TACGGYTACCTTGTTACGACTT‐3′) and PCR performed according to the conditions described by Hogg and Lehane (1999). Each 25 µl reaction contained: 1 mM MgCl<subs>2</subs>, 1 x Dream Taq green buffer with 20 mM MgCl<subs>2</subs> (Thermo Fisher Scientific, Waltham, MA), 0.2 mM dNTPs, 2.5 U Dream Taq polymerase (Thermo Fisher Scientific, Waltham, MA), and 0.2 µM of each primer. The amplification protocol consisted of a denaturation step at 95°C for 5 minutes, followed by 25 cycles at 95°C for 1 minute, 55°C for 1 minute, 72°C for 1 min, and a final elongation step at 72°C for 5 minutes. Amplification was performed using the 2720 thermal cycler (Applied Biosystems<sups>®</sups>, Foster City, CA). To visualize the PCR product, a 5 µl sample was stained with GelRed™ (Biotium, Inc., Hayward, CA) and run through gel electrophoresis on a 1% of agarose gel electrophoresis in TAE buffer at 100 V for 40 minutes.</p> <p>Amplicons were purified using the E.Z.N.A gel extraction kit (Omega Bio‐tek, Inc., Norcross, GA) and sent to Macrogen Inc. (Seoul, Korea) for sequencing. Nucleotide sequences were edited using the BioEdit software, version 7.2 (Informer Technologies, Inc., Los Angeles, CA) (Hall, 1999), and then, compared with sequences from the database of the National Center for Biotechnology using the BLAST tool (NCBI, 2020).</p> <hd id="AN0153983683-7">Students' Perception of the Anatomical Specimens Treated with Different Fixation/Preservation...</hd> <p>A questionnaire was adapted from Kennel et al. (2018) and the Likert scale used to obtain the preferences of the students about the visual, haptic, and odor characteristics of the prosections treated with the different solutions. Once the first questionnaire was constructed, it was validated by three experts (in education, biology, and anatomy), after which two questions were modified to be more understandable for the age range of the respondents.</p> <p>Students aged between 18 and 21 in the Bachelor of Biology Pedagogy, Physical Education Pedagogy, and Medical Technology voluntarily participated in the study. The three degrees to which the students belonged have only one subject of human anatomy. Therefore, the subject of human anatomy is their first approach to the discipline at a university level. However, prior to the experience with kidneys, students had had practical sessions with other animal prosections fixed in formaldehyde and glycerin (cardiac and pulmonary structures, among others). The theoretical contents of renal structure and function had also been taught to all participants before participating in the study.</p> <p>The first part of the questionnaire consisted of questions related to demographic data, such as the university where they were studying, their current university degree, their gender, personal ID number, and their age. The second part of the questionnaire constituted questions regarding the utility and perception of the organs (kidneys) in the three fixation solutions. Five‐point Likert scale questions were asked, with the response options being 1 = completely disagree, 2 = disagree, 3 = indifferent, 4 = agree, and 5 = completely agree (see Supporting Information 1).</p> <p>The questionnaire was given in the same human anatomy laboratory where the students carried out their practical classes. Students were presented with kidneys which had been preserved in each solution (formaldehyde chCFS, formaldehyde‐free chCFS, and 10% formaldehyde) for 2 months in separate trays (see Fig. 2) as well as a fresh sample for comparison. Each kidney was labeled with an identification number that was used to answer the questions. Gloves were provided to students so that they could safely handle the specimens.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/8Z8K/01nov21/ase2042-fig-0002.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="ase2042-fig-0002.jpg" title="2 Section of kidneys (Sus scrofa ssp. domestica), 7 days after being immersed in the indicated solutions; chCFS, Chilean Conservative Fixative Solution." /> </p> <p></p> <hd id="AN0153983683-9">Statistical Analysis</hd> <p>Descriptive statistics were calculated for basic demographic data. Frequencies and percentages were calculated for questionnaire items that were assessed using the Likert scale, and their reliability evaluated with Cronbach's alpha coefficient, where values greater than 0.7 were considered reliable (Peterson, 1994; Santos, 1999). The questionnaire's validity was assessed using Kendall's tau‐b coefficient as well as the opinions of experts in the fields of education, biology, and anatomy. Kendall's tau‐b coefficient measures the strength of association between paired data sets, and a statistically significant tau‐b coefficient provides support for construct validity (Sokal and Rohlf, 2012). Data were graphed and analyzed using the ANOVA two‐way test in the STATA software, version 16 (StataCorp LLC., College Station, TX).</p> <hd id="AN0153983683-10">Ethical Considerations</hd> <p>The students were informed of the procedures via a written consent form. All the procedures were in line with the ethical policies established in the Declaration of Helsinki (World Medical Association, 2013). The protocol was further approved by the Ethics Committee of the Pontificia Universidad Católica de Valparaíso, Chile (BIOEPUCV‐HB 311‐2019).</p> <hd id="AN0153983683-11">RESULTS</hd> <p></p> <hd id="AN0153983683-12">Coloration and Organ Size Measurement for the Three Fixative Solutions</hd> <p>When comparing tissues preserved in the three fixative solutions (10% formaldehyde, formaldehyde chCFS, and formaldehyde‐free chCFS), the change in coloration for all preserved material was already detected by day 7. The most noticeable change in tissue coloration was observed in tissues preserved in the 10% of formaldehyde solution compared to the other two fixative solutions, and this was seen both in the whole organ as well as in the cross section (see Figs. 1 and 2).</p> <p>There were no significant differences in the length and width measurements of the kidneys fixed with the different solutions. However, each of the fixed specimens had a significant retraction of length and width at the time of recording (all test results and statistical analyses have additionally been provided in the Supplemental Material File, Table S1; <emph>P</emph> < 0.05).</p> <hd id="AN0153983683-13">Bacterial Load Comparison between Different Fixative Solutions</hd> <p>For tissues kept at room temperature and in a closed petri dish, higher bacterial load was observed at 24 hours in tissues fixed with 10% of formaldehyde compared to tissues fixed with formaldehyde chCFS or formaldehyde‐free chCFS and decreased in all specimens between time 0 and 7 days. Similarly, when tissues were kept at 4°C temperature, a reduction in bacterial load was observed after 7 days for all specimens, although this difference was significant only for specimens fixed with 10% of formaldehyde and formaldehyde chCFS (<emph>P</emph> < 0.05), with an 80% decrease in bacterial load for both solutions. As expected, after 7 days the bacterial load in specimens kept at 4°C temperature was less than that for specimens kept at room temperature, although this difference was only significant for specimens fixed with formaldehyde chCFS. However, all observed differences were generally less than an order of magnitude, which suggests that neither the treatment used nor the storage conditions would considerably affect the bacterial load present in the tissues.</p> <p>RNA sequencing of the 28 isolated colonies revealed that 64% of the isolates belonged to the genus <emph>Staphylococcus</emph>, specifically the <emph>Staphylococcus warneri</emph> and <emph>Staphylococcus epidermidis</emph> species. The second biggest group among the isolated colonies (21.4%) corresponded to bacteria species of the <emph>Bacillus</emph> genus. Bacteria associated with the genera <emph>Psychrobacter</emph> and <emph>Pseudomonas</emph> were also identified, both in specimens stored at 4°C. However, it was not possible to establish a clear correlation between the presence of certain bacterial groups and a certain treatment or storage condition of the specimens (all results have additionally been provided in the Supplemental Material File, Table S2).</p> <hd id="AN0153983683-14">Validity and Reliability of the Student Questionnaire</hd> <p>Tests and expert opinion confirmed that the questionnaire administered to students demonstrated adequate validity and reliability. All paired elements in each subcomponent produced Kendall's tau‐b coefficients ranging from −0.303 to 0.58 (<emph>P</emph> < 0.05), except for the statement "In the modern era, the teaching of anatomy based on cadaveric material must be replaced by virtual/augmented reality applications or other computer‐assisted methods" (Kendall's tau‐b = 0.048, <emph>P</emph> > 0.05). Furthermore, Cronbach's alpha value for the Likert scale items on the perception of the specimens in the three solutions were: 0.71 for the sample in formaldehyde, 0.78 for the sample in formaldehyde chCFS, and 0.71 for the formaldehyde‐free chCFS.</p> <hd id="AN0153983683-15">Demographic Characteristics of the Students</hd> <p>A total of 86 questionnaires were answered. Questionnaires in which responses were omitted or not answered in their entirety were removed from the analysis (n = 14). The average age of the participating students was 19.13 (± 2.21) years, of which 48.6% (n = 35) were female and 51.4% (n = 37) were male.</p> <hd id="AN0153983683-16">Student Perceptions</hd> <p>For the statement "the smell of the organ affects my practical experience," 40.3% of the students chose the "completely agree" option for the 10% of formaldehyde solution compared to 15.3% and 4.2% for formaldehyde chCFS and formaldehyde‐free chCFS. Therefore, odor does affect the practical experience of students enough that they prefer solutions that are formaldehyde free. Regarding organ color and the ability to distinguish organ structures, formaldehyde chCFS performed the best, obtaining 36.1% in the option "completely agree," while 10% of formaldehyde obtained only 5.6%. For the statement "the organ has retained greater flexibility," formaldehyde‐free chCFS obtained a 75% in the options "completely agree" and "agree," followed by formaldehyde chCFS (63.9%) and 10% formaldehyde solution (2.8%). Regarding the difficulty to distinguish and identify the structures of the organs, 22.2% of students found this to be the case for 10% formaldehyde, while only 1.4% found this to be the case for tissues preserved in formaldehyde chCFS. For the statement "the color of the fixed organ is similar to that of a fresh organ," formaldehyde chCFS obtained the highest score with 43.1% in the options "completely agree" or "agree," while formaldehyde obtained the lowest score with only 1.4%. Finally, students were asked which fixative solution they would recommend for the preservation of anatomical items utilized for teaching. The highest score was obtained by formaldehyde chCFS (37.5%), followed by formaldehyde‐free chCFS (27.8%), and 10% formaldehyde (7%); see Supplemental Material File, Table S3.</p> <p>In Table 3, significant differences are observed in the students' perception of the characteristics of the three solutions for embalming pig kidneys. In this context, the formaldehyde solution's smell significantly affects the students' practical experience and their ability to distinguish anatomical structures (Statement 1 and 5). In contrast, students perceive that tissues preserved in formaldehyde chCFS and formaldehyde‐free chCFS are more flexible and are similar in color to that of a fresh organ (Statement 2, 3, and 4) compared to tissues preserved in formaldehyde solution. Finally, students highly recommend formaldehyde chCFS and formaldehyde‐free chCFS for learning anatomy, with the highest score being obtained for formaldehyde‐free chCFS and the lowest score for formaldehyde solution.</p> <p>3 TableComparison of 10% Formaldehyde Solution, Chilean Conservative Fixative Solution with Formaldehyde, and Chilean Conservative Fixative Solution with No Formaldehyde Group Attitudes Related to Characteristics of Embalmed Pig Kidneys</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Statement</th><th align="center">Chilean conservative fixative solution with formaldehyde</th><th align="center">Chilean conservative fixative solution formaldehyde‐free</th><th align="center">10% formaldehyde solution</th><th align="center"><italic>P</italic>‐value</th></tr><tr><th align="center">Mean (±SD)</th><th align="center">Mean (±SD)</th><th align="center">Mean (±SD)</th></tr></thead><tbody><tr><td align="left">The smell of the organ affects my practical experience</td><td align="center">2.43 (±1.15)<xref ref-type="fn" rid="tfn3" /></td><td align="center">2.99 (±1.26)<sup>a,c</sup></td><td align="center">3.82 (±1.25)<xref ref-type="fn" rid="tfn2" /></td><td align="center"><0.0001</td></tr><tr><td align="left">The color of the organ allows me to properly distinguish the structures</td><td align="center">3.33 (±1.11)<xref ref-type="fn" rid="tfn3" /></td><td align="center">3.86 (±1.08)<xref ref-type="fn" rid="tfn2" /></td><td align="center">2.14 (±1.08)<xref ref-type="fn" rid="tfn2" /></td><td align="center"><0.0001</td></tr><tr><td align="left">The organ has retained greater flexibility</td><td align="center">4.04 (±0.88)<xref ref-type="fn" rid="tfn4" /></td><td align="center">3.81 (±±1.04)<xref ref-type="fn" rid="tfn4" /></td><td align="center">1.43 (±0.78)</td><td align="center"><0.0001</td></tr><tr><td align="left">In general, I find it difficult to distinguish and identify the structures of the organs</td><td align="center">2.61 (±1.23)<xref ref-type="fn" rid="tfn4" /></td><td align="center">2.33 (±1.11)<xref ref-type="fn" rid="tfn4" /></td><td align="center">3.29 (±1.20)</td><td align="center"><0.0001</td></tr><tr><td align="left">The color of the fixed organ is similar to that of a fresh organ</td><td align="center">3.07 (±1.09)<xref ref-type="fn" rid="tfn4" /></td><td align="center">3.22 (±1.24)<sup>c</sup></td><td align="center">1.22 (±0.63)</td><td align="center"><0.0001</td></tr><tr><td align="left">I recommend anatomical specimens fixed in this solution for learning anatomy</td><td align="center">3.7 (±1.11)<xref ref-type="fn" rid="tfn4" /></td><td align="center">3.99 (±1.01)<xref ref-type="fn" rid="tfn4" /></td><td align="center">2.25 (±1.14)</td><td align="center"><0.0001</td></tr></tbody></table> </ephtml> </p> <ulist> <item>2 a Chilean conservative fixative solution with formaldehyde;</item> <item>3 b Chilean conservative fixative solution formaldehyde‐free;</item> <item>4 c Formaldehyde (10% solution).</item> <item>5 Students responded on a five‐point Likert scale with 1 = completely disagree, 2 = disagree, 3 = indifferent, 4 = agree, and 5 = completely agree. <emph>P</emph>‐values from one‐way ANOVA with Bonferroni post hoc test.</item> </ulist> <hd id="AN0153983683-17">DISCUSSION</hd> <p></p> <hd id="AN0153983683-18">Comparison of the Different Fixation/Preservation Solutions</hd> <p>This study is the first to compare the formaldehyde solution normally used in anatomical laboratories with formaldehyde chCFS and formaldehyde‐free chCFS to evaluate the advantages and disadvantages of using solutions with a low level of formaldehyde or without formaldehyde in the preservation of anatomical specimens. Current results support the use of formaldehyde chCFS and formaldehyde‐free chCFS as good alternatives to formaldehyde solution (10%) in anatomy laboratories. Most of the students agreed that anatomical specimens treated with these alternative solutions had a better odor, better haptic properties, coloration, and flexibility. The use of these alternative solutions also presented a lower risk to the health of those who handled them. Therefore, an important advantage of these alternative solutions is that despite having a very low concentration of formaldehyde or not having formaldehyde at all, the results are similar, if not better than that achieved with formaldehyde solution.</p> <p>Fixation based on formaldehyde chCFS and formaldehyde‐free chCFS complements existing embalming techniques (Thiel, 1992; Whitehead and Savoia, 2008; Messmer et al., 2010; Hammer et al., 2012; Brenner, 2014; Hammer et al., 2015; Wedel et al., 2019), and offers an alternative to or minimizes the use of hazardous formaldehyde (Franco, 2014). In this regard, the working group of the Anatomische Gesellschaft recommended a reduction in formaldehyde use in anatomy laboratories, and suggested further structural measures be taken such as installing ventilation systems and controlling room temperature. These recommendations include not exceeding formaldehyde concentrations of 4% in embalming fixatives (Waschke et al., 2019). Formaldehyde chCFS contains a percentage of formaldehyde similar to that suggested by the German group (5%), but there is also the alternative of formaldehyde‐free chCFS which in this study had similar results to that of formaldehyde chCFS.</p> <p>The mixture of chemicals that make up formaldehyde chCFS and formaldehyde‐free chCFS does not produce an unpleasant (intrusive) odor like the one that formaldehyde or Thiel solution has in embalming (Crosado et al., 2020).</p> <hd id="AN0153983683-19">Students' Perception of the Anatomical Specimens Treated with Different Fixation/Preservation...</hd> <p>The results of this research show that the smell of the solutions affects the students' learning experience as more formaldehyde is incorporated into the solution. Seventy‐five percent of the surveyed students (who answered "agree" and "completely agree") reported that the formaldehyde‐free chCFS produced more flexibility than the other solutions, with only 3% of students preferring the formaldehyde solution. It has been widely reported that formaldehyde generates a rigid effect on anatomical parts (Kennel et al., 2018; Waschke et al., 2019; Crosado et al., 2020), while formaldehyde‐free chCFS has been reported to provide flexibility to organs and cadavers (Villarroel and Troncoso, 2017), similar to the results in this study for formaldehyde chCFS and formaldehyde‐free chCFS. This could be because the Chilean solutions contain glycerin, which has been reported to maintain the flexibility of bodies and is therefore widely used in embalming solutions (Hammer et al., 2012; Benet et al., 2014; Hammer et al., 2015). Furthermore, it has been observed that tissues maintain their esthetics and flexibility even after prolonged use (Villarroel and Troncoso, 2017).</p> <p>Students also reported that formaldehyde chCFS and formaldehyde‐free chCFS preserved color better than formaldehyde solution (Supplemental Material File, Table S3), which has also been reported in a previous study for muscle tissue (Villarroel and Troncoso, 2017). Kennel et al. (2018) reported that students who worked with Thiel's solution, characterized by greater flexibility and placement of embalmed structures (Balta et al., 2015; Sawhney et al., 2017; Yiasemidou et al., 2017), felt more confident in recognizing structures in a living individual, found it easier to identify and dissect anatomical structures, and performed a more active exploration of functional anatomy compared to students who worked with anatomical specimens preserved in formaldehyde solution. Despite the apparent advantages of Thiel's solution, however, further testing of students' anatomical knowledge found no significant differences in knowledge of functional anatomy between the two cohorts (Thiel vs. formaldehyde). In general, although Thiel's embalming or that proposed in this study may provide an advantageous learning experience, more research is required to establish whether the students' perceptions are real, at least in terms of identifying structures.</p> <hd id="AN0153983683-20">Bacterial Load</hd> <p>Fixed specimens of this study presented bacterial loads that varied between 10<sups>6</sups> and 10<sups>8</sups> CFU/g (Fig. 3). To date, most of the studies that have analyzed the presence of bacteria in anatomical specimens have focused on their identification rather than the total bacterial load in the specimens (Tabaac et al., 2013; Molina et al., 2019), so it is difficult to establish whether these concentrations are normal in these types of specimens. Regardless, data show that the type of treatment and storage conditions used would not affect bacterial load, as the few observed differences did not exceed an order of magnitude. Since the bacterial load did not vary between the different solutions, from the microbiological point of view the solutions are interchangeable. This is because formaldehyde chCFS and formaldehyde‐free chCFS have benzalkonium chloride which acts as a sporicidal, disinfectant, and antiviral agent (Okahara and Kawazy., 2013; Leal et al., 2018).</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/8Z8K/01nov21/ase2042-fig-0003.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="ase2042-fig-0003.jpg" title="3 Bacterial concentration in tissues subjected to different treatments of Chilean Conservative Fixative Solution (chCFS) with formaldehyde, chCFS without formaldehyde and formaldehyde solution 10% maintained under different environmental conditions. A, Tissues subjected to different treatments and kept at room temperature (~25°C), exposed to the environment in an uncovered petri dish; B, Tissues subjected to different treatments and kept at room temperature (~25°C), unexposed to the environment in a covered petri dish; C, Tissues subjected to different treatments and kept at 4°C, unexposed to the environment in a covered petri dish; D, Bacterial concentration observed in tissues subjected to the different treatments after 7 days maintained under different environmental conditions. CFU/g: bacterial concentration in samples measured as colony‐forming‐units (viable cells) per gram of tissue. aSignificant differences at P < 0.05." /> </p> <p></p> <p>Most of the microorganisms isolated corresponded to the genus <emph>Staphylococcus</emph> (Supplemental Material File, Table S2). The species in this group are common inhabitants of the human skin microbiota (Grice and Segre, 2011), and species such as those found in this work (<emph>S. epidermidis</emph> and <emph>S. warneri</emph>) have also been found in cadavers used for teaching (Tabaac et al., 2013). One of the bacterial isolates found in the present study had a high percentage of identity with the <emph>S. saprophyticus</emph> species, which has been associated with urinary tract infections in humans (Raz et al., 2005). Therefore, it would be important to evaluate if this type of sample constitutes an environmental reservoir for this bacterial species. Similarly, another interesting aspect to evaluate is the origin of these bacteria, and if the people who handle the specimens can be a source of bacterial contamination. These results constitute the first effort to understand the microbiology present in these types of specimens and represent a starting point for other studies where it could be evaluated, for example, if these types of specimens can also act as a reservoir for antimicrobial‐resistant bacteria.</p> <p>The present research is the first to compare tissues preserved in formaldehyde solution normally used in anatomical laboratories with formaldehyde chCFS and formaldehyde‐free chCFS, to evaluate the advantages and disadvantages of using solutions with a low level of formaldehyde or without formaldehyde in the preservation of anatomical parts. These results support that formaldehyde chCFS and formaldehyde‐free chCFS could be good alternatives to replace formaldehyde solution in anatomy laboratories.</p> <hd id="AN0153983683-22">Limitations of the Study</hd> <p>Due to the design of the study where microbiological comparisons were made and students' perception was evaluated, work with one organ (pig kidney) made the study more standardized. However, previous studies of chCFS in other tissues have been reported (Villarroel and Troncoso, 2017). In this context, future research should incorporate comparisons with different tissues of animal and human origin, and study the use of chCFS over longer periods to better understand its usefulness in the teaching of anatomy. Furthermore, future research should develop studies comparing chCFS with formaldehyde and chCFS without formaldehyde with other embalming methods. Finally, another limitation of this study is that the bacterial load for the specimens was determined for only 7 days. It is therefore not possible to rule out potential differences in bacterial loads under different preservation treatments after this period.</p> <hd id="AN0153983683-23">CONCLUSIONS</hd> <p>The results of this work provide evidence on the advantages of formaldehyde chCFS and formaldehyde‐free chCFS over formaldehyde solution. Anatomy students indicated that formaldehyde chCFS and formaldehyde‐free chCFS produced fixed specimens with greater flexibility, better coloration, and better resemblance to fresh specimens compared to formaldehyde solution. As formaldehyde chCFS requires a minimal amount of formaldehyde and formaldehyde‐free chCFS replaces it with ethanol, either solution could be effective alternatives to embalming solutions containing formaldehyde in anatomy laboratories.</p> <hd id="AN0153983683-24">Acknowledgments</hd> <p>The authors are grateful to the Research Directorate, Vice‐rectory for Research and Advanced Studies, and the Institute of Biology at the Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Chile for their constant support.</p> <hd id="AN0153983683-25">NOTES ON CONTRIBUTORS</hd> <p>MARIANNE SKOPNIK‐CHICAGO, is a preservice biology teacher at the Pontificia Universidad Católica de Valparaíso in Valparaíso, Chile. She is an assistant in the human anatomy course and her research interest is in anatomical education and epidemiology.</p> <p>KATHERINE POBLETE‐CORDERO, is a preservice biology teacher at the Pontificia Universidad Católica de Valparaíso in Valparaíso, Chile. She is an assistant in the human anatomy course and her research interest is in anatomical education and epidemiology.</p> <p>NATALI ZAMORA, B.Sc., (biochemistry) is a graduate (Ph.D.) student in biological sciences with a mention in molecular genetics and microbiology at Pontificia Universidad Católica de Chile in Valparaíso, Chile and a candidate for a master's degree in statistics at the University of Valparaiso.</p> <p>ROBERTO BASTÍAS, Ph.D., is an associate professor of microbiology in the Institute of Biology at the Faculty of Sciences, Pontificia Universidad Católica de Valparaíso, Chile. He teaches microbiology to undergraduate and postgraduate students. His research interests are mainly in marine microbiology and the use of bacteriophages to control any kind of bacterial infection or contamination.</p> <p>PABLO A. 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  Group: Ti
  Data: Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys
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  Label: Language
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  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Skopnik-Chicago%2C+Marianne%22">Skopnik-Chicago, Marianne</searchLink><br /><searchLink fieldCode="AR" term="%22Poblete-Cordero%2C+Katherine%22">Poblete-Cordero, Katherine</searchLink><br /><searchLink fieldCode="AR" term="%22Zamora%2C+Natali%22">Zamora, Natali</searchLink><br /><searchLink fieldCode="AR" term="%22Bastías%2C+Roberto%22">Bastías, Roberto</searchLink><br /><searchLink fieldCode="AR" term="%22Lizana%2C+Pablo+A%2E%22">Lizana, Pablo A.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9366-6930">0000-0002-9366-6930</externalLink>)
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  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Anatomical+Sciences+Education%22"><i>Anatomical Sciences Education</i></searchLink>. Nov-Dec 2021 14(6):836-846.
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  Label: Availability
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 11
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2021
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Animals%22">Animals</searchLink><br /><searchLink fieldCode="DE" term="%22Laboratory+Procedures%22">Laboratory Procedures</searchLink><br /><searchLink fieldCode="DE" term="%22Chemistry%22">Chemistry</searchLink><br /><searchLink fieldCode="DE" term="%22Microbiology%22">Microbiology</searchLink><br /><searchLink fieldCode="DE" term="%22Tactual+Perception%22">Tactual Perception</searchLink><br /><searchLink fieldCode="DE" term="%22Color%22">Color</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Sciences%22">Health Sciences</searchLink><br /><searchLink fieldCode="DE" term="%22Biology%22">Biology</searchLink><br /><searchLink fieldCode="DE" term="%22Anatomy%22">Anatomy</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1002/ase.2042
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1935-9772
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: One of the most widely used solutions to fix and preserve organic tissues is formaldehyde, despite reservations regarding its toxicity and the fact that formaldehyde-embalmed bodies lose their original characteristics. Anatomy laboratories have been replacing formaldehyde with solutions that retain the characteristics of fresh tissue. For this purpose, alternative solutions with a very low concentration of formaldehyde or without any formaldehyde have been analyzed. The objective of this study was to compare biometry, coloration, haptic properties, and bacterial load on animal specimens (pig kidneys) embalmed with formaldehyde, and with Chilean Conservative Fixative Solution with and without formaldehyde (formaldehyde chCFS and formaldehyde-free chCFS). Also, the perception of health and biological science students toward specimens treated with different solutions was assessed. The results indicated that there were no significant differences in specimens' retraction, or bacterial load. Students showed a preference for organs embalmed in formaldehyde chCFS and formaldehyde-free chCFS; indicating that with these treatments they could better visualize structures and that the prosections had greater flexibility and the colors were more similar to those of fresh tissue. Additionally, students recommended the material embalmed in formaldehyde chCFS and formaldehyde-free chCFS for anatomy learning. In contrast, students indicated that formaldehyde-fixation negatively affected their practical experience. In conclusion, embalming with formaldehyde chCFS or formaldehyde-free chCFS provides an advantageous practical experience over the use of formaldehyde and may be an alternative to replace the use of formaldehyde in anatomy laboratories.
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  Label: Entry Date
  Group: Date
  Data: 2021
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  Label: Accession Number
  Group: ID
  Data: EJ1318923
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        PageCount: 11
        StartPage: 836
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      – SubjectFull: Animals
        Type: general
      – SubjectFull: Laboratory Procedures
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      – SubjectFull: Chemistry
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      – TitleFull: Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys
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