August 2017

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Page A24 AUGUST 2017 FUNERAL HOME & CEMETERY NEWS S ec t i on A
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By Matt Black
Embalming
Tips & Tools
The Importance
of Hands (Part 8)
As we continue to discuss pre-embalming treatment we
will focus this installment on treating skin slip and edema-
tous conditions of the hand.
When planning and executing a pre-embalming treat-
ment, the embalmer’s primary objective must always be
preservation. Without a solid foundation of good preser-
vation, family satisfaction at the viewing is simply not a
guarantee. Unless you have taken the required steps and
laid a good foundation for preservation, what happens to
the body when it leaves the prep room is a gamble at best.
Additionally, cosmetic treatment and restoration are very
difficult if you are not starting out with good preservation
base. Simply stated: preservation before coloration. Case
analysis is the key to success as there are many factors to
consider regarding the hands. As always, we are not merely
treating the symptoms. We must eliminate the underlying
cause of the condition.
At times we are challenged with skin slip on the hands.
Skin slip is defined as the separation of epidermal skin
layer from the deeper layer of the dermis. This condition
causes the epidermis and dermis to separate causing peel-
ing and slipping away of the epidermis leaving the under-
lying dermis exposed.
To review, the skin is composed of two distinct layers.
The epidermis is the outer layer that continually renews
and the dermis is the underlying layer of the skin. Some-
thing unique to remember about that skin is that it is the
largest organ of the body. Its purpose is to protect the body
against outside sources.
Generally, skin slip on the hands indicates a high form-
aldehyde demand embalming case. Skin slip is a tell-tale
sign that decomposition is present. Other signs that may
be present include odor, purge and gases. Specifically, skin
slip is the result of accumulation of liquid, gases and putre-
faction. A common issue seen with skin slip on the hands
is the presence of edema, blisters and color changes result-
ing from advancing decomposition and the putrefaction
of the proteins.
Thorough cleansing and disinfection of the localized skin
slip on the hands should be a top priority. This can be per-
will lead to enhanced preservation and cosmetic applica-
tion versus a “let’s wait and see” approach to treatment.
A problem seen with increased frequency is gross ede-
ma in the hands. Just imagine a hand that is three times
its regular size and leaking with very fragile skin. As em-
balmers, we must foremost be concerned with preserva-
tion. Since preservation is difficult, we will use a multi-
approach technique employing surface embalming prior
to embalming.
Position hands high to allow for gravity to work natu-
rally. Thorough cleaning and disinfection of the hands
is important. This can be performed with a topical em-
balming spray and a germicidal soap. Care must be taken
when washing because the skin is very delicate in gross
edema cases of the hands.
Frequent reassessment of the initial case analysis is rec-
ommended as the embalmer judges if arterial preserva-
tion is being achieved. A common complication with
gross edema is difficulty with circulation and high pres-
ervation demands. Again, we must remember that a pre-
served, firm and dry tissue is needed for restoration and
cosmetic treatment.
This treatment involves painting the entire hand area
with a formaldehyde preservative gel and should be
planned as a multi-step approach done prior to, dur-
ing and after embalming. This is an effective option that
causes very little bleaching effect. However, very little
cauterization of the tissue should be expected if leakage is
present.
An effective technique mentioned earlier used for dam-
aged tissue in various cases including hands and else-
where is painting the entire hand a with a super gel mix-
ture.
Employing these pre-embalming treatments, the em-
balmer may anticipate a greater opportunity for preser-
vation allowing for more effective cosmetic application
to achieve a natural appearance and family satisfaction.
In our next installment, we will continue the discussion
of hands but moving forward to the embalming process.
formed with a topical embalming spray and germicidal soap.
Puncture any blisters that are present and allow them to
drain. Examine the entire body thoroughly as blisters may
be present anywhere including backs of legs, arm pits, feet,
genitals, etc. It is very important to puncture all of the blis-
ters that are present. This can be accomplished with a trans-
dermal needle injection into the blister in a fan like manner
allowing drainage of liquid during pre-embalming treatment
and arterial injection. The removal of all loose skin should be
performed carefully trying not to damage normal undamaged
skin.
Spraying the entire hands with humectant arterial injection
accessory chemicals or massage cream is also a must. This will
help condition the skin that is not damaged and offer it some
protection. Re-spray with topical embalming spray.
Frequently, the initial case analysis needs to be reviewed and
a reassessment needs to be made to see if arterial preservation
will reach these areas hands damaged by skin slip. A normal
presentation of skin slip is difficulty with circulation and high
preservation demands. We must remember we need to pre-
serve, firm and dry out tissue for restoration and cosmetic
treatment.
When skin slip of the hands is present, a popular treat-
ment has been painting the skin slip areas with a formalde-
hyde preservative gel. This approach should be done in three
steps including pre-embalming, during embalming and after
embalming. This technique is effective and this approach has
very little bleaching effect on the skin. A disadvantage of this
approach is that there is very little cauterizing action from
these preservative gels in general.
Another pre-embalming technique to consider is the use of
a phenol/ non-phenol cauterant pack wrap or a non-phenol
cauterant gel on the skin slip areas. After coating the area with
the gel, it is covered well. Treatment with the gel has a dual
benefit of bleaching the affected area and cauterization of the
tissue.
A popular technique used to treat severe skin slip that can
also be used in the “normal” case is painting the damaged ar-
eas of the hands with a super gel mixture. Super gel is a phrase
popularized by embalming speaker Jack Adams and defines a
mixture of formaldehyde preservative gel and a phenol liquid
cauterant mixed in stainless bowl. This mixture can be then
used as pack or painted over the burned area. After painting
it on the area, the area is then covered. This allows for bleach-
ing, preservation and cauterizing of the area.
These pre-embalming treatments for skin slip of the hands
Matt Black has been a licensed funeral director and embalmer
in the State of Pennsylvania for over 20 years. He represents The
Dodge Company in Central and Western Pennsylvania. In addi-
tion to being a graduate of the Pittsburgh Institute of Mortu-
ary Science, Matt also holds degrees in Bio-Medical Engineering
Technology and Industrial Management. Matt has also attended
the Fountain National Academy of Professional Embalming Skills,
Springfield, MO, and is licensed in eye and corneal enucleation. He
has presented at Dodge Embalming Seminars as well as numer-
ous local seminars in Pennsylvania. He can be reached by email at
Funeral Home & Cemetery News
Contributors share insights and
exchange ideas. B
Of Drones, Autonomous Vehicles, and Cremated
Human Remains
choose that option? If Uber will use autonomous vehicles in
place of taxis, can our profession use autonomous vehicles in
place of our hearse, limousine, or body transport fleets?
Consumer trends point to greater acceptance of drone us-
age – it’s up to us to adapt that usage to our profession. Au-
tonomous vehicles are still in their infancy, however it’s not
too early to begin thinking about how to apply that technol-
ogy to our supply processes and service delivery models.
More than anything, the Amazon-Whole Foods acquisi-
tion positions tech companies as the dog that wags the tail
in our 21st century marketplace. Our profession is not ex-
empt from this fact. Cremation trends, consumer preference
trends, (and environmental concerns) empower innovative
and visionary colleagues to adopt and adapt technology as-
sets that streamline our processes, allow for greater consum-
er engagement on their terms, and position our businesses
for long-term relevance and environmental sustainability.
Darrell W. Hill is the founder and CEO of Eternity
Gardens. Eternity Gardens is building the largest, most
comprehensive on-line listing of cremation, memorial, and
scattering gardens for cremated human remains. Email Dar-
rell at
Antonietta Cuoco honored by Boy Scouts of America
BRIDGEWATER,NJ— Antonietta Cuoco, Funeral Di-
rector at Bongiovi Funeral Home and Somerville
Funeral Home, was honored with the “2017 Tribute
to Women Award” by the Boy Scouts of America, on
May 12, 2017 in Gladstone, NJ.
Cuoco attended Georgian Court College, Lakewood,
NJ, and received Certification in International Eco-
nomics. A 2001 graduate of American Academy McAl-
lister Institute of Funeral Service, Cuoco first joined the
staff at Bongiovi Funeral Home of Raritan in 1990,
and together with Anna Louise Bongiovi, opened
Somerville Funeral Home 10 years ago.
Cuoco is the Vice-president, and former Secretary,
of the Middlesex and Somerset County Funeral Direc-
tors Association, past Vice President of Immaculate
Conception School Board Advisory (2006-2012), a
member of the National Funeral Directors Association,
Somerset County Federation of Republican Women
(SCFRW) and the Somerville Elks.
Bongiovi, who is a past re-
cipient of this award, intro-
duced Cuoco with a speech
about her friend and col-
league. “Many years ago, she
came to work alongside my
father, who considered her
like a granddaughter. The
three of us created a won-
derful working environment
in a place where sadness pre-
vails on a daily basis. Her
special dedication is the ar-
rangements for infants and
children, donating her time Antonietta Cuoco
and services. She was blessed to be so caring and able to help
families. She’s the daughter I never had.” Cuoco is support-
ed by a loving family, including her husband and daughter.
Congratulations to Ms. Cuoco on her achievement.