Pre-embalming analysis of the arms and hands is a very important focus for embalmers. In our last issue we discussed just how important the hands are.

  Once the body reaches the prep room, it is necessary for the embalmer to do a case analysis with a focus on the hands and arms. Special arterial embalming treatments may be necessary depending on condition of the hands and arms. As we know, the embalming process will fix the proteins and we do not want to do that in the pre-embalming analysis.

  Case analysis of the hands is necessary because each case presents its own level of difficulty. Common problems the embalmer may encounter include: edema, emaciation, dehydration, skin slip and post mortem discoloration.

   Addressing these situations begins with disinfection of the hands and arms.

•     Thorough washing, cleaning and disinfection of the hands and arms can be done with topical embalming spray and a germicidal soap.

•     Unnatural stains on the tissue such as dirt, grease and topical medicine residue should be removed. Embalmers should pay close attention to personal identifiers from the tobacco stained fingers and stains from mechanic hands. It’s always wise to ask before removing these stains. The family could have special connections to these stains on the hands.

•     Embalmers frequently overlook and fail to remove dried blood, fecal material, grit and other substances that can be found under the nails and on the hands. This area is a breeding ground for bacteria, odor and the start of decomposition which is the enemy of the embalmer.

•     This cleaning process can be performed with a germicidal soap and a nail brush. An orange stick or the tip of a nail file work well to remove debris from under the nail. Cleaning under and around nails before injection is much easier than waiting until after you have done the arterial work. When cleaning the debris from under the nails, great care should be taken not to damage or puncture the skin.

•     Trimming and filing of the fingernails is also very important. Removing existing fingernail polish is recommended at this time. Nail polish can be removed with acetone or non-acetone remover, and hydrocarbon solvent. An acetone base will remove tough polishes more efficiently. An effective technique for removing glitter or gel coat polishes is to place a soaked cotton pad over the nail and wrap with aluminum foil for a few minutes. This loosens the polish for easier removal. A fresh application of polish can be applied after embalming.

•     The cuticles can be softened with massage cream or humectant injection accessory chemical. They can be trimmed or pushed back with an orange stick.

  After cleaning and disinfection of the arms and hands, you should focus on rigor mortis in the arms and hands. Although up to now you have been working with the arms and hands, trace amounts of rigor mortis can still be present. The rigor mortis can be removed through repeated manipulation, flexing and massaging of the hands, fingers, wrist and arms. However, avoid excessive manipulation of the hands and arms. This could damage capillaries and cause swelling during arterial injections treatment. Recall that when rigor mortis is relieved in a dignified manner, better distribution and drainage can be expected during your arterial injection.

  Manipulation of the hands and arms will allow for a more natural hand posture and position. Positioning the hands is normally determined by local funeral home customs. For example, if it is customary in a given area that the hands are relaxed but cupped, you can achieve this by using either a towel or paper towels. Simply ball up the towel or paper towels and place them in the cupped hands. This eliminates the “straight as a board” flat appearance that we have all seen. It is an unnatural look and can be eliminated easily.

  It is common to apply massage cream or humectant injection accessory chemical to the hands and arms prior to embalming. This practice will:

•     Help relieve dehydration and will condition and protect the skin during the embalming procedure;

•             Assist with cosmetics techniques and a more natural look of the hands after embalming;

•             Provide a moisture layer and lubricating factor, helping with massage and manipulation of the arms and hands during embalming; and

•             Provide an extra layer of moisture to protect the delicate skin prior to embalming.

  Check with your mortuary chemical sales representative on the various uses for their humectant injection accessory chemicals. Not all humectant injection accessory chemicals are formulated for topical application. Some humectant accessory chemicals use animal fat lanolin as the humectant component while others use a chemical water soluble humectant. The water soluble humectants are more efficient as a topical treatment and as an arterial injection chemical.

  A spray applicator attached to a humectant injection accessory chemical to spray the hands and arms has been used by many embalmers over the years. The late Don Sawyer and present speaker Jack Adams have written and spoken about these techniques for many years. When used topically prior to and during embalming these humectant can:

•     Help control dehydration;

•             Restore cellular hydration;

•             Restore natural contour of skin such as the finger tips; and

•             Prevent tissue shrinkage.

  Embalmers who are not currently using humectant injection accessory chemicals as a standard component in preparation may be overlooking a simple yet highly effective means for enhanced results. Using massage cream or humectant injection accessory chemicals as a pre-embalming treatment allows the skin tissue to be more conditioned for cosmetics or further restorative work.

  Using humectant injection accessory chemicals as topical conditioner on the skin has become very popular. Spraying the chemical on the hands and arms as pre-embalming treatment will condition the skin.

  If the hands and fingers are greatly emaciated or dehydrated, soaking Webril toweling with humectant injection accessory chemical and wrapping the fingers and hands with the saturated Webril will help plump the fingers and hands. By allowing the chemical to work for about 30 minutes, the skin will be rehydrated. It will also help round the fingertips and will help restore pliability to the skin.

  As evidenced by the many and varied uses, it becomes clear that humectant arterial accessory chemicals are unique and can be very helpful. Many embalmers prefer a humectant injection accessory chemical that contains no oils, animal fats, lanolin or emulsified fat. These synthetic water soluble humectants work on a biophysical action.

  A few humectant injection accessory chemicals are unique because they can be used as an arterial chemical and a topical treatment chemical. Using a humectant injection accessory chemical that is designed as a topical treatment will control dehydration, restore cellular hydration, control tissue shrinkage, velvetize skin tissue for a more natural appearance and restore natural contour.

  Using a humectant injection accessory chemical as a topical treatment will improve the skin’s overall appearance and allow for more cosmetic foundation effects and a more natural appearance to the hands.

  In our next installment, we will discuss assessing the tissues of the hands, possible chemical interventions for bruising and discolorations, and the ever-present bruising that we see on the hands of the deceased on a daily basis.