In our last installment we spoke about the power of bleaching agents on dealing with bruises or stains on the hands or arms. I have found that not all embalmers want bleaching and cauterant products in the prep room. But these products are the most effective in bleaching from within the bruised tissue or topically as surface pack. Unfortunately, with the effectiveness of these phenol based products comes a few dangers to the embalmer. Phenol is highly corrosive to living tissue. An example of this danger is the use of phenol based products in a spray bottle for easy application. While convenient, this uncontrolled spray presents an increased phenol contact with skin and or eyes. Significant phenol odor and increased opportunity to breathe in dangerous fumes accompany this increased exposure.
A pre-embalming treatment to reduce the negative effects of the bruise or stain on the hands involves treating unstable tissue which could make cosmetic treatment easier. This treatment has become very popular to help alleviate stained areas and discolored tissues (bruises) and is recommended to be done prior to arterial injection to lessen the chance of preserving and fixating the blood within the bruise and surrounding areas and tissue. The vascular drainage of the blood in the bruised or discolored tissue area could be difficult to remove. Once the blood becomes fixated in these areas, a formaldehyde reaction with the hemoglobin in the blood could cause methylehemoglobin. This staining effect could be increased in darkness and intensity. The fixation effect from embalming will inhibit the true abilities of the bleaching action of these bleaching agent products. The bleaching procedure after embalming normally will become more difficult. These treatments are recommended as pre-embalming techniques because the main goal once we start embalming is preservation. Unfortunately, some embalmers have taken a stance of cosmetic coloration over preservation. Please do not let me confuse you; preservation is always the most important goal. We can cover any blemish with cosmetic but it might not look natural. Decomposition, on the other hand, is very hard to cover.
Bleaching products may be used as a surface pack (topically) if used prior to embalming to bleach these bruises on the hands or as a transdermal hypodermic bleaching injection, a treatment considered much more effective than surface packs by an increasing number of embalmers.
A bleaching surface pack has a tendency to alter the skin surface and dehydrate the tissue and this will affect the application of cosmetics and natural appearance of the hands. The bleaching action from a surface pack is normally an osmotic absorption from the surface. The skin itself presents a barrier for absorption of the bleaching agent unlike transdermal injection that works from within the bruised tissue. Depending on the severity and condition of the bruise, the surface pack of cotton or Webril saturated with a bleaching product may need to be applied for hours. The area around the bruise should also be conditioned with massage cream or humectant accessory injection chemical to prevent unwanted bleaching of normal tissue. The pack should be covered to prevent evaporation of the chemical and odor and chemical exposure. The evaporation of the chemical can be a huge negative of this technique. A bleaching pack will work but you need time and it is normally not as effective as a transdermal hypodermic injection.
Increased effectiveness of post embalming bleaching treatments may be obtained by interrupting (penetrate) the skin barrier of the bruised tissue allowing better penetration of the topical bleaching agents. Employ a very small gauge needle to puncture the skin and transdermally channel in a fan like manner into the bruised tissue.
A combo-technique that works very well is first use a transdermal hypodermic injection and then place a surface pack, all prior to embalming.
Never forget the importance of the hands in the overall appearance of the deceased. These techniques and treatments are used to minimize cosmetic application and allow for more natural appearing hands. Whether they verbalize their impressions or not, families take notice of the care that we as embalmers provide and the difference between a positive and negative impression is most often found in the details.
A new product that has been getting a lot of attention is phenol free and odor free cauterant and bleaching gel. This phenol free gel is innovative among cauterizing and bleaching products. The thicker consistency allows this product to stay in contact with the affected tissue. Using phenol free gel as a surface bleaching agent we will need time again. The same protocol used with a bleaching surface pack should be followed, except for covering the hands with plastic. Since this product is a gel and phenol and odor free, many embalmers do not cover the product when applied. The new bleaching agent and cauterant is an amazing product.
Arterial chemicals and cavity chemicals are not really recommended for bruise control techniques on the hands prior to embalming and post embalming. Arterial chemicals normally do not have the bleaching and penetrating powers as transdermal hypodermic or surface pack techniques. Arterial chemicals are not designed for these types of application. A cavity chemical could be used if a bleaching product is not available and is your last resort. Cavity chemicals are mainly made to preserve or dry, and are normally very astringent. The bleaching aspect of cavity fluid will cause the tissue to become very dehydrated. I have found if using a cavity pack or transdermal hypodermic technique to bleach a bruise you’re going to have trouble with cosmetics coverage and the tissue will look less natural.
In our next installment, we will continue the discussion concerning bleaching and cauterizing agents, as well as the treatments used for discoloration of fingernails.