FSE2120 Restorative Art Study Guide 3.1

Describe first, second and third degree burns.

1st- redness of the skin. 2nd- acute inflammation of the skin and blisters. Hair may be singed or completely burnt. Eyes and lips may be swollen. 3rd- destruction of cutaneous and subcutaneous tissues.

Define a laceration.

A wound made by tearing the flesh varying from small scratches to deep jagged tears.

When do you pull a single intradermal taut, after each "bite" of the suture OR after the entire suturing is completed?

After the entire suture is completed.

Describe the restorative art treatment for skin slip.

After the freed tissue is removed, a cavity fluid compress is placed across the raw tissue to achieve surface preservation and dryness. (At the time of dressing, the area may be seared with phenol, if necessary; then painted with a liquid sealer.) When the derma is exposed to air, it turns hard and brown and should be treated as an abrasion.

What is an abrasion?

An injury caused by scraping of the skin.

Once a body with an abrasion has been embalmed and the area is smooth, what are the restorative art procedures for treating the abrasion?

An opaque cosmetic undercoat may be applied to the abrasion to hide the dark color, wax is applied overtop.

Describe the first treatment, following embalming, for an abrasion with small protrusions.

Any small irregularities that protrude from the abrasion should be removed after embalming so they do not protrude through the wax needed for restoration.

The type of suture in which the ligature is crossed over the wound and then a perpendicular suture is made to those original sutures in a crossing pattern to lock the suture together.

Basket weave

When are temporary sutures normally used? ... and for what purpose?

Before embalming to hold retracted surface tissues in position when the margins of non-linear cuts/gashes do not meet.

What is the restorative art treatment of a second degree burn?

Before embalming, blisters should be punctured. The face should be densely covered in massage cream. When there is extensive blistering, cavity fluid packs and hypodermic injection will be required because coagulation of the superficial tissues is likely. After embalming, loose skin should be peeled away and packed for several hours and treated as an abrasion later. If the lips and eyes are swollen, they may be reduced surgically immediately after embalming. If the hair is singed but the mass remains, it may be darkened with an eyebrow pencil to create the effect of greater density. If the hair is too short, it may be shaved and restored. Badly burned hands can be covered in gloves and placed at the sides of the deceased.

Describe the process of waxing the lips on a normal case.

Before embalming, the lips are heavily creamed. Scabs and fever sores are removed after embalming. The color of the wax will depend on the area involved (mucous membranes or integumentary lips). Place wax on each lip and blend into the surrounding area with a spatula or place a cylinder of wax in the separation and smooth into the mucous membranes. Be sure to recreate the medial lobe and vertical sulci.

Define compound fractures.

Broken bones which lacerate or puncture the skin.

If a person exhibits a large deep cut on the face, what restorative art treatment would be recommended?

Cauterize the area so it is dry. Place incision sealer powder in the incision for leakage precaution then the cut can be sutured using a hidden stitch.

What is the restorative art treatment, following arterial embalming, for a small cut (clean incision) on the face of a deceased?

Cauterize the cut and dry if it is moist. Since the margins can be realigned, the cut can be closed with an instant bond adhesive.

Another name for Skin slip.

Desquamation

If a person dies having a gash on the side of his/her head, what is the restorative art treatment for this gash? Assume a gash means that the tissue no longer aligns as in an incision.

Dry the inside with cauterant pack, use massage cream on surrounding tissue, after embalming dry and seal, pack with cotton and sealing powder, remove dehydrated skin from edges, use basket weave if necessary and apply wax to make level with surrounding surface, reproduce pores and facial lines, cosmetize.

Describe a temporary or interrupted suture.

Employed to hold retracted surface tissues in position, they are individual stitches which are knotted and cut immediately. They may also be used to attach a switch of hair to the cranium.

What is the restorative art treatment for a puncture wound?

First scabs are removed and the skin is heavily creamed. Any dehydrated marginal tissue may have to be excised. The hole is plugged with cotton while embalming and is later replaced and painted with liquid sealer to form a firm base for the wax. Where necessary, hair may be attached directly to the wax.

Another name for temporary sutures.

Interrupted sutures.

What is the most unique aspect of the double intradermal suture?

It is made with 2 needles and one thread.

What is the restorative art treatment for a small separation between the lips?

Lips should be topically treated with massage cream to prevent dehydration, separation can be treated with hypodermic tissue building, or waxing.

Describe the treatment for mold on a disinterred body which is being prepared for viewing.

Mold must be removed and fungus must be destroyed. Affected parts will be depressed and the air turns it brown. It may be treated like an abrasion; as necessary, it is dried chemically and coated with liquid sealer. A cosmetic undercoat may be applied before waxing. If the surface cosmetics are not in good condition, they can be removed with a solvent and new application may be made before waxing.

Describe the single intradermal suture.

Place the needle through the skin from surface to deep. Suturing on opposite sides of the incision in an alternating pattern never breaking the surface of the skin (only passing through the dermal tissues) other than the initial puncture and the final puncture. The two protruding ends of ligature (at opposite ends of the incision) are pulled simultaneously *after* the suturing is complete to close the incision. This is a hidden stitch because it is used on exposed areas and is directed through subcutaneous tissues only.

What are the basic steps of a restorative art treatment for any compound fracture of the head or face?

Re-align the bones; replace any missing tissue with wax; treat as a gash or laceration.

Define skin slip.

Separation of the epidermis from the derma that is caused by decomposition.

If a body has a cut with the skin on each side of the cut dehydrating and becoming discolored and hard, what should be done prior to incision of the cut?

The browned (dehydrated) tissue should be excised prior to suturing.

What is the treatment for a person who died with third degree burns in which the face is charred beyond recognition and viewing is not possible?

The embalmer must limit himself to deodorizing and preserving the tissues which remain.

What is the restorative art treatment for a first degree burn?

The face is covered with massage cream to inhibit dehydration during embalming. *After embalming, corrective cosmetic treatment is all that is necessary*. Superficial inflammations may accompany 1st degree burns and can be treated with external pressure during embalming.

Describe the restorative art treatment for a decapitation case, where the facial bones are still intact.

The head and trunk are embalmed separately. The deep tissues that are torn and the jagged edges of the stump of the neck are trimmed. A long wooden dowel or metal rod is inserted into the vertebral column and the foramen magnum to connect the head and torso back together. One or two sharpened short splints may be inserted into anterior parts of the neck and forced into deep muscular tissues. A series of sutures are made in the muscular tissues and finally skin margins are sutured and the area is filled with wax to correct surface contour. Plaster of Paris may be employed to fill out contours of the neck. Liquid sealer may be necessary to form a firm base for the wax.

What degree are all burns that result after death occurs?

Third degree burns.

Describe the purse string suture.

Used to secure the margins of small holes in position; A series of small stitches through the derma is made around the circumference of the opening. The ends of the thread are knotted within the opening. A small excess of thread is permitted to remain.

When is the basket weave suture employed?

When contact of the margins is not possible. i.e- *deep wounds or excisions*. This will maintain the position of the margins and provide an anchor for the wax.

When is the purse string suture employed?

When there are small holes such as one made by a trocar for aspiration.

When is the worm suture employed instead of the intradermal suture?

When there is excessive surface tissues.