Embalming is a funeral home procedure that prepares and preserves a body for an open-casket funeral and attempts to reduce the effects of various postmortem changes (75,76). Embalming leads to drying and hardening of soft tissues (75). Embalmed bodies eventually decay, beginning at pressure points such as the buttocks and legs, the areas least penetrated by embalming fluid (47,77).
After clothing is removed, the hair is shampooed and a man's face is shaved (76). The body is cleaned (76). An incision, usually in the subclavicular area, allows blood to be drained from the venous system and embalming fluid to be perfused, under pressure, into an artery (Fig. 39; refs. 75 and 77). Embalming fluid is a mixture of formaldehyde, anticoagulants, perfumes, surfactants to reduce surface tension and increase permeation of fluid, coloring agents, modifying agents (e.g., moisturizers or dehydrating agents), and solvents (alcohols, water, glycerine compounds) carrying the various embalming chemicals. Femoral and brachial arteries are also used (75,76). More than one access site has been seen (77). The incisions are sutured and absorbent powder or cotton is put into the incision base to prevent leakage (77).
To reduce gaseous distension, the abdomen is punctured near the umbilicus by a trocar that perforates the intestine (77). Other viscera are also punctured (Fig. 39; ref. 76). Injection of the scrotum may be done (77). Trocared hollow organs (e.g., heart, urinary bladder) are aspirated of their contents, and embalming fluid is injected into the body cavities (75-77). The trocar cutaneous wound is plugged with a button or sutured (Fig. 39; ref. 77). Sometimes a trocar is inserted directly into an extremity (77).
Cosmetics are applied to the face. Caps cover the eyes and the jaws are wired or sutured (77). Injection of "tissue builders" into the orbits and face, to lessen a gaunt appearance, may be done (76,77).
The body is reclothed. The backs of garments are cut to allow ease of dressing. Underlying plastic garments may be necessary to prevent leakage (77).
If there has been an autopsy, stabilizing metallic clamps are screwed into the skull and joined by wires (77). Cavities may be filled with material (e.g., cloth, paper towels) soaked in embalming fluid (77). A viscera bag may be present (77). Granular material inside the cavities consists of hardening or dehydrating compounds and embalming powders.
• Significance o The blood is unsuitable for toxicological analysis. Vitreous is an alternative (76).
° Blood coagulates, forming "pseudothrombi," and mimics pulmonary thromboembolism (Fig. 39; refs. 75 and 77).
° Injuries are simulated (75,76,78,79).
° Perfusion of embalming fluid can accentuate preexisting contusions or form postmortem bruises or hematomas (e.g., in the neck area) owing to vessel rupture (Fig. 40; refs. 75-77). The decrease in lividity from drainage of blood further enhances the appearance of real or artifactual bruises, which can be a source of consternation for next of kin and investigators (76).
° Trocar punctures affect not only intra-abdominal organs but also thoracic and pelvic structures (Fig. 39; ref. 75). Cases have been described of antemortem bullet wounds being covered by trocar buttons (75,76).
° Facial makeup can obscure trauma (Fig. 41; refs. 75 and 76).
° Eye caps need to be removed to observe ocular hemorrhage (76).
° Wounds can be altered (i.e., sutured [75,77,79]).
° Shaving can cause neck abrasions, simulating strangulation (76,77).
° Coloring agents impart a bright red appearance, mimicking carbon monoxide poisoning (76).
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