Monday, September 7, 2009

Process is key.  Once you know the rules of a process you can effect continous change with no continuing attention.

Virtual reality approaches objective experience by the creation,design and operation of rules. The greater the detail in rules, the deeper the  reality.

There is no ultimate speck of matter but only a rule or process at work. At all levels until the vacuum origin, the universe(s) is process, a series of rules,  
e.g.                                                      

 on/off    
yes/no    
0/1
  
and by combination of these selections facilitating  greater and greater choice and thereby complexity.


Yet it remains the vacuum.

TRICKS OF THE TRADE
MOUTH CLOSURE

Properly set features are vital to the best appearance of the deceased. A little care exercised during this phase of preparation will help ensure a good final outcome.

First relieve the rigor mortis if present, and then disinfect. If you do not disinfect the oral cavity, after the case has been embalmed a greenish or dark look can form around the mouth. This is a most important step that most embalmers never take the time to do. To disinfect, the Champion Company makes a product called Metriguard (a bactericidal, fungicidal, viricidal, pseudomonacidal and tuberculocidal disinfectant). It works better than any other product on the market today. You should always remove dentures before disinfecting the oral cavity; also clean and disinfect the dentures before replacing them.



Next, clean and dry the mouth, and pack the throat with some cotton with massage cream on it. This will help prevent the cotton from acting as a wick and help control purge and odor arising from the stomach or lungs.



Examine the lips and clean and remove all loose skin. Dodge makes a product called Dry Wash, which works great for cleaning off the lips. If the lips have scabs, massage cream will help in loosening them so that removal is easier. Observe the “weather line;” remember your basics you were taught in school. The expression of the deceased can be one of the most criticized areas of the embalming.



Secure the mandible. There are many different ways to do this, and I believe it is a personal choice of each embalmer. However, as a trade embalmer, I believe it is best to suture the mouth closed. You never know who might get your case ready; many unlicensed preparers have the tendency to drop the head back, and, when using the needle injector, the mouth will pop open. If this occurs, the embalmer will be told that his job wasn’t satisfactory. It will never be the fault of the person dressing and bouncing the body around; it will only be the fault of the embalmer. This is also why I prefer a full macue, or, as they call it today, a Mandibular Suture.



A mandibular suture is made by opening the mouth, inserting a threaded needle (I prefer black thread, it is less obvious) at the center of the mouth, at the base of the tongue behind the lower teeth. Push the needle downward, exiting about an inch or so past the point of the chin (see diagram below), and come out in the soft tissues on the base of the chin (NOT as close to the sunmandibular area as most have been taught - that’s the reason most of you have big dimples when suturing a mouth). Reinsert your needle into the same small hole at the base of the chin and guide your needle upward carefully, just in front of the left side of the center of the mandible (feeling or scraping the mandible with your needle as you go upward). You will then come up in front of the bottom teeth, where the lip attaches to the gum. Now the suture has passed completely around the mandible. Next, gently pull on both ends of the suture string (in a sawing motion) so you will saw through the soft tissue until it reaches the mandible. Place the palm of your hand under the chin and push it up with a forward motion from the neck to the chin. This will help you to not dimple the area.



Now you can insert your threaded needle into the left nostril at a point where the upper lip joins the maxilla under the nostril. Make sure you keep your needle as close to the bone as possible. Direct the needle into the opening of the nostril, making sure you don’t come out into any flesh (if you come out into the flesh this will cause a pulling of the nose, a big no-no). Then repeat the same step on the right nostril except, after you come out into the opening of the nostril, pass your needle trough the septum (as low as possible) of the nose, and come out the opening of the left nostril. I personally prefer to go from the right side to the left so that my liguature is tucked away in the non-viewing side of the nose.



Use your hand to hold the mandibile up into place (do not use your string alone to pull the jaw up), check out the postionings of your mouth closure, and, when you have it at the proper position (the mandible doesn’t have to always be pulled all the way shut for a good mouth closure), then tie off both of your free ends of the suture string in the nose to hold it gently snug. Place some Vaseline or massage cream on the lips to help hold them in place. It also helps to keep them moisturized while embalming. Tie your suture in a bow. I leave my string hanging out of the nostril while I am embalming so that if I need to adjust the mouth closure again after I am done embalming, I can do so.



When I have completed my embalming, I tuck the string down into the nose so it won’t be seen; then, if an adjustment is necessary, one can be done. Also, place a dab of massage cream on the hole you made under the chin so that dehydration won’t occur. This hole can be waxed in very easily when cosmetics are done.

Jon Snyder, author of this month’s tip, wishes to acknowledge the work of Mr. Bob Mayer, embalmer and textbook author, for some of the information contained in this description of correct mouth closure. The illustration used is from the textbook The Principles and Practice of Embalming by Clarence G. Strub, L.E. and L.G. “Darko” Frederick, L.E.-L.F.D.



 Things are good and the future looks bright.



Onset is from 10 minutes to several hours, beginning with facial muscles. Greatest stiffness may be 12-48 hours after death, and rigor mortis may last up to 72 hours. The bottom line is that the muscles remain contracted until they start decomposing.

No comments:

Post a Comment