Preliminary insights on high-fidelity embalming solutions for surgical skills training-An evaluation using the McMaster Embalming Scale and mechanical tests.

Simulation-based training is critical for surgical skill acquisition and typically uses soft-preserved body donors, as they represent high-fidelity models (vs. hard-fixed donors) with prolonged periods of preservation (vs. unembalmed donors). While many soft-embalming solutions exist, there remains no standardization between centers nor evaluation of the solution-associated tissue suitability for surgical skills training. The current study aims to remedy that by systematically comparing qualitative ratings (McMaster Embalming Scale [MES]) and quantitative tissue properties (biomechanical testing) of four differentially embalmed tissues (Surgical Reality Fluid, Imperial College London; soft preservation solution, Ethanol-Phenol, and Saturated Salt Solution) captured during analogous clinical and mechanical tests (chest tube insertion and anchoring, bone sawing and electrocautery). MES and mechanical testing results uncovered significant differences across both embalming solutions used and skills performed. Based on these findings and considering cost/safety/accessibility features, ethanol-phenol emerged as an optimal solution for embalming tissues for surgical skills. Still, in comparison to live tissues examined in published studies, embalmed tissues tend to require substantially more force to cut and pierce, which may account for the modest suitability rankings observed across all embalmed tissues. Overall, this suggests that while solution-specific differences exist, their performance is comparable enough to accept any of those tested as adequate models for surgical skills training-an optimistic outcome for laboratories looking to manage both performance and practical concerns during embalming solution selection.