2022 VCOM Research Retreat Program

Abstracts

Presenter: Marilyn Malia, DO Co-Authors: Teresa Kilgore, DO

Preventing Mold in the Anatomy Lab Presenter: Tiffany Carpenetti, PhD Co-Authors: Aaron Beger, PhD Maintaining formalin-fixed cadavers through an entire year of dissection is challenging at best. Of the many trials faced, including fluid management, desiccation, and unique donor characteristics, mold is a constant threat. Our lab employs mold abatement procedures that vary depending on the extent of the spread. Superficial mold is treated with either 50/50 phenol/ethanol or 10 percent formalin on a cloth compress. Extensive spread is treated with both compresses and injections of Trinity Long Term Preservation (LTP) fluid, an arterial fluid containing a proprietary ratio of ethanol, formaldehyde, ethylene glycol, and glutaraldehyde. In addition to treating mold on the donors, body bags are cleaned with Cavicide – a quaternary ammonium disinfectant. Overall, the efforts to treat and prevent mold are based on experience and conjecture, with no history of controlled studies to support the protocols in place. To determine the most effective method of killing mold and preventing spread, mold was cultured from a donor and exposed to six disinfectants currently employed in the anatomy lab: Lysol (both concentrated and diluted 1:20 with tap water, which is used as a wetting solution), Trinity Wetting Solution, Trinity LTP fluid, Cavicide, Dis-spray (a disinfectant employed funeral homes), and a hydrogen peroxide-based disinfectant. Potato dextrose and Sabourand plates were inoculated with mold, and 7mm circles of filter paper were saturated with one disinfectant or tap water as a control and evenly spaced over the plates to determine inhibition levels. Of the six, only Dis-spray successfully prevented mold growth, with an established zone of inhibition that persisted for at least fourteen days. Additionally, a sample of the mold was sent to a medical microbiology facility for potential identification. Based on the results of this experiment, mold treatment and prevention strategies in the anatomy lab will include Dis-spray as a first-line defense. In 2016 the American Medical Association eliminated pain as a "fifth vital sign". In the same year, Morbidity and Mortality Weekly reported opioid-involved drug overdoses to be the most common cause of accidental death nationally. Presently, the opioid epidemic is a public health crisis with sufficient magnitude to impact the overall life-expectancy of the aforementioned population. The future of healthy and individualistic pain management in a variety of clinical settings requires considerations which update approaches to acute and chronic pain as the medical culture in the United States attempts to address the opiate epidemic, including an objective approach to pain. A search of computer databases was conducted from EBSCOhost including MEDLINE, as well as federated library search engines. Selection criteria was constrained to peer reviewed medical journal articles published between 1980 and 2022 relevant to the objective of this analysis, with an emphasis on contemporary articles. This review found that there is a plethora of considerations that may be effective in reducing the incidence of iatrogenic addiction and decreasing overall opioid use. Additionally, the literature revealed methodological errors in prior studies evaluating interventions which were not habit forming. A critical review of the literature explores the history of medical opioid use, the pharmacological spectrum of pain management, efficacy of available complementary and alternative medicine (CAM), psychological factors, the avoidance of iatrogenic addiction, and ultimately an objective approach to pain. Systematic Review of Pain Management with Proposed Non-opioid Treatment Algorithm and Objective Pain Measures