2. INTRODUCTION
Importance of Body Donation
Every human body is a source of knowledge with anatomic variations and a medium for
gaining knowledge more than any textbook or computer. The concept of body donation has
evolved over centuries and there are still considerable discrepancies among people
regarding how human bodies are acquired and used for education and research.
Many countries have well-established donation programs. In contrast, there are countries
without donation programs that use unclaimed bodies or perhaps a few donated bodies
instead. In several countries, the use of cadavers for dissection is unthinkable for cultural or
religious reasons.
Against this background, successful donation programs are highlighted in the present
review, emphasizing those aspects of the programs that make them successful. There are
also uses of body donation such as cadaveric banks for the brain, and skin, a vessel for
molecular research, and cadaveric grafting.
In the western world, State and/or institutional Anatomical Donation Programs (ADPs) are
tasked with the responsibility of acquiring body donors for basic and clinical science
curricula. To ensure those body donors are ethically acquired and suitable for anatomy
education, ADPs develop and implement policies that address requirements for body
donation and the use of body donors.
In present times, Cadaveric dissection is not only limited to medical graduates and
postgraduates but also helps various surgical disciplines (neurosurgeons, plastic surgeons,
ortho surgeons) to explore the human body realistically before performing any complex
surgery on patients (Ajitasingh et al.,2007).
3. BODY DONATION AND CADAVERIC
AVAILABILITY DURING COVID-19
With the emerging research regarding COVID-19, many medical
scientists have unanswered puzzles about the consequences and
influence of body donation on teaching. This pandemic has indeed
raised many more questions for the medical academia across the
globe regarding receiving of the bodies and nonidentified bodies.
When one is not very sure whether such bodies are affected by
COVID-19 or not, the department dealing with embalming of such
bodies faces a major risk thereby causing concerns for the medical
students as well. Not much literature do we find on the acceptance or
rejection of dead bodies during such a pandemic(Rajashekhar et
al.,2021).
The risk of Covid-19 infection from an infected donor is unknown at
this time and needs proper screening before being donated and used
for teaching purposes. The complete lockdown applied to dissection
rooms is not justified by scientific evidence and represents a break
of the confidence deposed in the institutions by the donors.
4. A consensus is required for the adoption of a renewed, comprehensive protocol for present
and future body donations including the evidence the Covid‐19 pandemic has contributed to
creating. Cadaveric dissection is one of the methods of training hands and fingers for future
surgical procedures on living human beings (Ajita R et al.,2007).
It gives students a real-time learning experience and helps them develop surgical skills at a
very early stage, whereas virtual cadavers provide realistic visualization of 3D anatomical
details. Safety measures, physical distances, and regulations imposed by the government
worldwide due to the outbreak of the Covid‐19 pandemic caused sudden and deep changes
to anatomical education, forcing lecturers and students to rapidly switch their approach
from in-person to online learning.
It is indispensable for a medical student despite the hindrances caused in the procurement
of cadavers due to the ongoing COVID-19 pandemic. So, it is incumbent on the medical
schools to seek means to procure an adequate number of cadavers to cater to the needs of
medical students in various courses.
Acknowledging the personal and institutional impact of the SARS‐CoV‐2 pandemic and the
worldwide spread of a novel infectious disease, a national survey was conducted to
examine the current effect of the pandemic on ADP protocols, and body donation, and the
sustainability of ADPs in the United States (U.S.)It was observed that almost all ADPs
reported that the pandemic has affected their ADP operations in some way.
The majority of the ADPs that accepted body donors did so only after the implementation
of a SARS‐CoV‐2 screening process, and half of ADPs reported a decrease in the number
of body donors received (Cumber et al.,2021). With all the above-mentioned aspects we
have considered, it goes without saying that body donation is reduced compared to normal
times during the pandemic affecting the teaching process
5. RESPECTING THE CHOICE AND RIGHT OF THE
INDIVIDUAL
Certainly confirmed body donors who have voluntarily come for donation and
have received donation cards, have a moral right to donate. The emotional
aspect and individual's will must be respected even during the hard pandemic
time.
EMERGING TECHNIQUES FOR TEACHING
It is imperative to keep in mind the challenges and face them with this situation.
The pandemic has posed several challenges to medical education (e.g.,
suspension of face-to-face teaching, lack of cadaveric dissections, and
practical/laboratory sessions) but has provided many opportunities as well, such
as the incorporation of online learning in the curriculum and upskilling and
reskilling in new technologies (Uma Gaur et al.,2020).
Learning anatomy with virtual dissection is unrealistic. The feel of touching the
cadaver, incising the skin, and looking into the natural complexities of the body
cannot be simulated perfectly. So, these newer technologies can be used as an
add-on to visualize the anatomy of complex structures.
One has to consider, given the situation whether the possibility of real cadavers
is to be replaced by virtual cadavers. One study revealed that such a possibility
remains viable however, the impact and the results may not be satisfactory.
6. Having said all these, as the time with global
digitalization keeps changing, anticipating pandemics of
this sort, the world should be prepared for entering in to
the review of teaching methodology in medical schools.
Some possibilities for effective teaching may be
considered which are given below :
Cadaveric videos with in-person dissection sessions for a
better understanding of the students.
Implementation of audio podcast.
The use of emergent technology (e.g., artificial
intelligence for adaptive learning)
The use of social media platforms (such as Twitter) can
help effectively network with larger academic
communities.
Transition to hybrid style labs.
7. SCREENING PROTOCOL FOR BODY DONATION
DURING COVID-19 PANDEMIC
Infection prevention guidelines for Covid-19 must be
followed. Screening protocols that must be followed are
as follows:
1) Information regarding the history of the
patient(whether the patient was symptomatic)
2)RT-PCR (within last 48-72 h); Rapid antigen test is not
preferred
3)Vaccination status of the deceased
4)History of COVID-19 among the family members
8. PROCEDURE FOR A DONATION OF A HUMAN
DEAD BODY
The concerned individuals who are interested in
donating their bodies or bodies of their known after
death are required to duly fill up a form which
includes-:
1) Information about the deceased
2) Information about the applicant
3)Undertaking by the applicant
9. MEASURES WHILE HANDLING A SUSPECT OR
A CONFIRMED CASE OF COVID-19
The augmented risk of Covid-19 contamination from a dead body to health care
professionals who follow standard precautions while handling the body is unlikely.
However, healthcare workers identified to handle dead bodies in the isolation area,
mortuary, ambulance, and crematorium should be trained concerning best infection
prevention and control practices. Some preventive measures are:
1)Hand hygiene
2) Use of PPE kit
3)Use of head covers, shoe covers, surgical masks, goggles, face shields, waterproof gowns
4) Drains and tubes to be removed
5)Disinfection and dressing of punctured holes with impermeable material.
6)Guidelines also advise keeping the dead body in a leakproof plastic body bag. The
exterior of the bag can be decontaminated with a 1% sodium hypochlorite (NaOCl)
solution.
7)Mortuary personnel managing the dead body of Covid-19 patients are advised to observe
standard precautions like storing the dead body in coolers maintained at approximately 4
degrees Celsius (4°C), disinfecting environmental surfaces, instruments, transport trolleys,
and cleaning the doors, handles, and floor with sodium hypochlorite 1% solution after
removing the body (K.S. Ravi et el.,2020)
10. EMBALMING FLUID(USED DURING COVID-19
TIMES)
TOTAL VOLUME: 11 liters
Formalin: 583 ml
Spirit: 6875 ml
Double distilled water: 528 ml
Phenol:737g
Glycerol:2277 ml
