Safe practice in dissection What this guide is about The guide is a step-by-step method covering all aspects involved in the delivery of dissection activities in schools and colleges. The sections being: • • • • • Preparing for dissection Carrying out dissection activities Clearing away after dissection activities Disposal of materials from the dissection Storage of dissection materials and equipment Relationship to other CLEAPSS documents The guide gives details of measures that control the risks from sharp instruments and biological agents of disease (such as microbes and viruses) that occur throughout the preparation, delivery and disposal. The control measures are summarised in G267: Dissection a starter guide to health and safety. The details of how to carry out safe procedures for dissection of separate organs or systems in whole organisms, are found in other CLEAPSS documents, and are summarised in G268: Dissection, a starter guide to procedures. Preparing for dissection Obtaining and preparing the animal materials Animal materials that have not been preserved Fresh or frozen animal material should be obtained from premises licensed to sell them for human or pet consumption, or alternatively from a reputable biological supplier. In these cases, meat inspectors will have carried out tests to ensure that the products of only healthy animals are released for consumption. The tests do not remove all possibility of human pathogens being present, so good hygiene is essential when handling the materials. During storage, the animal materials should be treated as meat products until the point of use, following guidelines from the supplier or from government agencies, such as the Food Standards Agency. In general, the guidelines will advise that animal material should be kept at 50C or below until just before use. Frozen materials should be thoroughly defrosted in a fridge. Avoid using heat (e.g. from a microwave) to defrost materials, as this is likely to increase in the populations of microbes. All non-preserved animal materials should be used within 2 days of purchase or defrosting. Preserved animal materials Preserved animal material is often fixed in methanal (formalin) prior to preservation. The methanal will have been almost completely removed from the specimen during the preservation process, but it is sensible to ensure that the room is well ventilated during and after the dissection. Nitrile disposable gloves should be worn when handling the materials. G268 September 2013 Page 1 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Selecting dissection instruments The above photograph shows the instruments that are most often used in schools. They have been laid out on a cloth dissection roll. The instruments are (L-R): - Sharp/pointed forceps - Blunt-end forceps - Point-end dissection scissors - Point-end mounted needle - Blunt-end mounted needle - Scalpel with non-sterile detachable blade The teacher should select the least hazardous instruments that will allow the activity to proceed. The instruments that are usually appropriate for the common dissections are:- Organs that require opening out (i.e. not lungs etc.) Heart - Blunt- end scissors for cutting through the muscle wall. Scalpel if fine sectioning of the heart muscle wall is needed Kidney Eye - Blunt-end forceps for holding the kidney Point-end (pointed) scissors for making a longitudinal section of the kidney Egg cup lined with polystyrene for holding the eye Point-end scissors for cutting into and opening the eye Whole animal For opening skin and thorax and abdomen to display organs - Blunt-end forceps - Blunt end scissors For removal of overlying tissue and fat from structures - Point-end scissors - Point-end forceps Where particularly hazardous instruments such as scalpels and pointed forceps/scissors are being considered, the teacher should trial a range of the instruments available in the G268 July 2013 Page 2 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk school before making their final selection. This is to establish that the instruments are sharp enough to perform the operation. These pictures show different instruments being trialled to dissect out celery fibres. The procedure is very similar to clearing connective tissue from the digestive tract in mammals. The trial concluded that blunt-ended forceps and needles were the most effective and least hazardous for the process. Preparing equipment Dissection instruments • • • All instruments used for dissection activities should be completely free of organic material. See the section on clearing away for cleaning dissection instruments. If any instruments appear to be contaminated with organic matter remaining from previous use, they should be steam sterilised at 121 0 C for 15 minutes before cleaning. It is usually very difficult to clean very sharp instruments, such as scalpel blades. The re-use of such instruments therefore needs to be carefully considered. The blade on the right of this picture was used once (to cut onion epidermis), then washed and dried. The picture shows the blade after a period of two weeks. There is significant corrosion in comparison with the new blade shown in the left picture. A corroded blade is more likely to fragment, and more difficult to remove from the handle. Microbial contamination of the organic material on the blade may cause serious infection if the user’s skin is cut during use. In general, avoid re-using disposable scalpel blades. G268 July 2013 Page 3 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Preparing dissection instruments for carrying around the school Common sharp dissection instruments The sharp instruments most often used are: Sharp pointed forceps Sharp pointed scissors, Mounted needles Scalpels. Preparing individual sets of instruments for carrying The instruments should be placed with the sharp point facing into the compartments of a dissection roll made from thick cloth. When the instruments are tied into the dissection roll, there is no possibility of the cutting edge or a sharp point moving to cause an injury. Preparing class sets of instruments for carrying Instruments should be placed in rectangular boxes, as described later for storage. The boxes should be securely lidded and placed in high sided trays. Preparing surfaces to go under the animal material If sharp pointed instruments or scalpels are selected, the dissection should take place on a surface that will absorb any impact with the dissection instrument. A wooden dissection board is common, but wax trays are sometimes used. If non-hazardous instruments are selected, a dissecting board / wax tray is not necessary. Dissection surfaces if non-hazardous instruments are being used A washing up bowl is useful, as the sides shield sight of the dissection away from squeamish students. In the heart dissection shown here, the waterproof surface allows water to be measured into heart compartments, to measure the volume. The bowl can also be very thoroughly cleaned, and if necessary disinfected afterwards. G268 July 2013 Page 4 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Dissection surfaces if hazardous instruments are being used This is a standard dissection board, but any soft wood board (e.g. a wooden chopping board) could be used. Contaminated wooden boards are difficult to clean/disinfect. A plastic sheet or Clingfilm can be used to prevent fluids from the dissection penetrating into the wooden board. The board/wax tray can be further protected with several layers of newspaper to absorb any fluids. Protective aprons/ Lab coats The use of aprons or lab coats prevents the clothing of dissectors becoming contaminated with fluids from the dissected animal material. This is necessary, as some items of clothing are laundered infrequently (e.g. jackets). It is therefore important to ensure that clothing is not contaminated with fluids from the dissecton, as biological agents may remain active for some time. The most appropriate protection for clothing is usually a disposable waterproof apron, that will be discarded immediately after it has been used. Arranging dissection chambers for containment of hazardous aerosols If there is a possibility of human pathogens being released into the air during the dissection, there should be an arrangement for containing any aerosols released from the animal. The intestine of a non-preserved intact animal is particularly hazardous, as it is likely to contain large numbers of microbes. The animal should be dissected inside a containment chamber, if there is a possibility of the intestinal wall being perforated. Here are some examples of ways to contain aerosols from dissection: G268 July 2013 Page 5 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk 1. Using a transparent plastic box An upturned clear plastic box will stop aerosols reaching the room air. One end of the plastic box should be cut away, to allow access for the dissection. Plastic sheeting placed over the “cut away” end allows access, and reduces the possibility of aerosols escaping. Clearing/disposal: After the dissection, the box must be thoroughly disinfected with 1% VirKon, or 70% ethanol. The disinfected box should be left outside to ventilate fully. 2. Using a transparent plastic bag A large transparent plastic bag will contain aerosols released during dissections of small animals. However, the plastic bag may make it difficult to see a demonstration dissection. Clearing/disposal: The bag should be disposed of with the remains of the dissected animal material. 3. Using a fume cupboard The picture shows dissection taking place using a non-vented/portable fume cupboard. Extra protective plastic could be taped to the window of the fume cupboard, if considered necessary. The demonstration dissection can be clearly seen by the class. Clearing/disposal: The fume cupboard must be very thoroughly disinfected after the dissection. It may be necessary to change the filters of if the dissection material is considered to be particularly hazardous. As it is not possible to disinfect a vented fume cupboard fully, they are not suitable for dissection containment chambers. TIP Chambers used to contain aerosols from the dissection also reduce any odours, so the dissection is much less smelly. G268 July 2013 Page 6 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk A lab coat will also protect the clothes, but must be professionally laundered very shortly after it has been contaminated with fluids from a dissection. Gloves As most materials for dissection are food quality, gloves are usually not necessary as thorough hand washing is effective in removing most of any biological agents, and residues of the dissection from the hands. Students are generally more likely to wash their hands thoroughly if they have not been wearing gloves, and are much less likely to touch their face etc. with unwashed hands. However, if the dissector is unable to wash their hands (e.g. because they are wearing a bandage), then gloves would be sensible. If the dissector is wearing gloves to protect cuts etc. from microbes, then the gloves used should bear the number, BSEN 374. If preserved animal material is to be dissected, the chemicals present on the animal may necessitate the use of chemically protective gloves. Details of suitable gloves can be found in CLEAPSS documents . For instance, if methanal (formalin) has been used to fix or preserve the animal, then disposable nitrile gloves should be used. The suppliers’ safety data sheet should be consulted when deciding. Eye Protection Eye protection is necessary only if there is likely to be a sudden spurt of fluid, and the dissector has to operate close to the animal material. The most usual case for this will be when an eyeball is being opened up. Splash resistant spectacles or goggles should be worn (at least BSEN 166). Safe use of instruments during dissection It is very important that the teacher clearly shows students how to use dissection instruments safely. Safe practice in demonstration dissections • Hold the instruments so that any sharp points or exposed sharp edges point down into the dissection board/wax tray. If there is any slippage when using the instrument, the point/exposed edge will be absorbed by the board/wax. • Always point sharp points or edges away from yourself, to reduce the possibility of stab wounds from slippage of pointed instruments, or cuts from scalpels. G268 July 2013 Page 7 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Safe practice in dissections by students • Students should be shown how to use hazardous instruments to carry out the procedure safely. • Prior to animal dissections, the teacher may train students in the use of the instruments, by dissecting non-hazardous materials (as shown here). • The teacher must be vigilant while the students are carrying out the dissection, to ensure that they use instruments safely at all times. G268 July 2013 Page 8 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Dissection procedure to reduce the likelihood of perforation of the gut wall 1. Cutting through and clearing the skin Use blunt forceps to pinch and hold a fold of skin on the animal’s dissection scissors to make a cut across the fold. Close the scissors, and insert the point of the into the cut made in the skin Open up the scissors in the cut. This action will free the skin from the underlying muscle. G268 July 2013 Page 9 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Using the forceps to lift the skin, cut the freed skin Repeat the clearing and cutting process, working up and then down the abdomen Clear the skin away from the entire surface of the abdomen. The skin should then either be cut away, or pinned back onto a dissecting board. G268 July 2013 Page 10 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk 2. Cutting through the abdominal muscles Use the same technique as for clearing the skin, to lift and then cut and clear the abdominal muscles. Identify what each structure/tissue is before cutting. TIP If available, sharp pointed scissors are more effective in making the initial cut through the skin or abdominal wall. For clearing the connective tissues, however, blunt ended scissors are less likely to cause damage to underlying structures. 3. Identifying the mesenteries and gut regions Identify the mesenteries- folds of connective tissue that link the different regions of the intestines to each other. G268 July 2013 Page 11 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk 4. Cutting the mesenteries Using round-end forceps, lift a mesenteric fold and carefully cut it using very tiny cuts with sharp pointed scissors. Continue until all the mesenteric folds have been cut. 5. Displaying the gut Use your fingers to carefully spread out the entire gut onto the dissecting board at the side of the animal. The relative length of the different gut regions can be clearly seen. TIP The careful dissection of the gut of a non-preserved animal takes a considerable length of time. If a teacher wishes to dissect out the gut as a demonstration for a class, it is better to use a preserved animal, as the process can be carried out much more quickly without there being concerns about releasing microbes. Alos note that a non-preserved animal must be disposed of immediately after dissection. A partially dissected aniaml cannot be stored for a continuation on another day. G268 July 2013 Page 12 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Clearing away and disposal Safety when cleaning dissection instruments • Remove and discard scalpel blades into an appropriate sharps container. • If instruments are likely to be heavily contaminated with microbes, sterilise before cleaning. • Remove most of the organic material from instruments by soaking them in a strong detergent solution (such as that made by adding dishwasher tablets to water) .Place the instruments upright with any points, or sharp edges facing downwards. • After soaking, use a brush with a handle to scrub the instruments very thoroughly. It is important to all remove traces of organic matter. • Rinse and dry the instruments thoroughly. • Take care to avoid cuts when cleaning. Safe storage of sharp instruments Instruments should be placed with the all the hazardous points or edges pointing towards one end of the container. The container/drawer should be narrow, preventing the instruments moving around to face the opposite direction during storage/ transport. Large instruments (such as the knives shown here), should be individually sheathed. G268 October 2013 Page 13 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Placing/replacing scalpel blades Scalpel blades are designed to cut cleanly through soft materials such as skin. Blades used in schools are generally non-sterile, so care take care when placing the blade. NOTE: Used scalpel blades can splinter , wear eye protection when placing or removing them Placing scalpel blades Unwrap the blade from its protective wrapper. Using the wrapper to protect your hands, slide the handle onto the bottom of the blade. Carefully ease the blade onto the handle. It is safer to use forceps as shown here. When the blade is fully in position, it clicks into place. Removing scalpel blades For removing the blade manually, follow the previous instructions for blade placement in reverse order. Commercially available scalpel blade removal systems are a safer alternative for removing scalpel blades. See the following for operation of a system for removing non-sterile blades. G268 April 2013 Page 14 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk The blade remover is in the lid of the device, and the removed blade drops into a sealed lower container. Insert the scalpel blade into the slot in the side of the device, immediately under the lid . The blade attachment should be pointing upwards. When the scalpel blade is fully inserted, it should click into place. Press down firmly on the lid, to release the blade from the handle. The scalpel handle can now be pulled free. The scalpel blade remains in the sealed lower compartment. The lower compartment acts as a sharps container. G268 April 2013 Page 15 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk Disposal of used scalpel blades Scalpel blades that have been used in animal dissections should be placed in a stout sided container, with no possibility of the blades protruding. The lid should be secured with tape, and the sharps container should then be wrapped and disposed of in the normal refuse. If there is a possibility of large numbers of human pathogens being present (e.g. if the scalpel has perforated an animal’s gut, or the sharps contain organic material that might have decomposed), the sharps container should be steam sterilised at 1210C for 15 minutes. The sterilised container should then be wrapped and placed in the normal refuse. If the scalpel has cut through a person’s skin, then the blade should be placed in a clinical sharps’ container, and disposed of by a licensed contractor. Disposal of dissected animal materials All animal materials should be wrapped in newspaper, and placed in a double layer of bin bags. The wrapped materials should be placed in a non-recycle bin that is directly handled by the refuse collectors on the day of refuse collection. G268 April 2013 Page 16 of 16 © CLEAPSS®, The Gardiner Building, Brunel Science Park, Kingston Lane, Uxbridge UB8 3PQ Tel: 01895 251496; Fax: 01895 814372; E-mail: science@cleapss.org.uk; Web site: www.cleapss.org.uk