May 2021

Page A16 MAY 2021 FUNERAL HOME & CEMETERY NEWS Se c t i on A By Wally Hooker, CFSP, MBIE We talked last month about the importance of a firm, dry, base on which to begin reconstructive efforts…in addition we discussed the need to excise any jagged, rough, torn or exposed tissue and to ‘degrease’ the skin surrounding the area to be restored to ensure waxes, artificial skin or adhe- sives will adhere without fail. For the purpose of this month’s article, we will assume all these steps have been successfully completed. I’ll again remind you, I am not an educator nor an expert…I’ve just been asked to share what works for me. I will be sharing a couple examples of soft tissue repair with accompanying photos of before and after to demon- strate the steps taken and the results. These cases represent, injuries we routinely see in our embalming rooms and are not overly complicated to overcome. In the event you have traumatic injuries of the forehead, with significant skin and tissue missing, ( Fig. 1 ). I would suggest to not simply fill the area with reconstructive materials. It is important to first create a ‘secure base’ that will not separate and leave an embarrassing or noticeable line of demarcation. Even worse, if a family mem- ber inadvertently moves the surrounding skin causing a crack in your restorative work for all to see. First, following the drying of the area, I recommend an ‘undercut’ beneath the outer margins. This will allow your reconstructive material to be worked be- neath the skin, creating a firm secure base. I use a snug ‘basket weave’ with suture material beneath the surface of the skin, in somewhat of a star shape to hold the margins together. If the margins are too loose, it is difficult to ex- pect a flawless transition from your reconstructive work to the surrounding skin. The damaged area beside the lip was sutured with the use of waxed dental floss ( Fig. 2 ) and covered with surface restoring wax. For deep wounds I begin with creating a foun- dation using a thin layer of mortuary putty, (gently forced into the suture material securing the margins), covered with a single thickness of Webril cotton, the netting material from a large bandage, or even a tissue, covered with manipulate the tissue before excising the rough margins. We want to ensure you have plenty of loose tissue to suture. You don’t want the skin so tight, that it disrupts the natural form of the area. It is important to use these natural landmarks of the face to close wounds and create a natural appearance. By using a hidden suture and stay- ing within the wrinkle, I pre- vented leakage and it required no additional re- storative materials to cover the entry wound. Fig. 5 is a fin- ished view of the proper closure of the GSW using a natu- ral existing feature to recreate a seamless repair. No residual damage appears to those viewing the deceased. Neither of these cases required significant time to repair. Both were seen by their family with the wounds at the time of death. It was impor- tant to give these folks back to their fami- lies ‘whole’, for an open casket goodbye by family and friends. Going the extra mile to allow open casket goodbyes is more important now than any time in our history. Funeral service always seems to be under attack from some self appointed ‘do gooder’…we as technical practitioners must never waiver as we strive to serve our families…no other professional in you commu- nity can do what you do! Be proud to be a funeral director/ embalmer! Next month we will continue with more case studies on traumatic injuries and how to overcome those issues. Until then stay safe out there! pore closer. The mortuary putty creates the base, the tissue or cotton adds structural integrity and the pore closer seals to stop dehydration. As this material dries repeat this step until you are within 1/8th inch of the surface. Once the final base is dry and secure you can begin your final application of restor- ative wax or artificial skin materials (there are several products currently available that work well). As with any topical ma- terial you use as a replacement for skin, remember…it’s easy to over work the material and make it appear too smooth. Most of us have imperfections on our skin surfaces and it is imperative we replicate those in our reconstructive efforts. It is important to keep in mind, infants and younger children would be treated differently, as their skin is still smooth and supple. Their skin would not have the same imperfections as an adult. Too smooth or too rough will stand out and take away from your exhaustive restorative ef- forts. Fig. 3 indicates the final result. I used hair from the back of the neck to recreate the eyebrow. This hair will normally be a close match for any facial hair needing to be replaced. If you are us- ing mortuary wax, it is simple to ‘tamp’ hair into place. I have used acrylic nail adhesive in facial hair replacement, it dries remarkably quick and is easy to use. It just takes patience to replace facial hair. We have discussed not having your restorative materials fin- ished too smoothly. There are a multitude of ways to texture your finish and create a more natural appearing skin surface. I often use a stippling brush or nylon bristle brush to recre- ate pores and the tip end of a small cosmetic brush to recreate wrinkles, folds, scars, etc. After recreating the features, gen- tly smooth them down with DriWash II on a soft brush to knock down the sharp edges. We want our restorative work to be completed in such a manner that it doesn’t require ‘over cosmetizing’! This takes away from the natural appearance. Fig. 4 is the result of a contact gunshot wound. It seems like most of these types of injuries occur on the viewing side which often present a challenge to the embalmer. You can see the point of entry, burns and tearing of the tissue. If you examine the pho- to closely, you can observe the natural crease/wrinkle of the skin on the neck, from the tip of the ear forward. Be sure to workt or FUNERAL HOME & CEMETERY NEWS www.nomispublications.com Monthly Columns online at Wallace P. (Wally) Hooker CFSP, MBIE, is the owner, funeral direc - tor and embalmer of Family & Friends Funeral Home of Wingate, IN. He and his wife, Janet designed, established and built their funeral home in 2004. Wally is a graduate of Worsham College of Mortuary Science, where he serves on the Advisory Board. He is Past President of the Indiana Funeral Directors Association and board member of North American Division of the British Institute of Embalmers. In ad - dition, he has served as chief deputy coroner/investigator of Fountain County, IN for the last 24 years. Embalming 101 Restorative Tips and Techniques (continued) Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Service Corporation International announces partnerships with TAPS and National Alliance For Grieving Children HOUSTON,TX— Service Corpo- ration International , (SCI) and its brand, Dignity Memorial ®, have announced partnerships with Trag- edy Assistance Program for Survivors (TAPS) and National Alliance for Grieving Children (NAGC). SCI will become an official part- ner of TAPS with a $250,000 contribution, which will provide valuable support programs and ma- terials to help survivors cope with grief and loss. “Our Dignity Memorial associates are committed to supporting mili- tary families in our communities and appropriately honoring their sacri- fices and service to our Country,” said SCI Chief Operating Officer Jay Waring . “Our partnership with TAPS is an extension of that com- mitment as we work together to help survivors of military and veteran loss through their grief journey.” Bonnie Carroll , TAPS Founder and President, added, “TAPS is honored to be partnering with SCI to support our military survivors. The entire or- ganization has shown their dedica- tion to honoring the lives of those who have served and died for our country’s freedoms by caring for the families they loved and left behind.” Since 1994, TAPS has provided support and hope around the clock through a national peer support net- work, grief counseling services and support groups – all at no cost to surviving families and loved ones. TAPS also provides a variety of pro- grams to survivors worldwide, as well as resources for grief professionals to better serve the military and veteran communities. For more information go to www.taps.org. SCI is also partnering with the Na- tional Alliance for Grieving Children (NAGC) with a grant of $250,000. Funds will be used for programs and initiatives, including new grief sup- port materials, for children and teens who are grieving a death. “We are committed to support- ing the families and communities who entrust their loved ones into our care before, during and after the service. The loss of a loved one and the accompanying grief can be extremely difficult, especially for children who experience loss in a variety of ways,” said Jay Waring. “Often, children may feel isolated from friends and family who have not experienced a similar loss. Our partnership with NAGC is a natu- ral extension of the grief support we, as funeral professionals, pro- vide to families every day.” “We are excited at the potential impact of our partnership with Dignity Memorial locations for those we collectively serve. Our shared goal of comforting those who grieve, coupled with the NAGC’s proven capacity to pro- duce resources, creates the poten- tial for a successful partnership that builds families up,” said Vicki Jay , Chief Executive Officer, National Alliance for Grieving Children. The National Alliance for Griev- ing Children (NAGC), headquar- tered in Lubbock, TX, is a non- profit organization that raises awareness about the needs of chil- dren and teens who are grieving a death and provides education and resources for anyone who supports them. The NAGC is a North Amer- ican network comprised of over 1,300 professionals, institutions, and volunteers who promote best practices, educational program- ming, and critical resources to fa- cilitate the mental, emotional and physical health of grieving children and their families. For more infor- mation about the NAGC, please visit www.childrengrieve.org. Service Corporation Internation- al (NYSE: SCI) is North Ameri- ca’s leading provider of deathcare products and services. At Decem- ber 31, 2020, we owned and op- erated 1,470 funeral service loca- tions and 483 cemeteries (of which 297 are combination locations) in 44 states, eight Canadian provinc- es, the District of Columbia, and Puerto Rico. Through our business- es, we market the Dignity Memo- rial® brand, which offers assurance of quality, value, caring service, and exceptional customer satisfac- tion. For more information about Service Corporation International, please visit our website at www.sci- corp.com. For more information about Dignity Memorial®, please visit www.dignitymemorial.com.