The practical problems of acupuncture research on cadavers

1. Condition of the cadavers. Donated bodies are often studied and shared by both medical students and researchers. The research can be compromised if the donated bodies are destroyed after medical student dissection. The student learning experience can also be compromised if the bodies are dissected by researchers. Researchers should seek a balance by liaising with anatomy course coordinators to arrange a suitable timing for data collection so as to minimise disturbance to students and to start the research before the target areas are destroyed by medical student dissection.

2. Position of the cadavers. Donated bodies must remain in either supine or prone position. It is dangerous to turn a 70 kg fixed body from the supine to prone position, and vice versa, and it is impossible to turn the body laterally. Researchers should have a clear plan for workflow and manpower before on-site data collection.

3. Visual needling pathway. Dye injection using a hypodermic needle with syringe can help visualise the needling pathway when the donated body is dissected layer by layer. However, the injection needle does not provide measurements and is therefore not suitable for studies of needling depth. In such situations, the use of vernier callipers should be considered as they mimic needle insertion with accurate measurement. ³ Moreover, they do not bend when being inserted into a hard and fixated cadaver.

4. Measurements. To increase the accuracy of measurements, observations should be made by at least two independent researchers.

5. Research methodology. To improve the quality of the research project, researchers can consider using validated and standardised checklists such as the Quality Appraisal for Cadaveric Studies (QUACS) scale. ⁴

1. Time interval from cadaveric processing to dissection. In my experience, cadavers can be frozen for 3–5 years before being transported to the University for teaching and research purposes. Fresh cadavers are often not available. The shorter the duration of the cadavers being stored, the less the effects of drying, fixation, ¹ and dehiscence of tissue layers.

2. Human body preservation method. Formaldehyde is a common agent for preservation. It is a resin-based product with a greying effect. Different agents can be added to provide extra effects. For example, addition of phenol into formaldehyde can reverse the greying effect. ⁵ However, this information is often not available to researchers.

3. Accuracy. Magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound provide better resolution and accuracy regarding anatomy than cadaveric studies.

4. Demographic information. This information is sometimes not available.

5. Sample size. The sample size is often small because donated bodies are invaluable resources in the community. Therefore, the results are often influenced by limited sample size.