Bone maceration: A systematic review of techniques, efficiency and structural outcomes

Bone maceration aims to remove soft tissue to obtain clean skeletal elements. It is a widely used technique, applied across different fields including education, scientific research, forensics and museum exhibitions. The selection of the maceration technique must be tailored to each specific application, as it can critically influence outcomes, such as DNA preservation and bone surface structure among others. The aim of this systematic review was to provide a comprehensive guide on bone maceration techniques, most common approaches, their advantages, limitations and suitability for various techniques.

Thirty-eight articles were included after searching the databases PubMed (MEDLINE), SCOPUS and EMBASE for the terms ("maceration" AND "bone") OR ("defleshing" AND "bone") OR ("skeletonization" AND "bone") OR ("osteotechnics" AND "bone") according to PRISMA 2020 guidelines and the application of previously defined inclusion and exclusion criteria.

Most frequently described was maceration with chemical or enzymatic additives, followed by water maceration, with combined methods also commonly utilized. The most extensively described application was in forensic contexts, with analyses primarily targeting microscopic bone structure and DNA preservation.

No single maceration method proved optimal for all applications. Enzymatic and insect maceration require more resources and are slower but offer superior bone and DNA preservation. In contrast, hot-water and chemical maceration are more time-efficient but can lead to bone surface damage and loss of biomolecular content. Therefore, the choice of bone maceration technique should be specifically tailored to specimen type, available resources and specific goals of the analysis. As the effect of maceration on bone and bone structure is irrevocable, preprocedural planning is therefor of importance.