INTRODUCTION: Understanding pelvic anatomy is essential to training as an ob/gyn. In most residency programs, residents learn anatomy through self-guided reading and direct experiences in the operating room, which can be limited by time constraints and patient safety concerns. The purpose of our study was to develop and assess a novel pelvic anatomic education program for residents. METHODS: We utilized three different learning modalities: cadaveric dissection on unused cadavers from our medical school’s anatomy course, clay models of the pelvic floor, and didactic lectures. The cadaver dissection was presented in a “mock surgery” format. Learning objectives and relevant procedures were established for each year of training: abdominal wall anatomy and cesarean section for first years, pelvic spaces and abdominal hysterectomy for second years, presacral space and sacrocolpopexy for third years, and pelvic neuroanatomy for fourth years. Participants completed before and after multiple choice tests and a qualitative survey. RESULTS: 16 residents from all 4 years of training were recruited to participate in the program. The average pre-test score was 45% and average post-test score was 50%, (p=0.22). The majority of participants strongly agreed that the program was interesting (67%), enhanced their understanding of pelvic anatomy (73%), and increased their confidence in the operating room (53%). CONCLUSION: Our multi-modality pelvic anatomy program improved residents’ anatomic knowledge (although this was not statistically significant) and was well received as a clinically applicable educational activity. The cadaveric lab mirrored the gynecological surgical curriculum of our residency and was cost efficient through collaboration with the anatomy department.

Background Lower extremity reconstruction often requires soft tissue transfer for limb salvage. Flaps are allocated based on injury size, location, and shape coupled with surgeon expertise. Ideally, vascularized tissue should have similar outcomes across local and free tissue transfers. By evaluating outcomes from a Level 1 trauma center, we aim to provide recommendations regarding surgical management of leg reconstruction with respect to local versus free flap implementation. Methods This retrospective review evaluated patient medical history, demographics, flap characteristics, and outcomes from LAC + USC between 2007-2021 using an internal database. Outcomes included failure rates, complications, and ambulation. Results 357 lower extremity flaps were placed on 322 patients; 187 (52.4%) were local and 170 (47.6.%) were free flaps. Twenty-one (11.2%) local flaps suffered significantly more postoperative hardware infections and/or osteomyelitis compared to nine (5.3%) free flaps. Eleven (5.9%) local flaps developed partial necrosis, four requiring revision; 12 (6.4%) total local flaps required revision. Comparatively, sixteen (9.4%) free flaps developed partial necrosis, seven requiring revision; 18 (10.6%) total free flaps required revision. Flap survival was 96.3% for local versus 93.5% for free flaps. Percentage of fully ambulatory patients and time to final ambulation was not significant across cohorts. Discussion Local flaps may portent higher risk for infection; though the cause is not clear, the results may be confounded by comorbidities. Nevertheless, there were no significant differences in flap survival or number of fully ambulatory patients across cohorts. Future studies should evaluate aesthetic results and patient satisfaction across flap types.

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Introduction Proper assessment and management of burn patients requires practical knowledge and timely interventions in a high-stakes setting. Although much of burn care emphasizes critical care, nuances exist among this patient population, creating challenges for surgeons-in-training. As a result, low- and high-fidelity burn simulations have become increasingly popular means to educate burn care physicians and their teams in a safe environment without compromising care or endangering patients. The aim of this report is to systematically review the literature for existing simulations related to burn care. Methods A systematic review was conducted using the following databases: PubMed, Scopus, Embase, Web of Science, and Cochrane. Inclusion criteria were peer-reviewed articles about surgical simulation models related to burn care and surgery. Skills and techniques taught, assessment methods, model type, fidelity, and equipment were extracted from included studies. Conference proceedings, reviews, non-English and non-burn-specific literature were excluded. Results Our search criteria identified 2,585 articles, 16 of which met inclusion criteria. Simulation methods included 7 simulation courses (43.8%), 6 synthetic benchtop models (37.5%), 2 augmented/virtual reality interfaces (12.5%), and 2 iOS applications (12.5%). There were no burn-specific animal or cadaveric models. Model fidelities included 9 (56.3%) high-, 3 (18.8%) medium-, and 4 (25.0%) low-fidelity. The most common topics included in the simulations were burn wound assessment/management (n=10, 62.5%), escharotomy (n=6, 37.5%), fluid management (n=2, 12.5%), electrical burns (n=1, 6.2%), skin graft harvest (n=1, 6.2%), tangential excision (n=1, 6.2%), and cricothyrotomy (n=1, 6.2%). Conclusions Burn management requires an expansive breadth of intensive care knowledge and surgical expertise combined with a distinct, burn-specific skill set. A paucity exists in the literature for augmented/virtual reality and animal/cadaver models unique to burn care and surgery. Our review identified a need to expand simulator options to improve training in skin grafting, burn reconstruction, and burns-specific intensive care management. Applicability of Research to Practice Given the rapidly expanding emphasis on remote learning in the post-COVID era, developing accessible surgical simulation infrastructure adjacent to clinical training may better prepare global burn providers for the complexity of burn care.