A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg

The external diameters of the superficial epigastric vessel and common thoracic vessel are small enough for supermicrosurgery training. The pedicle lengths of both the superficial epigastric and common thoracic-long thoracic flaps are sufficient to perform free flap experiments. Supermicrosurgical free flaps using these two vessels and a study of the physiology and pharmacology of the flaps will likely be possible in the future.

Section: Discussionmentioning

confidence: 74%

Proper Choice of Vessels for Supermicrosurgery Training: An Experimental Animal study

Song

Kang

et al. 2018

“…Nowadays, nonliving specimen such as chicken thigh model can simulate micro-(vessel diameter > 0.8 mm) and supramicroanastomoses (diameter 0.3-0.8 mm). 21,22 Due to the smallest needle gauge we had and size of human hair, our DIY microsuture was proper for practicing microsurgical anastomosis in vessel diameter larger than 0.8 mm.…”

Section: Discussionmentioning

confidence: 99%

Do-It-Yourself Microsuture from Human Hair for Basic Microsurgical Training

Luangjarmekorn

Kitidumrongsook

Honsawek

2018

Background Microsuture is an essential material for basic microsurgical training. However, it is consumable, expensive, and sometimes unavailable in the microsurgical laboratory. To solve this problem, we developed a microsuture made from human hair and needle gauge. Methods Do-It-Yourself (DIY) microsuture is made from human hair and needle gauge 32G (BD Ultra-Fine Pen Needles 4 mm × 32G). Methods are explained step by step. This DIY microsuture (labeled as “test microsuture”) and nylon 8–0 (Ethilon suture 8–0, labeled as “standard microsuture”) were used for teaching orthopaedic residents to perform arterial anastomosis in chicken thighs. All residents practiced without knowing that “test microsuture” was made from the DIY method. After completing the training, quality of both microsutures was evaluated by questionnaire in topics of (1) thread quality (size, strength, elasticity, handing, knot perform, and knot security), (2) needle quality (size, curve, shape, sharpness, handling, and strength), (3) needle–thread interface (size, strength, and smoothness), and (4) overall quality of microsuture. Each category was evaluated by Likert score (5 = excellent, 4 = good, 3 = fair, 2 = poor, and 1 = very poor). Results The DIY microsuture was performed in three steps: (1) insert human hair into needle gauge by microforceps, (2) bend needle into smooth curve, and (3) disconnect needle and create needle–hair interface. The questionnaire was completed by 30 orthopaedic residents and showed that thread quality of DIY and standard microsuture had “good” and “good-to-excellent” quality (mean Likert score: 3.77–4.23 and 3.80–4.27, respectively, with no statistical difference). Thread–needle interface quality of DIY and standard microsuture also had “good” and “good-to-excellent” quality (Likert score: 3.73–4.20 and 4.07–4.33, respectively, with no statistical difference). Needle part of DIY microsuture had lower quality than standard suture (fair-to-good compared with good-to-excellence quality, score 3.30–3.67 vs. 4.20–4.27, respectively, with a statistically significant difference, p-value < 0.05). However, overall quality of DIY suture and standard microsuture had “good” and “good-to-excellent” (mean Likert score: 3.73 and 4.00, respectively, with no statistical difference). Conclusion The DIY microsuture from human hair and needle gauge could be an alternative for basic microsurgical training with lower cost, easy production, and more availability for use in practice with acceptable quality compared with that of standard microsuture.

“…21 A simple chicken leg model for supermicrosurgery skill development has also been described for vessels between 0.3 and 0.7 mm. 22 Two commonly described techniques for end-to-end anastomosis include the biangulation technique and the triangulation technique. The biangulation technique involves two stay sutures, each at 180 degrees; while the triangluation technique places three stay sutures, each at 120 degrees.…”

mentioning

confidence: 99%

Ahead of the Curve: Tracking Progress in Novice Microsurgeons

Brosious

Kleban

Goldman

et al. 2018

Background The purpose of this study was to evaluate learning curves for an existing microsurgical training model. We compared efficiency and amount of training needed to achieve proficiency between novice microsurgeons without operative experience versus those who had completed a surgical internship. Methods Ten novice microsurgeons anastomosed a silastic tube model. Time to perform each anastomosis, luminal diameter, and number of errors were recorded. Results First year residents improved up to a brief plateau at 10 repetitions, followed by continued improvement. Second year residents improved up to a plateau at 10 repetitions with no further improvement thereafter. There was no significant difference in luminal area or errors between groups. Conclusion Residents with no operative experience can benefit from early exposure to microsurgical training. These interns continue to improve with additional repetitions while second year residents achieve proficiency with fewer repetitions.