An alternative model for teaching tendon repair and surgical skills in plastic surgery

Abdulal, S.; Onyekwelu, Obi

doi:10.1016/j.jpra.2015.11.003

Cited by 5 publications

(4 citation statements)

References 1 publication

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“…In fact, to the best of our knowledge, there are no specific devices available on the market for such applications. The previous attempts in this field were absolutely trivial and not biomimetic [53][54][55].…”

Section: Discussionmentioning

confidence: 99%

Morphologically bioinspired hierarchical nylon 6,6 electrospun assembly recreating the structure and performance of tendons and ligaments

Sensini

Gotti

Belcari

et al. 2019

Medical Engineering & Physics

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Reconstructions of ruptured tendons and ligaments currently have dissatisfactory failure rate. Failures are mainly due to the mechanical mismatch of commercial implants with respect to the host tissue. In fact, it is crucial to replicate the morphology (hierarchical in nature) and mechanical response (highly-nonlinear) of natural tendons and ligaments.The aim of this study was to develop morphologically bioinspired hierarchical Nylon 6,6 electrospun assemblies recreating the structure and performance of tendons and ligaments. First, we built different electrospun bundles to find the optimal orientation of the nanofibers. A 2nd-level hierarchical assembly was fabricated with a dedicated process that allowed tightly joining the bundles one next to the other with an electrospun sheath, so as to improve the mechanical performance. Finally, a further hierarchical 3rdlevel assembly was constructed by grouping several 2nd-level assemblies. The morphology of the different structures was assessed with scanning electron microscopy and high-resolution X-ray tomography, which allowed measuring the directionality of the nanofibers in the bundles and in the sheaths. The mechanical properties of the single bundles and of the 2nd-level assemblies were measured with tensile tests. The single bundles and the hierarchical assemblies showed morphology and directionality of the nanofibers similar to the tendons and ligaments. The strength and stiffness were comparable to that of tendons and ligaments. In conclusion, this work showed an innovative electrospinning production process to build nanofibrous Nylon 6,6 hierarchical assemblies which are suitable as future implantable devices and able to mimic the multiscale morphology and the biomechanical properties of tendons and ligaments.

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Section: Discussionmentioning

confidence: 99%

Morphologically bioinspired hierarchical nylon 6,6 electrospun assembly recreating the structure and performance of tendons and ligaments

Sensini

Gotti

Belcari

et al. 2019

Medical Engineering & Physics

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“…The epitendinous suture is important in tendon repairs; it re-aligns the periphery of the transected tendon and adds strength to the repair (Wade et al, 1989). Some simulation models do not assess the efficacy of epitendinous sutures (Abdulal and Onyekwelu, 2016;Musbahi and Henton, 2019). This study illustrates some variation in scores for models between the core repair and the epitendinous.…”

Section: Discussionmentioning

confidence: 94%

“…A number of tendon repair simulation models have been described, including pig trotters and synthetic models such as drinking straws, catheters, liquorice, silicone sealant, dental rolls and fishing lures (Abdulal and Onyekwelu, 2016;Holmes et al, 2013;Ingraham et al, 2009;Musbahi and Henton, 2019;Tare, 2004). There is limited evidence about the comparative values of these simulation models for trainees.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of seven simulation models for tendon repairs

Vinnicombe

Asher

Super

et al. 2021

J Hand Surg Eur Vol

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Seven models for tendon repair simulation (urinary catheter, liquorice, fishing lure, dental rolls, drinking straw, silicone sealant and the authors’ modification of silicone sealant with Micropore™ tape) were assessed for their performance in a number of domains. The silicone sealant and surgical tape model scored highest overall and for each individual domain. This was significantly higher than all other models with the exception of the silicone sealant alone. The lowest scoring model was the drinking straw model.

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“…29 The most realistic materials to replicate the intra-operative experience of a flexor tendon repair are cadavers and animal models; however, these come with restrictions of availability, disposal, cost and licencing. 30,31 Alternative materials have been discussed in the literature, such as rubber worms, 32 liquorice, 33 feeding tubes, 34 catheters, 35 drinking straws 36 and microfoam tape 37 ; however, few have been validated.…”

Section: Tendon Simulationmentioning

confidence: 99%

A validated benchtop simulation model for flexor tendon repair

Robb¹,

Rust²

2023

J Surg Simul

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Background: The coronavirus disease 2019 pandemic has had an unprecedented impact on surgical training. Innovative approaches should be sought to aid the acquisition of technical skills to maximise intra-operative learning opportunities. This study evaluates the validity and reliability of low-cost low-fidelity flexor tendon repair simulators. Methods: Qualitative and quantitative data were gathered from participants working in a plastic surgery department through the performance of a simulation task and completion of a validation questionnaire. Results: Most of the participants (75%) agreed that the model accurately represents the intended procedure, demonstrating an overall high content validity. The three materials used in the model were found to have beneficial features. Participants, overall, did not have a clear preference for the material used, suggesting that the material itself is inconsequential. Conclusions:The skill acquisition of a flexor tendon repair is gained through repeated deliberate practice. Providing a vessel for practice is more important than replicating the biological tissue.

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An alternative model for teaching tendon repair and surgical skills in plastic surgery

Cited by 5 publications

References 1 publication

Morphologically bioinspired hierarchical nylon 6,6 electrospun assembly recreating the structure and performance of tendons and ligaments

Morphologically bioinspired hierarchical nylon 6,6 electrospun assembly recreating the structure and performance of tendons and ligaments

A qualitative study of seven simulation models for tendon repairs

A validated benchtop simulation model for flexor tendon repair

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