Effectiveness of a microsurgery training program using a chicken wing model

Dave, Aniket; Singhal, Maneesh; Tiwari, Raja; Chauhan, Shashank; De, Moumita

doi:10.1080/2000656x.2021.1953043

Cited by 11 publications

(5 citation statements)

References 45 publications

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“…Validated simulation training programs and models have shown to be effective means to acquire complex microsurgical skills. 18,19 These programs have focused primarily on training plastic surgery residents and fellows in basic microsurgical techniques such as anastomosis of vessels or preparation of internal mammary vessels. However, its use could be applied to more efficiently train microsurgeons to acquire skills necessary to efficiently react when rare complications are confronted.…”

Section: Discussionmentioning

confidence: 99%

Quantifying Complications: An Analysis of Operative Time and Intraoperative Factors in Microsurgical Breast Reconstruction

Egan

Elver

Godbe

et al. 2022

J Reconstr Microsurg

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Background Analysis of operative flow has been shown to improve efficiency in breast microsurgery. Both complex decision-making skills and technical mastery are required to overcome intraoperative challenges encountered during microsurgical reconstruction. Effects of intraoperative complications on operative time have not yet been reported. Methods A retrospective chart review of microsurgical breast reconstructions by three surgeons between 2013–2020 analyzed operative variables and duration. Intraoperative complications were determined from the operative report. Correlations between continuous variables were determined using Spearman correlation coefficients. Nonparametric testing was used when comparing operative duration between groups. Results Operative duration was analyzed for 547 autologous breast reconstruction cases; 210 reconstructions were unilateral and 337 were bilateral. Average operative duration was 471.2 SD 132.2 minutes overall (360.1 SD 100.5 minutes for unilateral cases and 530.5 SD 110.5 minutes for bilateral cases). Operative duration decreased with surgeon experience (r = -0.17, p< .001).Regarding intraoperative complications, difficult donor dissection was correlated with an average operative duration increase of 91.7 minutes (n = 43, 7.9%, p< .001), pedicle injury with an additional 67.7 minutes (n = 19, 3.5%, p = .02) and difficult recipient vessel dissection with an increase of 63.0 minutes (n = 35, 6.4%, p = .003). Complications with anastomosis also showed a statistically significant increase in operative duration, with arterial complications resulting in an increase of 104.3 minutes (n = 41, 7.5%, p< .001) and venous complications resulting in an increase in 78.8 minutes (n = 32, 5.8%, p< .001). Intraoperative thrombus resulted in an increase of 125.5 minutes (n = 20, 3.7%, p< .001), and requiring alternative venous outflow added an average of 193.7 minutes (n = 8, 1.5%, p< .001). Conclusion Intraoperative complications in autologous breast reconstruction significantly increase operative time. The greatest increase in operative time is seen with intraoperative thrombosis or requiring alternative venous outflow. As these complications are rarely encountered in breast microsurgery, opportunities for simulation and case-based practice exist to improve efficiency.

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Section: Discussionmentioning

confidence: 99%

Quantifying Complications: An Analysis of Operative Time and Intraoperative Factors in Microsurgical Breast Reconstruction

Egan

Elver

Godbe

et al. 2022

J Reconstr Microsurg

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“…The SAMS tool is being increasingly used to evaluate microsurgical skills. We believe our program is more interesting and unique than other programs, as it not only provides a sequential application of different materials but also minimizes the use of live animals while still exposing the trainee to high-fidelity scenarios (19)(20)(21)(22). The advantages of a detailed structured evaluation include identifying specific strengths and weaknesses to improve the student's techniques rather than only observing the outcomes (23,24).…”

Section: ' Discussionmentioning

confidence: 99%

Structured evaluation of a comprehensive microsurgical training program

Mattar¹,

Santos²,

Telles³

et al. 2021

Clinics

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“…Another low-cost alternative is the dissection and replication of the microanastomosis in a cadaveric animal model of a chicken wing, finishing the practice in the same way until making a microanastomosis without leakage. [7,8] Placental vessels…”

Section: Microsuture Fine Movements Microanastomosismentioning

confidence: 99%

“…In addition, there is no substantial evidence to justify the use of live animal models over other training models. [8] Below, we present the steps for the creation of a low-cost, basic microsurgery laboratory in a second-level hospital with zero funds designated for microsurgical training (similar to the vast majority of hospitals in countries with medium and low resources), as well as the final result (our laboratory and some examples of our work) and future objectives in the medium and long term.…”

Section: Introductionmentioning

confidence: 99%

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Enhancing microsurgical skills in neurosurgery residents of low-income countries: A comprehensive guide

Torres,

Mora,

Campero

et al. 2023

Surgical Neurology International

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Background: The main objectives of this paper are to outline the essential tools, instruments, and equipment needed to set up a functional microsurgery laboratory that is affordable for low-income hospitals and to identify cost-effective alternatives for acquiring microsurgical equipment, such as refurbished or donated instruments, collaborating with medical device manufacturers for discounted rates, or exploring local suppliers. Methods: Step-by-step instructions were provided on setting up the microsurgery laboratory, including recommendations for the layout, ergonomic considerations, lighting, and sterilization processes while ensuring cost-effectiveness, as well as comprehensive training protocols and a curriculum specifically tailored to enhance microsurgical skills in neurosurgery residents. Results: We explored cost-effective options for obtaining microsurgery simulators and utilizing open-source or low-cost virtual training platforms. We also included guidelines for regular equipment maintenance, instrument sterilization, and establishing protocols for infection control to ensure a safe and hygienic learning environment. To foster collaboration between low-income hospitals and external organizations or institutions that can provide support, resources, or mentorship, this paper shows strategies for networking, knowledge exchange, and establishing partnerships to enhance microsurgical training opportunities further. We evaluated the impact and effectiveness of the low-cost microsurgery laboratory by assessing the impact and effectiveness of the established microsurgery laboratory in improving the microsurgical skills of neurosurgery residents. About microsutures and microanastomosis, after three weeks of training, residents showed improvement in “surgical time” for ten separate simple stitches (30.06 vs. 8.65 min) and ten continuous single stitches (19.84 vs. 6.51 min). Similarly, there was an increase in the “good quality” of the stitches and the suture pattern from 36.36% to 63.63%. Conclusion: By achieving these objectives, this guide aims to empower low-income hospitals and neurosurgery residents with the necessary resources and knowledge to establish and operate an affordable microsurgery laboratory, ultimately enhancing the quality of microsurgical training and patient care in low-income countries.

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Effectiveness of a microsurgery training program using a chicken wing model

Cited by 11 publications

References 45 publications

Quantifying Complications: An Analysis of Operative Time and Intraoperative Factors in Microsurgical Breast Reconstruction

Quantifying Complications: An Analysis of Operative Time and Intraoperative Factors in Microsurgical Breast Reconstruction

Structured evaluation of a comprehensive microsurgical training program

Enhancing microsurgical skills in neurosurgery residents of low-income countries: A comprehensive guide

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