Microsurgical reconstruction in the time of <scp>COVID</scp>‐19

Ramella, Vittorio; Papa, Giovanni; Bottosso, Stefano; Cazzato, Vito; Arnež, Zoran Marij

doi:10.1002/micr.30604

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…Grober et al [41] concluded that microsurgical skills attained in low-and high-fidelity training models are equally effective for novice participants. In the current COVID-19 era, where clinical exposure for trainees is minimized, VR/AR helps sustain skills through simulated-based practice [77][78][79][80][81]. Following the advent of new-age VR technology, the next goal was to determine its predictive validity in human operating rooms.…”

Section: Advantages Of Virtual Reality and Nonliving Training Modelsmentioning

confidence: 99%

Superiority of living animal models in microsurgical training: beyond technical expertise

et al. 2021

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Background Many studies are investigating the role of living and nonliving models to train microsurgeons. There is controversy around which modalities account for the best microsurgical training. In this study, we aim to provide a systematic literature review of the practical modalities in microsurgery training and compare the living and nonliving models, emphasizing the superiority of the former. We introduce the concept of non-technical skill acquisition in microsurgical training with the use of living laboratory animals in the context of a novel proposed curriculum. Methods A literature search was conducted on PubMed/Medline and Scopus within the past 11 years based on a combination of the following keywords: “microsurgery,” “training,” “skills,” and “models.” The online screening process was performed by two independent reviewers with the Covidence tool. A total of 101 papers was identified as relevant to our study. The protocol was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Living models offer the chance to develop both technical and non-technical competencies (i.e., leadership, situation awareness, decision-making, communication, and teamwork). Prior experience with ex vivo tissues helps residents consolidate basic skills prior to performing more advanced techniques in the living tissues. Trainees reported a higher satisfaction rate with the living models. Conclusions The combination of living and nonliving training microsurgical models leads to superior results; however, the gold standard remains the living model. The validity of the hypothesis that living models enhance non-technical skills remains to be confirmed. Level of evidence: Not ratable.

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Section: Advantages Of Virtual Reality and Nonliving Training Modelsmentioning

confidence: 99%

Superiority of living animal models in microsurgical training: beyond technical expertise

et al. 2021

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“…Some authors have elected for conservative treatment in COVID-19-positive or untested patients where free tissue transfer would have been performed otherwise. 21 Many surgeons advocate for early coverage of lower-extremity wounds. However, rapid testing to achieve a reconstruction within 72 hours, as advocated by some authors, may not be achievable at all institutions.…”

Section: High-risk and Standard-risk Reconstructionmentioning

confidence: 99%

Microsurgery in the era of COVID-19

Payton

Wong

Lombana

et al. 2021

Baylor University Medical Center Proceedings

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The COVID-19 pandemic has presented new challenges to microsurgeons. The virus is highly transmissible, with increased risk during operations that involve the aerodigestive tract. It is important to be able to identify high-risk operations and scenarios to guide management decisions and selection of personal protective equipment. Preoperative testing is a key element in identifying high-risk scenarios, and preoperative testing protocols are essential to maintaining safety in the COVID-19 era. Because COVID-19 can be transmitted via the conjunctiva, adaptations to loupes and microscopes are necessary to safely perform microsurgery in high-risk scenarios. We outline a potential risk stratification algorithm, as well as precautions for each scenario. Potential areas for innovation are also discussed.

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“…1 Microsurgery services have had to carry on being available for lower limb injuries and head and neck cancers, even during the peak of the disease. 2 At the same time, outpatient clinics and elective operating lists were reduced dramatically, due to hospital staff reassignments and to minimise the risk of patient exposure to the virus. Elective surgery, including immediate breast reconstructions, were held back and the guidance from world surgical societies was to delay reconstructive procedures.…”

Section: Impact Of Covid-19 Pandemic On Microsurgery Fellowshipsmentioning

confidence: 99%