Microsurgical Training

Marsh, Daniel; Norton, Samuel E.; Mok, Ji Oh; Patel, Hasu; Chen, Hung-Chi

doi:10.1097/sap.0b013e3180ca8739

Cited by 18 publications

(19 citation statements)

References 2 publications

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Section: Discussionmentioning

confidence: 99%

“…The fresh chicken tissue is a simple, readily available and robust microsurgical non-living training model [ 9 ]. It has consistently been used for microvascular anastomosis training [ 9 ]; however, it has not been fully utilised for teaching the skills necessary for more macro- tissue dissection or free tissue transfer in the early stages of microsurgical training. The chicken thigh abductor profundus free muscle flap is based on the muscular branches of the ischiatic pedicle, which supply other muscles in the posterior thigh necessitating careful dissection of the adductor profundus (AP) muscular branch, and control other branches.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, similar construct validity was demonstrated for tissue dissection with the more senior trainees being able to complete the AP free muscle flap in 20% less time than their less experienced counterparts. Accordingly, adding the flap dissection component to the arterial and venous anastomosis traditionally taught on the fresh chicken model, a more realistic simulation of free tissue transfer is possible with the same level of validity [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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The Chicken Thigh Adductor Profundus Free Muscle Flap: A Novel Validated Non-Living Microsurgery Simulation Training Model

et al. 2017

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BackgroundSimulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here.MethodsA step-by-step dissection guide on how to perform the chicken thigh adductor profundus free muscle flap is demonstrated. Forty trainees performed the novel simulation muscle flap on the last day of a 5-day microsurgery course. Pre- and post-course microvascular anastomosis assessment, along with micro dissection and end product (anastomosis lapse index) assessment, demonstrated skills acquisition.ResultsThe average time to dissect the flap by novice trainees was 82±24 minutes, by core trainees 90±24 minutes, and by higher trainees 64±21 minutes (P=0.013). There was a statistically significant difference in the time to complete the anastomosis between the three levels of training (P=0.001) and there was a significant decrease in the time taken to perform the anastomosis following course completion (P<0.001). Anastomosis lapse index scores improved for all cohorts with post-test average anastomosis lapse index score of 3±1.4 (P<0.001).ConclusionsThe novel chicken thigh adductor profundus free muscle flap model demonstrates face and construct validity for the introduction of the principles of free tissue transfer. The low cost, constant, and reproducible anatomy makes this simulation model a recommended addition to any microsurgical training curriculum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Chicken Thigh Adductor Profundus Free Muscle Flap: A Novel Validated Non-Living Microsurgery Simulation Training Model

et al. 2017

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“…As such, the concept of training on the femoral structures of store-bought chicken thighs has been entertained for decades. This model was recently reestablished in 2007 by Marsh et al 1 and further characterized for supermicrosurgery by Chen et al 2 This model has been well received due to significant advantages in material availability, price, and minimal location and scheduling requirements. 3 Nevertheless, a major deficiency remains: the inability to realistically simulate vessel perfusion.…”

mentioning

confidence: 99%

“Blue-Blood”- Infused Chicken Thigh Training Model for Microsurgery and Supermicrosurgery

Zeng

Shulzhenko

Feldman

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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“…These include living animals 1,2 , human cadaveric specimens 3 , inert models 4,5 and non-living animal models [6][7][8][9] .The Living animal models, specifically those using rats have been extensively used in the teaching of microsurgery 1,2 ; and they are considered the current gold standard of training. In spite of their remarkable instructive value, when an intensive or prolonged training is required; economical and ethical concerns can hinder their practical usage.…”

Section: Introductionmentioning

confidence: 99%

Step By Step: Microsurgical training method combining two nonliving animal models

Couceiro

Castro

Tien

et al. 2015

JoVE

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The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly laboratory rats. This method although extremely valuable can be economically demanding both for the surgeon and the sponsoring institution; it also requires special training facilities that may not always be available or accessible. Furthermore ethical concerns can limit the use of living animals for training purposes. Alternative training methods, such as inert tubes and gloves have not gained popularity among surgeons since they do not offer an experience similar to that of a clinical situation. Non-living animal models include the use of chicken thighs and wings; they offer a practice experience that resembles a clinical situation to a considerable extent. This type of training is relatively cheap and easily available. The microscope and instruments required can be acquired over the internet, and the chicken pieces can be bought at the local supermarket.This approach allows a motivated trainee to rehearse different types of surgical techniques several times at a reasonable expense, helping to develop or maintain his surgical expertise if more complex facilities are not available. On the current manuscript we describe how to setup a small practice station, how to dissect the specimens, and how to practice both with the chicken thighs and with the chicken wings in a progressive fashion. This approach takes advantage on the versatility of the chicken thigh model and the small size of the chicken wing Brachial artery. Video LinkThe video component of this article can be found at

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Microsurgical Training

Cited by 18 publications

References 2 publications

The Chicken Thigh Adductor Profundus Free Muscle Flap: A Novel Validated Non-Living Microsurgery Simulation Training Model

The Chicken Thigh Adductor Profundus Free Muscle Flap: A Novel Validated Non-Living Microsurgery Simulation Training Model

“Blue-Blood”- Infused Chicken Thigh Training Model for Microsurgery and Supermicrosurgery

Step By Step: Microsurgical training method combining two nonliving animal models

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