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Macrosurgical Training of Microsurgical Skills: Model Design and Initial Results
Ian Chow, MD; Edward H. Davidson, MA (Cantab), MBBS; Vu T. Nguyen, MD
University of Pittsburgh Medical Center
2017-02-14
Presenter: Ian Chow, MD
Affidavit:
certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The work enclosed represents approximately 80% of the submitting resident's work. Model conception was split between EHD and VTN. Study design was split between the three submitting authors. The submitting resident was responsible for 100% of the acquisition of data, analysis of the data, and drafting of the abstract.
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Novice microsurgeons are often thrust into technically demanding procedures with little to no prior experience. Although models for microsurgical training exist (live rat, chicken thigh); they are hampered by high cost, the need for specialized equipment, and limited availability. In this study, we propose a novel "macrosurgical" model of microsurgery that is readily reproducible, low cost, and amenable to use in multiple settings.
Methods: An initial model was developed and tested during the 2016 Plastic Surgery Boot Camp consisting of a penrose drain attached via staples to a rigid platform with paperclips used to rotate the anastomosis. Practice on the model was performed with microsurgical principles and techniques with standard surgical instruments. A voluntary survey was distributed and results were analyzed based on resident pathway and the training model utilized.
Results: Overall, 47.1% of participants (32/68) responded to the survey. All respondents either had a minimal or moderate understanding of microsurgical principles prior to model utilization. Following training, 87.5% of residents reported moderate to excellent improvements in understanding of core microsurgical principles. Nearly all individuals who trained with the macrosurgical model felt that it could be utilized for home practice (96.3%).
Conclusions: A low fidelity macrosurgical model of microsurgical skills is easily reproducible at home, is low cost, and appears to be most useful in the development of a conceptual framework for microsurgery. Further refinements of the model are possible including the use of smaller caliber simulated vessels, the introduction of microsurgical instruments, and the inclusion of magnification.
