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European Journal of Plastic Surgery
Published in: European Journal of Plastic Surgery 6/2021

01-12-2021 | Experimental Study

Smoothing the steep microsurgery learning curve: considering alternative suture sizes for early-stage microsurgery training with in vivo rat models

Authors: YuanDian Zheng, John J. Corvi, Joseph R. Paladino, Yelena Akelina

Published in: European Journal of Plastic Surgery | Issue 6/2021

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Abstract

Background

Laboratory microsurgery training using invivo rat models is essential for clinical operation. However, challenges existin a structured training course when students transition from a non-livingmodel exercise to a living one. In the present article, we first demonstratethis steep learning curve in early-stage microsurgery training. We then proposethe potential solution of using various sizes of sutures for different trainingpurposes.

Methods

Twoseparate preliminary studies were included. First, we reviewed the records of25 students enrolled in our basic microsurgery training course. Each studentcompleted exercises in a non-living model before graduating to a live animalmodel where their performance on end-to-end arterial and venous anastomoses wasevaluated. Second, we examined the feasibility of different suture sizes in amillimeter microvascular anastomosis. Four groups of identical procedures inrat femoral artery were completed using sutures from 8-0 to 11-0. Patency rateand mean blood flow at 60 min post-op were measured and compared.

Results

Thirty-minute patency rates for firstarterial and venous anastomoses were 18/25 and 14/25. Those students who hadnon-patent anastomoses spent significantly longer time than those who hadpatent ones (p<.05). For varioussuture sizes, all groups achieved a 100% patency rate. No significantdifferences were found between the mean blood flow volume at 60 min post-op (p>.05).

Conclusions

Steep learning curve existed in the early-stagemicrosurgery training when transitioning from non-living to living exercisemodels. The feasibility of using various suture sizes in millimeter anastomosismay be a potential solution for instructors to ease this steep learning curve.
Level of Evidence: Not gradable
Literature
1.
Stewart CJ, Yusoff SKM, Widdowson D, Lam WL (2016) Microsurgical skill acquisition in a one-day introductory course with performance evaluation using software-assisted scoring system. J Plast Reconstr Aesthet Surg 69:783–788CrossRef
2.
Gomez M, Nicotet C, Verdier J et al (2019) Does the repetition over a short time of a microsurgical suture improve its reliability? Hand Surg Rehabil 38:348–352CrossRef
3.
Shurey S, Akelina Y, Legagneux J, Malzone G, Jiga L, Ghanem AM (2014) The rat model in microsurgery education: classical exercises and new horizons. Arch Plast Surg 41(3):201–208CrossRef
4.
Cooley BC (2009) A laboratory manual for microvascular and microtubal surgery. 2nd ed. Reading: Surgical Specialties Corporation, pp 10–11,39–59
5.
Acaland RD, Sabapathy SR (2008) Acaland’s practice manual for microvascular surgery, 3rd edn. Louisville: Indian Society for the Surgery of the Hand, p 7
6.
Ghanem A, Kearns M, Ballestín A et al (2020) International microsurgery simulation society (IMSS) consensus statement on the minimum standards for a basic microsurgery course, requirements for a microsurgical anastomosis global rating scale and minimum thresholds for training. Injury 51(Suppl 4):S126–S130CrossRef
7.
Macdonald JD (2005) Learning to perform microvascular anastomosis. Skull Base 15(03):229–240CrossRef
8.
Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam B-K (2011) A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: the role of deliberate practice. J Thorac Cardiov Sur 142(3):496–503CrossRef
9.
Balasundaram I, Aggarwal R, Darzi LA (2010) Development of a training curriculum for microsurgery. Br J Oral Max Surg 48(8):598–606CrossRef
10.
Studinger RM, Bradford MM, Jackson IT (2005) Microsurgical training: Is it adequate for the operating room? Eur J Plast Surg 28(2):91–93CrossRef
11.
Cooley BC (2009) A laboratory manual for microvascular and microtubal surgery, 2nd edn. Reading: Surgical Specialties Corporation, pp 58–59
Metadata
Title
Smoothing the steep microsurgery learning curve: considering alternative suture sizes for early-stage microsurgery training with in vivo rat models
Authors
YuanDian Zheng
John J. Corvi
Joseph R. Paladino
Yelena Akelina
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 6/2021
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-021-01850-0

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