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Novel and easy curriculum with simulated models for microsurgery for plastic surgery residents: reducing animal use

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Microsurgical training is currently limited by high costs, lack of equipment and infrastructure, increasing concerns about patient safety and expectations, which have resulted in a perception of deficit in the training of new surgeons. Therefore, simulated models offer controlled and effective training, minimizing animal use.

Methods

A simple and economical protocol was designed and applied in microsurgery training using exvivo models in 11 plastic surgery residents, lasting 40 h, during 13 sessions (3 h each), with a theoretical module and an explanatory video, supervised and given feedback by an expert. The initial assessment (IA) and a final assessment (FA) were recorded on video, subsequently evaluated by two blinded experts according to OSATS regulations, recording the tremor of participants using Apple Watch. A univariate and multivariate analysis were performed.

Results

All participants improved overall performance scores. In non-living models, IA = 19.6 points (CI: 16.2–23.1%) versus FA = 29.6 points (CI: 21.8–32%), and in ex vivo models, IA = 15.5 points (CI: 12.2–18%) versus FA = 23.9 points (CI: 19.3–28.5%), p = 0.005. Greater impact was identified in exercises that involve manipulation of fine elements, dexterity, precise movements, respect for the tissue, use of irrigation, saving sutures, and knotting techniques. No statistically significant improvement was found in tremor. No association was found with better performance for participants who engaged in extracurricular or meditation activities.

Conclusions

This curriculum allows for structured and sequential training in exvivo models, with a statistically significant improvement in global microsurgery performance scores among participants.

Level of evidence: Not ratable.

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Data Availability

The information supporting the data presented in graphs 2, 3 and 4 is from data collected during the study and not publicly available in order to protect participants privacy, but the data is available on request. Graph 1 and Figures 1, 2 and 3 are the product of the lab sessions and are publicly available in the figshare repository, as part of this record: https://figshare.com/s/a1ba1bdc7dc0c3cb1288.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Hospital Universitario de Santander, Universidad Industrial Santander, Carrera 33 # 28–126, 680002, Bucaramanga, Colombia

    Laura C. Zambrano-Jerez, Mónica A. Ramírez-Blanco, Diego F. Alarcón-Ariza & Genny L. Meléndez-Flórez

  2. Division of Plastic and Reconstructive Surgery, Hospital Internacional de Colombia, Universidad Industrial Santander, Bucaramanga, Colombia

    Mónica A. Ramírez-Blanco & Diego F. Alarcón-Ariza

  3. Division of Plastic and Reconstructive Surgery, Hospital Universitario de Santander, Bucaramanga, Colombia

    Laura C. Zambrano-Jerez, Genny L. Meléndez-Flórez, Daniela Pinzón-Mantilla, María A. Rodríguez-Santos & Carmen Ligia Arias-Valero

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  1. Laura C. Zambrano-Jerez
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Corresponding author

Correspondence to Laura C. Zambrano-Jerez.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Universidad Industrial de Santander and Hospital Universitario de Santander (Act No 1, February 5, 2021) and Hospital Universitario de Santander (Act No 08, June 18, 2021).

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Written consent was obtained from the residents for participate and sharing their data and photos.

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Written consent was obtained from the residents for sharing their data and photos.

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Editor: Horacio F Mayer, MD, FACS.

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Zambrano-Jerez, L.C., Ramírez-Blanco, M.A., Alarcón-Ariza, D.F. et al. Novel and easy curriculum with simulated models for microsurgery for plastic surgery residents: reducing animal use. Eur J Plast Surg 47, 36 (2024). https://doi.org/10.1007/s00238-024-02177-2

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