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Microvascular surgery training in a low volume setting: a single healthcare center experience

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Today, the surgical approach in the treatment of complex injuries is changing in that complex and intricate procedures, such as microvascular surgery, are no longer kept as a last resort. In Plastic and Reconstructive surgery, microvascular surgery has been described in the treatment of extensive tissue defects using free tissue transfer. This study discusses the incorporation of microvascular training in residency programs, as well as identifying the factors that influence residents’ confidence in performing microsurgery without supervision.

Methods

This is a cross-sectional study conducted on thirteen current and former Plastic and Reconstructive surgery residents who practiced microsurgery during the past 8 years at the American University of Beirut Medical Center in Lebanon.

Results

Nine residents (69.2%) started scrubbing in and became actively involved in microsurgery procedures at the PGY IV level with the majority being exposed to cases every 2–3 weeks (69.2%). Residents were mostly exposed to breast (100%) and orthopedic reconstruction (92.3%), and facial trauma reconstruction was the least practiced (46.2%). Eleven residents (84.6%) reported that music and choice of OR staff assisting in the operation significantly affected their speed and performance. Eleven residents (84.6%) were satisfied with the training program, and ten found the training program beneficial for their career (76.9%).

Conclusion

Our findings suggest that residents who had a higher workload and were actively involved in microsurgery early during residency felt more confident in performing the procedure by themselves. The choice of operating staff, playing music, and the presence of different attendings in the operating room were found to affect the speed and performance of residents.

Level of evidence

Level V, Risk/Prognostic.

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Author notes

  1. Marwan S. Hajjar and Abdulghani Abou Koura contributed equally to this work.

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon

    Marwan S. Hajjar, Abdulghani Abou Koura & Amir E. Ibrahim

  2. Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Morgan Bou Zerdan

Authors
  1. Marwan S. Hajjar
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  2. Abdulghani Abou Koura
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  3. Morgan Bou Zerdan
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  4. Amir E. Ibrahim
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by first, second, and third authors. The first draft of the manuscript was written by first and second authors, and all authors commented on previous versions of the manuscript. The corresponding author supervised the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Amir E. Ibrahim.

Ethics declarations

Ethics approval

This project was approved by the American University of Beirut Institutional Review Board (SBS-2021-0105). This paper is not currently being considered for publication elsewhere. It reflects the authors’ own research and analysis in a truthful and complete manner. All authors have been personally and actively involved in substantial work leading to the paper and will take public responsibility for its content.

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An online consent form was sent explaining the purpose of the study and confidentiality followed by a link that redirects participants to the survey.

Competing interests

The authors declare no competing interests.

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Hajjar, M.S., Koura, A.A., Zerdan, M.B. et al. Microvascular surgery training in a low volume setting: a single healthcare center experience. Eur J Plast Surg 46, 1377–1382 (2023). https://doi.org/10.1007/s00238-023-02111-y

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  • DOI: https://doi.org/10.1007/s00238-023-02111-y

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