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

  • Pafitanis, Georgios (Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London) ;
  • Serrar, Yasmine (Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London) ;
  • Raveendran, Maria (Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London) ;
  • Ghanem, Ali (Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London) ;
  • Myers, Simon (Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London)
  • 투고 : 2016.12.29
  • 심사 : 2017.04.05
  • 발행 : 2017.07.15

초록

Background Simulation 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. Methods A 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. Results The average time to dissect the flap by novice trainees was $82{\pm}24$ minutes, by core trainees $90{\pm}24$ minutes, and by higher trainees $64{\pm}21$ 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 $3{\pm}1.4$ (P<0.001). Conclusions The 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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참고문헌

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피인용 문헌

  1. Current status of simulation and training models in microsurgery: A systematic review vol.39, pp.7, 2017, https://doi.org/10.1002/micr.30513
  2. Microsurgery Training in Plastic Surgery vol.8, pp.7, 2017, https://doi.org/10.1097/gox.0000000000002898