Michael Atlan1, Alexandre G Lellouch2, Josette Legagneux3, Marc Chaouat4, Alain-Charles Masquelet3, Didier Letourneur5. 1. Faculty of Medicine, University Pierre et Marie Curie, Paris, France; Plastic Surgery Department, APHP, Hôpital Tenon, Paris, France; Department of Microsurgery, Faculty of Medicine, School of Surgery of Paris, University Pierre et Marie Curie, Paris, France; Inserm; Institut National de la Sante et de la Recherche Medicale 1148, Laboratory for Vascular Translational Science, University Paris Diderot, University Paris 13, CHU X Bichat, Paris, France. Electronic address: drmichaelatlan@gmail.com. 2. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 3. Department of Microsurgery, Faculty of Medicine, School of Surgery of Paris, University Pierre et Marie Curie, Paris, France. 4. Inserm; Institut National de la Sante et de la Recherche Medicale 1148, Laboratory for Vascular Translational Science, University Paris Diderot, University Paris 13, CHU X Bichat, Paris, France; Plastic Surgery Department, Burn Unit, APHP, Hôpital Saint Louis, Paris, France. 5. Inserm; Institut National de la Sante et de la Recherche Medicale 1148, Laboratory for Vascular Translational Science, University Paris Diderot, University Paris 13, CHU X Bichat, Paris, France.
Abstract
INTRODUCTION: Assessment of a resident's microsurgical competency with the rodent model remains the current gold standard. However, cost and ethical issues related to animal welfare may limit training opportunities. Therefore, synthetic alternatives such as silicone tubes have been developed to provide easy access to training, shorten the learning curve, and have been incorporated into microsurgical courses as a low-fidelity model for basic skills acquisition. This study compares the use of polyvinyl alcohol (PVA) gelatin tubes with silicone for resident microsurgical training. MATERIAL AND METHODS: Residents were randomized into silicone (S) or PVA (P) groups and underwent the same training. Following basic instruction, microsurgical anastomoses were performed with the rat's aorta or carotid artery or both. Performance was assessed using the Objective Structured Assessment of Technical Skills (OSATS) score and 5 different items to assess the quality of the anastomosis. Posttest questionnaires were also conducted for qualitative assessment of both students' and trainers' experience with silicone and PVA in comparison with rat vessels. RESULTS: OSATS score in Group P was higher than Group S (18.2 ± 2.6 vs 16.6 ± 2.5, p = 0.015). Results of anastomoses were similarly better in Group P based on OSATS score (19.3 ± 1.2 vs 17.7 ± 0.7, p = 0.027). Subjectively, both students and trainers found that PVA tubes resembled the rat aorta more closely than silicone. The number of rats used was also significantly lower in Group P than Group S (65 vs 75 total, p = 0.023). CONCLUSION: PVA gelatin tubes may be a viable alternative to silicone for microsurgical training because this synthetic model mirrors better rat vessels and can improve training performance based on objective assessment while using less animals overall.
INTRODUCTION: Assessment of a resident's microsurgical competency with the rodent model remains the current gold standard. However, cost and ethical issues related to animal welfare may limit training opportunities. Therefore, synthetic alternatives such as silicone tubes have been developed to provide easy access to training, shorten the learning curve, and have been incorporated into microsurgical courses as a low-fidelity model for basic skills acquisition. This study compares the use of polyvinyl alcohol (PVA) gelatin tubes with silicone for resident microsurgical training. MATERIAL AND METHODS: Residents were randomized into silicone (S) or PVA (P) groups and underwent the same training. Following basic instruction, microsurgical anastomoses were performed with the rat's aorta or carotid artery or both. Performance was assessed using the Objective Structured Assessment of Technical Skills (OSATS) score and 5 different items to assess the quality of the anastomosis. Posttest questionnaires were also conducted for qualitative assessment of both students' and trainers' experience with silicone and PVA in comparison with rat vessels. RESULTS: OSATS score in Group P was higher than Group S (18.2 ± 2.6 vs 16.6 ± 2.5, p = 0.015). Results of anastomoses were similarly better in Group P based on OSATS score (19.3 ± 1.2 vs 17.7 ± 0.7, p = 0.027). Subjectively, both students and trainers found that PVA tubes resembled the rat aorta more closely than silicone. The number of rats used was also significantly lower in Group P than Group S (65 vs 75 total, p = 0.023). CONCLUSION:PVA gelatin tubes may be a viable alternative to silicone for microsurgical training because this synthetic model mirrors better rat vessels and can improve training performance based on objective assessment while using less animals overall.
Authors: S Cem Millik; Ashley M Dostie; Dylan G Karis; Patrick T Smith; Michael McKenna; Nathan Chan; Chad D Curtis; Elizabeth Nance; Ashleigh B Theberge; Alshakim Nelson Journal: Biofabrication Date: 2019-07-12 Impact factor: 9.954
Authors: Vadim Byvaltsev; Roman Polkin; Dmitry Bereznyak; Morgan B Giers; Phillip A Hernandez; Valery Shepelev; Marat Aliyev Journal: Surg Neurol Int Date: 2021-05-10
Authors: Jéssika da Silva Antas; Ana Karolina Gama de Holanda; Achilles de Sousa Andrade; Alinne Mirlania Sabino de Araujo; Isabella Guilherme de Carvalho Costa; Luciano Ribeiro Dantas; Silvane Katerine Medeiros de Lima; Priscilla Lopes da Fonseca Abrantes Sarmento Journal: J Vasc Bras Date: 2020-11-11