Marco Pignatti1, Pierluigi Tos2, Cristina Garusi3, Fabrizio Schonauer4, Mario Cherubino5, Cesare Tiengo6, Davide Ciclamini7, Santolo Cozzolino8, Eva Di Maro9, Lucian P Jiga10, Mihai Ionac11, Alexandru Nistor12, Alexandru V Georgescu13, Valentina Pinto14, Federico A Giorgini15, Giorgio De Santis16, Salvatore D'Arpa17. 1. Plastic Surgery, Sant'Orsola University Hospital, DIMES, Bologna University, Bologna, Italy. Electronic address: mrpignatti@gmail.com. 2. UOC di Microchirurgia e Chirurgia della Mano - ASST Gaetano Pini - CTO Milano, Milano, Italy. 3. Dipartimento di Chirurgia Plastica e Ricostruttiva, Istituto Europeo di Oncologia, Milano, Italy. 4. Chirurgia Plastica e Ricostruttiva, Università Federico II, Napoli, Italy. 5. Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy. 6. Plastic and Reconstructive Surgery Unit, Padova University Hospital, Padova, Italy. 7. Orthopaedic and Traumatology 2, Hand and Microsurgery Unit, A.O.U. Città della Salute e della Scienza, C.T.O. Hospital, Torino, Italy. 8. Direttore UOC Formazione, Ricerca e Cooperazione Internazionale, Aorn A., Cardarelli, Italy. 9. Veterinario Designato UOC Formazione, Ricerca e cooperazione Internazionale, Aorn A., Cardarelli, Italy. 10. Department for Plastic, Aesthetic, Reconstructive and Hand Surgery, Evangelisches Krankenhaus, Medical Campus - University of Oldenburg, Germany. 11. Division of Reconstructive Microsurgery, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. 12. Division of Reconstructive Microsurgery, Pius Brazneu Center. Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. 13. Plastic Surgery and Reconstructive Microsurgery, University of Medicine Iuliu Hațieganu . Spitalul Clinic de Recuperare Cluj Napoca, România. 14. Plastic Surgery, Sant'Orsola University Hospital, Bologna, Italy. 15. Plastic Surgery, Sant'Orsola University Hospital, DIMES, Bologna University, Bologna, Italy; Chirurgia Plastica, Università di Modena e Reggio, Policlinico di Modena, Italy. 16. Chirurgia Plastica, Università di Modena e Reggio, Policlinico di Modena, Italy. 17. Plastica and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (DICHIRONS), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy. Electronic address: salvatore.darpa@unipa.it.
Abstract
INTRODUCTION: The training to learn how to perform perforator flaps requires practice on a living model to optimize dissection and to evaluate outcome. The purpose of this study was to describe a training model that optimizes the use of animals in order to perform the maximum number of exercises per animal. MATERIAL AND METHODS: The sequence has been planned and practiced by the first and last author, recorded perfected and implemented in a two-day surgical course. The sequence was then evaluated by the trainers and the trainees by means of a questionnaire. RESULTS: All students were able to complete the sequence of exercises before the end of the second day except two (8/10) who could not complete one exercise each. The students considered the Deep Superior Epigastric Artery Perforator flap the most difficult to perform, being the most technically demanding. The sequence of exercises was judged either easily reproducible or reproducible by all the students. Two students suggested to postpone the DSEAP flap to the second day, after some training, to optimize the experience with the most challenging and rewarding flap. CONCLUSIONS: The training sequence proposed offers a wide range of exercises and allows four trainees, divided in two teams, to work and learn on the same animal. They can perform a wide range of flaps and also harvest the internal mammary vessels. The living model allows for evaluation of the quality of the surgical performance, judged by the difficulties and complications encountered during dissection, and finally through the feedback of flap perfusion.
INTRODUCTION: The training to learn how to perform perforator flaps requires practice on a living model to optimize dissection and to evaluate outcome. The purpose of this study was to describe a training model that optimizes the use of animals in order to perform the maximum number of exercises per animal. MATERIAL AND METHODS: The sequence has been planned and practiced by the first and last author, recorded perfected and implemented in a two-day surgical course. The sequence was then evaluated by the trainers and the trainees by means of a questionnaire. RESULTS: All students were able to complete the sequence of exercises before the end of the second day except two (8/10) who could not complete one exercise each. The students considered the Deep Superior Epigastric Artery Perforator flap the most difficult to perform, being the most technically demanding. The sequence of exercises was judged either easily reproducible or reproducible by all the students. Two students suggested to postpone the DSEAP flap to the second day, after some training, to optimize the experience with the most challenging and rewarding flap. CONCLUSIONS: The training sequence proposed offers a wide range of exercises and allows four trainees, divided in two teams, to work and learn on the same animal. They can perform a wide range of flaps and also harvest the internal mammary vessels. The living model allows for evaluation of the quality of the surgical performance, judged by the difficulties and complications encountered during dissection, and finally through the feedback of flap perfusion.
Authors: Alexandru Nistor; Lucian P Jiga; Gratian D Miclaus; Bogdan Hoinoiu; Petru Matusz; Mihai E Ionac Journal: PLoS One Date: 2022-04-11 Impact factor: 3.240