Advanced non-animal microsurgical exercises.

For the novice microsurgeon, suturing simple lines on a static model ill prepares them for the technically difficult live model that is to follow. A practice card was therefore designed to make the transition easier. The basic building block is rubber glove sutured to form a simple tube. From this point, progressive exercises are carried out. These are (1) simple suturing, (2) tube anastomosis, (3) end-to-end anastomosis, (4) end-to-side anastomosis, (5) side-to-side anastomosis, (6) inequality of diameters, and (7) free graft placement. Since the student is faced with problems that are challenging and progressively complex, a noticeable improvement is seen in their skills. These models introduce the student to planning and instrumentation that they would deal with in the clinical situation. Once the student has mastered these exercises, he/she is ready to advance to the rat model.