Optimizing the Chicken Wing Anatomy: Nomenclature Review and Description for Microsurgery and Supermicrosurgery Training

Microsurgery-simulated training has been demonstrated as an effective tool for skill acquisition. Training models described in literature are numerous,[1] [2] being the chicken wing one of the most popular because of its versatility, low cost, easy access, and storage. First described by Hino in 2003,[3] it has been widely used since, with recent emphasis in supermicrosurgery.[4] However, even though many authors have published about the chicken wing model, we have found great differences in their nomenclature and anatomical description. Moreover, even some veterinary anatomy textbooks do not use the correct updated nomenclature.[5]

The International Avian Anatomy Nomenclature Consensus was developed by Julian J. Baumel (1922–2006), PhD in Anatomy and member of the Nuttall Ornithological Club (United States), the World Association of Veterinary Anatomists (United States), and the International Committee on Avian Nomenclature. The first edition of the “Nomina Anatomica Avium” was published in 1979 and updated in 1993, and corresponds to the more detailed avian anatomical description to date.[6]

Given the increasing development of simulated training programs in microsurgery based on chicken wings, there is a need to standardize its nomenclature. The aim of our study was to properly describe its anatomy with correct nomenclature and measure its principal neurovascular structures to optimize its use for training.

Sixty chicken wings (Gallus Gallus Domesticus) were bought on a local market. They were weighted, dissected, and external diameters of a selection of vessels and nerves were measured using a submillimetrical scale with 0.05-mm intervals (Shinwa Measurement, Niigata, Japan). Measures were done by two independent microsurgeons and results were analyzed in Excel v.16.9. calculating mean, standard deviation and compared using Bland and Altman analysis with adequate agreement ([Supplementary Table S1], available in the online version).

We dissected and measured 16 structures: median ulnaris nerve, basilic vein, brachial artery, ulnar artery, radial artery, collateral ulnar artery and vein, anconeal nerve, superficial ulnar artery, deep and superficial radial arteries, deep ulnar vein, ventral metacarpal artery and vein, interossei metacarpal artery, and dorsal metacarpal artery ([Fig. 1]). The bifurcation of the brachial artery into radial and ulnar arteries is at the proximal third of the brachium, approximately 29.95 ± 5.97 mm from the humeral head. The main vein of the brachium is the basilic vein (1.43 ± 0.25 mm) and from the antebrachium the deep ulnar vein (0.90 ± 0.15 mm), whereas its corresponding deep ulnar artery is rather minor or absent in the Gallus. Our results in the antebrachium and hand were concordant with those published by Hayashi et al; however, our chicken wings were bigger with a mean weight of 79.4 g (range 53–100 g).[7]

Fig. 1 Schematic anatomical chicken wing illustration showing its main neurovascular structures and their diameters.

The dissection and anatomical review presented allows guided harvesting of the vessels and better planning for training sessions, optimizing resources by selecting the most suitable for specific training in microsurgery (2.0–0.8 mm) or supermicrosurgery (<0.8 mm), saving the remaining unused vessels ([Video 1]). In our experience, chicken wings can be safely frozen and unfrozen at least four times. To our knowledge, this would be the most updated, complete, anatomically and nomenclature accurate chicken wing description focused on microsurgery training.

Video 1 Chicken wing dissection.

Publikationsverlauf

Eingereicht: 01. Juni 2020

Angenommen: 25. August 2020

Artikel online veröffentlicht:
01. Oktober 2020

• References

• 1 Shulzhenko NO, Zeng W, Albano NJ. et al. Multispecialty microsurgical course utilizing the blue-blood chicken thigh model significantly improves resident comfort, confidence, and attitudes in multiple domains. J Reconstr Microsurg 2020; 36 (02) 142-150
• 2 Costa AL, Cucinotta F, Fazio A. et al. Anterolateral thigh flap in a chicken model: a novel perforator training model. J Reconstr Microsurg 2019; 35 (07) 485-488
• 3 Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery 2003; 52 (06) 1495-1497 , discussion 1497–1498
• 4 Ganry L, Fuse Y, Sakai H, Reiko T, Yamamoto T. Refinement of the chicken wing supermicrosurgical training model: Pre-operative indocyanide green injection highlighting vessels' visualization under 0.4 mm of diameter. Microsurgery 2019; 39 (03) 280-281
• 5 Yasuda M. The Anatomical Atlas of Gallus (Japan). Tokyo: University of Tokyo Press; 2002
• 6 Baumel JJ. Handbook of Avian Anatomy: Nomina Anatomica Avium. Cambridge, MA: Harvard Univ Nuttall Ornithological; 1993
• 7 Hayashi K, Hattori Y, Yii Chia DS, Sakamoto S, Marei A, Doi K. A supermicrosurgery training model using the chicken mid and lower wing. J Plast Reconstr Aesthet Surg 2018; 71 (06) 943-945