Open Access
CC BY 4.0 · Arch Plast Surg 2023; 50(06): 621-626
DOI: 10.1055/s-0043-1771272
Research/Experimental
Idea and Innovation

High-Fidelity Perforator Visualization for Cadaver Dissection in Surgical Training

Allen Wei Jiat Wong 
1   Plastic Reconstructive and Aesthetic Surgery Service, Sengkang General Hospital, Singapore, Singapore
2   Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
,
Yee Onn Kok 
1   Plastic Reconstructive and Aesthetic Surgery Service, Sengkang General Hospital, Singapore, Singapore
2   Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
,
Khong Yik Chew 
2   Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
,
Bien Keem Tan 
2   Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore
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Abstract

In the first half of the third century B.C., Herophilus and Erasistratus performed the first systematic dissection of the human body. For subsequent centuries, these cadaveric dissections were key to the advancement of anatomical knowledge and surgical techniques. To this day, despite various instructional methods, cadaver dissection remained the best way for surgical training. To improve the quality of education and research through cadaveric dissection, our institution has developed a unique method of perforator-preserving cadaver injection, allowing us to achieve high-fidelity perforator visualization for dissection studies, at low cost and high efficacy. Ten full body cadavers were sectioned through the base of neck, bilateral shoulder, and hip joints. The key was to dissect multiple perfusing arteries and draining veins for each section, to increase “capture” of vascular territories. The vessels were carefully flushed, insufflated, and then filled with latex dye. Our injection dye comprised of liquid latex, formalin, and acrylic paint in the ratio of 1:2:1. Different endpoints were used to assess adequacy of injection, such as reconstitution of eyeball volume, skin turgor, visible dye in subcutaneous veins, and seepage of dye through stab incisions in digital pulps. Dissections demonstrated the effectiveness of the dye, outlining even the small osseous perforators of the medial femoral condyle flap and subconjunctival plexuses. Our technique emphasized atraumatic preparation, recreation of luminal space through insufflation, and finally careful injection of latex dye with adequate curing. This has allowed high-fidelity perforator visualization for dissection studies.

Keywords

cadaver - high fidelity - dissection - perforator

Authors' Contributions

A.W.J.W.: surgeon, design of study, data collection and analysis, interpretation of data, drafting the manuscript, approval of manuscript.

Y.O.K.: surgeon, design of study, data collection, interpretation of data, drafting and revising the manuscript, approval of manuscript.

K.Y.C.: data collection, interpretation of data, drafting and revising the manuscript, approval of manuscript.

B.K.T.: interpretation of data, drafting and revising the manuscript, approval of manuscript.


Ethical Approval

This was not required for the study.


Patient Consent

Since bodies were deceased and unidentified, consent was not necessary and not applicable.




Publication History

Received: 30 September 2022

Accepted: 15 June 2023

Article published online:
31 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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