Abstract
Background Microsurgery requires a high level of skill achieved only through repeated practice.
With duty-hour restrictions and supervision requirements, trainees require more opportunities
for practice outside the operating room. Studies show simulation training improves
knowledge and skills. While numerous microvascular simulation models exist, virtually
all lack the combination of human tissue and pulsatile flow.
Methods The authors utilized a novel simulation platform incorporating cryopreserved human
vein and a pulsatile flow circuit for microsurgery training at two academic centers.
Subjects performed a standardized simulated microvascular anastomosis and repeated
this task at subsequent training sessions. Each session was evaluated using pre- and
postsimulation surveys, standardized assessment forms, and the time required to complete
each anastomosis. Outcomes of interest include change in self-reported confidence
scores, skill assessment scores, and time to complete the task.
Results In total, 36 simulation sessions were recorded including 21 first attempts and 15
second attempts. Pre- and postsimulation survey data across multiple attempts demonstrated
a statistically significant increase in self-reported confidence scores. Time to complete
the simulation and skill assessment scores improved with multiple attempts; however,
these findings were not statistically significant. Subjects unanimously reported on
postsimulation surveys that the simulation was beneficial in improving their skills
and confidence.
Conclusion The combination of human tissue and pulsatile flow results in a simulation experience
that approaches the level of realism achieved with live animal models. This allows
plastic surgery residents to improve microsurgical skills and increase confidence
without the need for expensive animal laboratories or any undue risk to patients.
Keywords
simulation training - microvascular - pulsatile flow
