Development of a haptic model for teaching in reconstructive surgery--the radial forearm flap

The great value of the radial forearm flap (RFF) for reconstructive surgery stresses the importance of developing effective teaching methods. Our aim was to develop a realistic anatomic model that concisely simulates vital surgical steps while offering a haptic and visual experience. It should be cost-effective, easy to use, reusable, and quick to set up.

The development commenced by constructing a prototype presenting basic features. Together with photographic surgery documentation, it served as a blueprint for the advanced model. The flap-raising process was condensed into the 6 most important steps to illustrate the procedure concisely and chronologically.

Our final version consists of polyurethane, and a customized forearm flexor muscle model serves as the basic structure. Diverse plasticizers give different degrees of hardness to mimic anatomic structures. Special didactic features of the model include a movable elastic ramus superficialis nervi radialis. The flap island is attachable/detachable by a patrix/matrix mechanism. The brachioradialis muscle is elastic and detachable, and the fascia antebrachii is additionally severable. Vessels can be disconnected, and the removable forearm skin features a wave-shaped incision for the flap pedicle. To investigate the didactic benefit of the RFF model, we used it in a teaching course for medical students. The group receiving teaching supported by the RFF model showed a statistically significant improvement of knowledge (P = 0.007) in comparison with the group solely receiving a standard lecture supported by surgery images.

In our opinion, the RFF model is an excellent compromise with regard to realism, didactic benefit, and cost-/time-effectiveness and has proven successful in the teaching of medical students.