Description and implementation of an ex vivo simulator kit for developing microsurgery skills

Microsurgical training is an essential part of the plastic surgery training curriculum. Given the emphasis on safety and standardization in surgical training, use of simulators is key. We used a novel microsurgical skills training set to inexpensively, safely, and reproducibly teach and perfect microsurgical skills.

The microsurgery training set consists of a number of items, including 2- and 3-mm polyvinyl tubes (used to simulate blood vessels), a foam background, and a particulate dye used to test vessel patency after microvascular anastomosis. During a 2-year period, trainees were exposed to the system on at least 3 separate occasions. Qualitative and quantitative performance metrics were recorded at each setting.

Resident performance on the skills exercises improved with each exposure. Composite performance scores and completion times correlated significantly with the number of microsurgical cases each resident performed (P < 0.05). Utilization of the system was positively received by trainees on posttraining interviews.

On the basis of our experience, this system is a cost-effective way to introduce trainees to microsurgical skills. Furthermore, performance on the skills trainer positively correlates with actual microsurgical experience. Use of this system is a valuable alternative, compared to animal-based skills laboratories. Its use as a metric to establish competence in microsurgical skills acquisition is described.