Banana fruit: An "appealing" alternative for practicing suture techniques in resource-limited settings

Suturing is an important core surgical competency that requires continued practice. The purpose of this study was to evaluate bananas as a medium for practicing suture techniques in resource-limited settings.

Using a crossover design, 20 University of Rwanda medical students practiced suturing on banana peels and commercial foam boards. Students were randomized into 2 groups: group A practiced on foam boards first and then bananas, and group B practiced on banana peels first and then foam boards. A post-workshop survey was then administered to students to gauge their attitude towards banana peels as a suturing practice material. Suture performance for each student was graded by three fellowship-trained facial plastic surgeons based on consistent spacing, knot location, appropriate knot, absence of air knots, and adequate bite size.

Suture performance graded by facial plastic surgeons demonstrated that suturing outcomes with bananas were equal or superior to foam in 56.7% of instances. Twenty students participated in the workshop; 16 students responded to the survey (response rate = 80%). Students were comfortable practicing suturing with banana peels (Mdn = 4, IQR = 1) and strongly agreed that suturing banana peels was a useful activity (Mdn = 5, IQR = 1). Students thought banana peels and foam were comparable learning platforms (Mdn = 3.5, IQR = 1) and felt their suturing abilities improved with practice on banana peels (Mdn = 4, IQR = 1.3).

Banana peels are a low cost, equally viable alternative to synthetic suture media.