Experimental swine models for perforator flap dissection in reconstructive microsurgery.

Area of Science:

• Microsurgery
• Surgical Education
• Reconstructive Surgery

Background:

• Perforator flaps are increasingly popular in reconstructive surgery.
• Acquiring microsurgical skills for perforator flap harvesting is challenging with traditional training methods.
• Existing animal models do not adequately simulate human perforator dissection.

Purpose of the Study:

• To develop and validate five standardized perforator flap models in living pigs for surgical training.
• To provide a hands-on learning tool for microsurgical skills in perforator flap harvesting.
• To compare porcine flap anatomy and dissection parameters with human counterparts.

Main Methods:

• Utilized CT angiography to map vascular anatomy in ten living pigs.
• Employed microsurgical techniques to harvest five distinct perforator flaps.
• Standardized the harvesting process with an operator-assistant team over seven weeks.
• Assessed flap survival by measuring perforator pulsation post-harvesting.

Main Results:

• Successfully standardized five perforator flaps based on specific arteries (e.g., deep cranial epigastric, thoracodorsal).
• Porcine perforator and pedicle sizes closely matched human anatomical measurements.
• Demonstrated a significant learning curve, with harvesting time decreasing by 44.4% and pulsation time increasing by 275% by the sixth animal.
• Identified common errors and provided guidance for training on these models.

Conclusions:

• The five pig perforator flap models serve as an efficient and safe training tool for microsurgical skills.
• These models provide a realistic hands-on dissection experience comparable to human tissue.
• The models facilitate the development of perforator flap harvesting expertise, addressing limitations of current training methods.