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OUTCOMES OF A LONG-TERMS MICROVASCULAR TRAINING FOR RESIDENTS IN ORTHOPEDIC.

M D'Orio1, M Passiatore2, L Caruso1

  • 11Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

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Training orthopedic and hand surgery residents using a live rat model significantly improves microsurgical skills. This preclinical animal model training, following non-living simulations, enhances dexterity and reduces anastomosis time for complex limb trauma management.

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Area of Science:

  • Microsurgery
  • Surgical Training
  • Orthopedics
  • Hand Surgery

Background:

  • Microsurgical skills are crucial for managing complex upper limb trauma.
  • Pre-clinical training on animal models can shorten the learning curve for microsurgical techniques.

Purpose of the Study:

  • To standardize a long-term in vivo microsurgery training protocol for orthopedic and hand surgery residents.
  • To evaluate the benefits of weekly practice on a live animal model for improving surgical skills.

Main Methods:

  • A protocol for in vivo microsurgery training on Wistar rats was implemented.
  • Residents progressed from non-living models to ex vivo chicken leg models, then to in vivo rat exercises.
  • Training involved weekly sessions over multiple years, with evaluations using the Global Rating Scale (GRS) and time to completion.

Main Results:

  • Mean GRS scores significantly improved from 15±2 to 21±6 (p<0.005).
  • Mean time to complete anastomosis significantly decreased from 31:18±9:21 to 21:15±6:10 minutes (p<0.005).
  • The training curriculum proved effective in enhancing resident microvascular surgical skills.

Conclusions:

  • A microvascular training curriculum using a live rat model, preceded by non-living simulations, offers a superior surgical simulation.
  • This approach is effective in improving resident microvascular surgical skills, essential for complex trauma care.