A Novel Framework for Optimizing Efficiency and Education in Microsurgical Breast Reconstruction

Area of Science:

• Plastic Surgery
• Surgical Education
• Microsurgery

Background:

• Deep inferior epigastric perforator (DIEP) flaps are a preferred method for autologous breast reconstruction.
• DIEP flap procedures are complex, lengthy, and present a significant learning curve for trainees.
• Optimizing both efficiency and educational outcomes in DIEP flap training is challenging.

Purpose of the Study:

• To present a structured framework for resident training in DIEP flap reconstruction.
• To enhance both the efficiency of the surgical procedure and the educational experience for trainees.
• To provide a reproducible model for institutions seeking to improve DIEP flap training.

Main Methods:

• Implementation of a framework focusing on efficiency and education at each procedural stage.
• Utilized a two-team approach with defined faculty and resident roles for improved efficiency.
• Incorporated laboratory-based microsurgical training and structured rotation goals for enhanced education.
• Retrospective review of patients undergoing DIEP flap reconstruction from 2017 to 2020.

Main Results:

• Operative times and complication rates were comparable to previously published data.
• The framework facilitated resident learning across all stages of the DIEP flap procedure.
• The structured approach demonstrated feasibility for training plastic surgery residents without microsurgical fellows.

Conclusions:

• The presented framework effectively balances efficiency and education in DIEP flap reconstruction training.
• This model supports resident competency development in a complex microsurgical procedure.
• The framework offers a valuable strategy for optimizing surgical training in breast reconstruction.