Comparison of Porcine Tendon to Novel 3D-Printed Silicone Model for Learning Flexor Tendon Repair Techniques

Surgical simulation has become an important component of surgical residency. Several animal and synthetic flexor tendon repair simulators have been described, with variable degrees of fidelity. The purpose of this study was to determine the effectiveness of a silicone flexor tendon repair model in comparison to a porcine tendon repair model. Methods: A silicone flexor tendon model was created using polypropylene fibres bound in cured silicone to simulate epitenon with the use of a 3D printed mold. Deep flexor tendons were harvested from porcine forelimbs for comparison. Participants tested the models by completing core and epitendinous tendon repairs. Models were evaluated with 5-point Likert Scale questions and a comment section. Results: Nine plastic surgery residents and three plastic surgeons participated in the study. Simulation realism was 3.9/5 for the silicone model and 4.6/5 for the porcine model (p = 0.001). Educational utility was 4.6/5 for the silicone model and 4.6/5 for the porcine model (p = 0.546). Overall, the silicone model scored 4.3/5 and the porcine model 4.6/5 (p = 0.078). Conclusion: We created a moderate-fidelity tendon repair model that is convenient to use, easily reproducible, and of equal educational utility to a porcine model based on our study results. This model has significant potential for simulation learning in postgraduate surgical education. Further validation is required to confirm its efficacy in postgraduate surgical education and skill transfer to the operating room.