Taking microvascular training through the elevator: institutional experience in structured microsurgical training in...

Area of Science:

• Microsurgery
• Plastic Surgery
• Surgical Education

Background:

• Microsurgery is crucial for oncological reconstructions in plastic surgery.
• Traditional Indian training is lengthy (approx. 12 years).
• Rising cancer incidence necessitates expedited training.

Purpose of the Study:

• To implement and evaluate a structured, accelerated microsurgical training program for plastic surgery residents.
• To assess the impact of simulation-based training on resident competency and patient outcomes.

Main Methods:

• A four-phase program using Peyton's four-step approach and simulation (latex gloves, silicon tubes, rat models).
• Objective assessment via the Microsurgical Anastomosis Rating Scale (MARS10) for progression.
• Residents progressed from assisting to independently performing microsurgical procedures.

Main Results:

• High flap survival rate (94.73%) in resident-performed surgeries, comparable to the institute's overall rate (95.53%).
• No significant difference in outcomes between resident-performed and overall surgeries (p=0.812).
• Residents performed 73-79 flap harvests and 18-22 microvascular anastomoses each.

Conclusions:

• The structured training model effectively reduced the microsurgical learning curve.
• Simulation-based practice and objective assessment maintain high patient care standards.
• The program provides a replicable framework for accelerating microsurgical competency.