The COVID-19 Pandemic has had a significant disruption to the provision of Surgical Training. Core and Improving Surgical Trainees (CSTs and ISTs) are noted to be a group profoundly affected due to the impact of the pandemic in reducing operative time, cancelled elective procedures and redeployment to other specialities We aimed to evaluate the benefit of Small Group Surgical Simulation teaching for CSTs and ISTs recently deployed in the Norfolk and Norwich University Hospital.Physical simulation models were designed with the use of animal tissue and/or surgical simulators (such as laparoscopic box trainers) to simulate surgical procedures appropriate for the grade of trainees.We designed a monthly Surgical Simulation Programme, which took place in the Surgical Skills Laboratory. Topics were selected from those suitable for Simulation from the Intercollegiate Surgical Curriculum Programme (ISCP) Core Surgical Curriculum Participants felt that the COVID pandemic affected opportunities to perform/assist or observe the surgical skills. Participant comments on COVID affecting opportunities included ‘Reduced opportunities due to cancelled lists’, ‘Fewer elective cases so less opportunity ‘ and ‘Affected in the Peak of COVID but it is improving. Following the session, 100% of participants found the sessions to be effective in improving confidence in performing the surgical skill and 87% found the sessions to be extremely effective. Participants found the teaching sessions to be useful due to the opportunities of ‘Close supervision and direct feedback’, ‘Set of tasks’, ‘Practise with animal models’, ‘Having the tutor there to assist and help us’ and ‘[Discussing] theory prior to learning the procedure’.Surgical simulation provides opportunities for early-year trainees to learn and perform surgical skills during the COVID-19 pandemic. Small-group surgical simulation allows CSTs and ISTs to develop and practise skills under supervision of tutors, with trainees finding real-time feedback useful. In a post-COVID era, a surgical simulation teaching programme could provide an effective training opportunity to shorten the steep learning curve of core surgical training.
Aim The aims of this study are to assess published data regarding infection rates, delayed wound healing, cosmetic appearance and application time compared to conventional wound closure techniques across multiple surgical procedures. Method A literature search was conducted according to PRISMA guideline using PubMed, SCOPUS and Science Direct. The primary outcome was the incidence of wound infection after Prineo Dermabond compared to controls. Secondary outcome measures included allergic reactions and time for application. Literature search identified 52 studies, of which 19 were eligible for qualitative synthesis and 12 for meta-analysis. Results Studies included reflected a broad range of applications of Dermeo-Prineo to wound closure in Abdominoplasty, Mammoplasty and Arthroplasty. Overall, all studies reporting on time of application found a positive indicator of Prineo Dermabond reducing time for wound closure. Meta-analysis identified a statistically significant reduction in rates of the 6 studies that described wound infection (Prineo 1.51%, Control N=2.13%, OR 0.65 (0.46–0.91); P=0.01) and in the 5 studies reporting delayed wound healing (Prineo 0.99%, Control N=1.79%, OR 0.42 (0.18–0.98); P=0.05) in the use of Prineo Dermabond versus controls. Three studies reported outcomes of scar cosmesis or long-term maturation. All attested to better cosmetic results in comparison to sutures. Two studies discussed cost-effectiveness of Dermabond with a hypothetical model concluded that Skin Closure System of Prineo Dermabond could achieve savings of $50–76 per patient, whilst a retrospective model found no statistically significant difference in Total Hospital costs or Operating room time. Conclusions Prineo Dermabond provides an alternative method of wound closure in reported studies.
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