Basic Skin Flaps for the General Surgeon

Dinsmore, Robert C.; North, James H.

doi:10.1097/00007611-200093080-00008

Cited by 14 publications

(14 citation statements)

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“…[4][5][6]9,10,12 Moreover, intact animal models such as anesthetized pigs have been used, and artificial self-made models have been established. 7,10,11,13,14 Even hot dogs have been evaluated for their suitability, 4 but in our opinion, all previously described and evaluated models to train surgeons in wound closure skills have specific weaknesses that make them unfavorable for general usage; their skin properties are not similar to those of humans, they merely allow the closure of simple defects by direct suturing, they have only a small area of skin for preparation, or they are open to ethical concerns by using animals or wasting human food. In this context, pig calves represent the most acceptable and frequently used animal model for wound closure skills training, 4,6,10 but despite their cost efficiency and easy availability of, they have two major disadvantages: limited skin size and tough skin.…”

Section: Discussionmentioning

confidence: 99%

“…1,3 Hence, different models have been introduced in recent years to impart these skills using artificial constructs such as living animals and their limbs or organs. [4][5][6][7][8][9][10][11][12][13][14] Even food items, such as hot dogs, have been used for this purpose more recently. 4 The necessary requirements for a model used in teaching advanced wound techniques are clearly defined.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Teaching Advanced Wound Closure Techniques Using Cattle Digits

Khalil¹,

Kanz²,

Siebeck³

et al. 2011

Dermatologic Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Teaching Advanced Wound Closure Techniques Using Cattle Digits

Khalil¹,

Kanz²,

Siebeck³

et al. 2011

Dermatologic Surgery

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“…However, only in the simulation model of Taylor et al, the candidates mentioned satisfaction in resemblance to fascial anatomy, with more than 80% of candidates suggesting that the gelatin model is realistic in terms of resembling the fascial anatomy and 100% opining that the model collates with the essential skills needed for fascial flap and increases the residence competency. Dinsmore et al found that the simulator contained positive feedback relating to the basic understanding of the design, execution, biomechanics, and application of flaps ( 17 , 26 ).…”

Section: Resultsmentioning

confidence: 99%

Simulation models for learning local skin flap design and execution: A systematic review of the literature

et al. 2022

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IntroductionEarly exposure to practical skills in surgical training is essential in order to master technically demanding procedures such as the design and execution of local skin flaps. Changes in working patterns, increasing subspecializations, centralization of surgical services, and the publication of surgeon-specific outcomes have all made hands-on-training in a clinical environment increasingly difficult to achieve for the junior surgeon. This has been further compounded by the COVID-19 pandemic. This necessitates alternative methods of surgical skills training. To date, there are no standardized or ideal simulation models for local skin flap teaching.AimThis systematic review aims to summarize and evaluate local skin flap simulation and teaching models published in the literature.Materials and MethodsA systematic review protocol was developed and undertaken in accordance with PRISMA guidelines. Key search terms encompassed both “local skin flaps” and “models” or “surgical simulation”. These were combined using Boolean logic and used to search Embase, Medline, and the Cochrane Library. Studies were collected and screened according to the inclusion criteria. The final included articles were graded for their level of evidence and recommendation based on a modified educational Oxford Center for evidence-based medicine classification system and assessed according to the CRe-DEPTH tool for articles describing training interventions in healthcare professionals.ResultsA total of 549 articles were identified, resulting in the inclusion of 16 full-text papers. Four articles used 3D simulators for local flap teaching and training, while two articles described computer simulation as an alternative method for local flap practicing. Four models were silicone based, while gelatin, Allevyn dressings, foam rubber, and ethylene-vinyl acetate-based local flap simulators were also described. Animal models such as pigs head, porcine skin, chicken leg, and rat, as well as a training model based on fresh human skin excised from body-contouring procedures, were described. Each simulation and teaching method was assessed by a group of candidates via a questionnaire or evaluation survey grading system. Most of the studies were graded as level of evidence 3 or 4.ConclusionMany methods of simulation for the design and execution of local skin flaps have been described. However, most of these have been assessed only in small cohort numbers, and, therefore, larger candidate sizes and a standardized method for assessment are required. Moreover, some proposed simulators, although promising, are in a very preliminary stage of development. Further development and evaluation of promising high-fidelity models is required in order to improve training in such a complex area of surgery.

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“…In this review, 11 of the studies described full-task trainers 35,38,40,55,65,66,68,70,[72][73][74][75] and 52 described a parttask trainer who focused on a particular part of the procedure. 36,37,39,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][56][57][58][59][60][61][62][63][64]67,69,71,73 Type of Simulators Of the 63 articles selected, 49 describe a synthetic physical simulator [13][14][15][17][18][19][20][21]…”

Section: Simulator Complexitymentioning

confidence: 99%

“…[13][14][15]17,18,[21][22][23][24]26,27,29,30,32,33,[35][36][37][40][41][42][43][44][45][46][47][48]53,54,56,59,[61][62][63] Fifteen studies described the cost of the simulator. 13,19,23,30,[39][40][41]46,47,50,59,61,63,66,67,70 Skin pad ranged from US $0.4 to $10. Vascular simulators ranged from US $0.5 to $150 with one estimating a cost of US $100 for the kit and US $25 for each replaceable vessel.…”

Section: Costmentioning

confidence: 99%

Simulation in Upper and Lower Limb Trauma Skill Acquisition

Heskin

Galvin²,

Traynor³

et al. 2021

Sim Healthcare

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This review aimed to explore the published evidence with regard to the types and composition of both full-and part-task trainers to teach surgeons extremity exploration procedures in limb trauma management. Studies were included if they reported the development and/or validation of synthetic or virtual task trainers. Studies were evaluated to determine their derivation, usability, and clinical utility. A total of 638 citations were identified and 63 satisfied the inclusion criteria. Twenty-five articles addressed simulator validation and 36 addressed level of learning achieved with simulator engagement. Two studies described a dedicated limb simulator. Simulators were developed to repair limb structures including skin (n = 15), tendon (n = 7), nerve (n = 1), fascia (n = 1), muscle (n = 1), vascular (n = 24), and bone (n = 11). Considerations such as material fidelity, learning outcomes, cost or reusability, validity, and effectiveness are inconsistently reported. Future studies should address design standards for the effective production of synthetic or virtual simulators for limb trauma management.

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Basic Skin Flaps for the General Surgeon

Cited by 14 publications

References 0 publications

Teaching Advanced Wound Closure Techniques Using Cattle Digits

Teaching Advanced Wound Closure Techniques Using Cattle Digits

Simulation models for learning local skin flap design and execution: A systematic review of the literature

Simulation in Upper and Lower Limb Trauma Skill Acquisition

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