Efficacy of a perfused cadaver model for simulated trauma resuscitation in advanced surgical skills training

Abstract

Background To develop a perfused cadaveric model for trauma surgery simulation, and to evaluate its efficacy in trauma resuscitation advanced surgical skills training. Methods Fourteen fourth-year general surgery residents attended this workshop at Siriraj Hospital (Bangkok, Thailand). Inflow and outflow cannulae and a cardiopulmonary bypass pump were used to create the perfusion circuit. Inflow was achieved by cannulating the right common carotid artery, and outflow by cannulation of both the right common femoral artery and the internal jugular vein. Arterial line monitoring was used to monitor resuscitation response and to control perfusion pressure. The perfusion solution comprised saline solution mixed 1:1 with glycerol (50%) and water with red food dye added. Advanced surgical skills during life-threatening injuries and damage control resuscitation operations were practiced starting from the airway to the neck, chest, peripheral vessels, abdomen, and pelvis. Resuscitative endovascular balloon occlusion of the aorta (REBOA) was also practiced. Post-workshop survey questions were grouped into three categories, including comparison with previous training methods; the realism of anatomical correlation and procedures; and, satisfaction, safety, and confidence. All questions and tasks were discussed among all members of the development team, and were agreed upon by at least 90% of experts from each participating medical specialty/subspecialty. Results The results of the three main groups of post-workshop survey questions are, as follows: (1) How the training compared with previous surgical training methods—mean score: 4.26/5.00, high score: 4.73/5.00; (2) Realism of anatomical correlation and procedures—mean score: 4.03/5.00, high score: 4.60/5.00; and, (3) Satisfaction, safety, and confidence—mean score: 4.24/5.00, high score: 4.47/5.00. Conclusion The developed perfused cadaveric model demonstrated potential advantages over previously employed conventional surgical training techniques for teaching vascular surgery at our center as evidenced by the improvement in the satisfaction scores from students attending perfused cadaveric training compared to the scores reported by students who attended earlier training sessions that employed other training techniques. Areas of improvement included ‘a more realistic training experience’ and ‘improved facilitation of decision-making and damage control practice during trauma surgery’.

Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study

“…Our study indicated that mortality rates may have decreased with increasing proficiency in REBOA, suggesting the need for further expansion and development of structured training programs such as ET-REBOA. This would include simulationbased training and the incorporation of REBOA training into undergraduate or residency curricula, which have been shown to improve surgical skills and patient outcomes [4,[23][24][25][26]. Additionally, further investment in research is crucial.…”

Red line the red line: Optimizing emergency medicine physicians and surgeons collaborative roles on trauma teams

“…While ATLS is a solid foundation, there are advanced surgical courses, such as perfused cadaver courses, that could be expanded to include EPs outside of GME programs. 32,33 EPs could practice initial resuscitation/procedures and then the…”

“…Include EPs in trauma focused surgical courses. While ATLS is a solid foundation, there are advanced surgical courses, such as perfused cadaver courses, that could be expanded to include EPs outside of GME programs 32,33 . EPs could practice initial resuscitation/procedures and then the surgeon can be integrated into patient scenarios prior to proceeding to surgical exposures.…”