Ulnar artery concomitant veins of the chicken wing for advanced supermicrosurgery training

Rodríguez, José Ramón; Fuse, Yuma; Sakai, Hayahito; Tsukuura, Reiko; Yamamoto, Takumi

doi:10.1002/micr.30643

Cited by 2 publications

(7 citation statements)

References 5 publications

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“…Afterward, the second screening process generated 38 articles that were incorporated in the qualitative synthesis (Fig. 1) 7,33–67 . Twenty-three articles reported the use of in vivo models (60.5%), 12 used ex vivo models (31.5%), and three used synthetic models (7.9%).…”

Section: Resultsmentioning

confidence: 99%

“…33,38,39,77 The chicken wings have been traditionally the preferred choice for training in small vessels. 40 Nevertheless, searching for vessels under 0.3 mm can be tedious and time consuming. 40 On this matter, several techniques for their identification including diluted ICG intravascular injections without the need for an infrared camera, 39 blue dye injection, 38 or extensive intramuscular dissection have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…40 Nevertheless, searching for vessels under 0.3 mm can be tedious and time consuming. 40 On this matter, several techniques for their identification including diluted ICG intravascular injections without the need for an infrared camera, 39 blue dye injection, 38 or extensive intramuscular dissection have been reported. 37 In recent years and with further understanding of the microvascular anatomy, the wing's ulnar artery with its respective concomitant veins has been acknowledged to be an adequate alternative, as the vessels can be easily identified.…”

Section: Plastic and Reconstructive Surgery • May 2023mentioning

confidence: 99%

“…40 Remarkably, the vein wall features were regarded as similar to human lymphatics or venules, which allowed for supermicrosurgical training. 40 Similarly, in the chicken leg, the 0.3-mm collaterals emerging from the most proximal segment of the intramuscular pedicle (1-mm diameter) as primary branches from the medial tibial artery were readily identifiable, and little dissection was required as opposed to dissecting secondary and tertiary branches, 55 making these models practical for performing the most demanding anastomosis techniques, like side-toside anastomoses. 41,55 As an alternative supermicrosurgical lymphatic model, the pig's tissue structure holds close resemblance to that of humans because of the similar size, allocation, and position of the vessels.…”

Section: Plastic and Reconstructive Surgery • May 2023mentioning

confidence: 99%

See 3 more Smart Citations

Experimental Models and Practical Simulators for Supermicrosurgery: An Updated Systematic Review and Meta-analysis

Escandón

Ciudad²,

Poore

et al. 2022

Plastic &Amp; Reconstructive Surgery

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ince first described, supermicrosurgery has been broadly accepted and implemented because of a superior and widespread knowledge of the anatomy of perforators and of lymphatic surgery. [1][2][3][4] In fact, the technical considerations and applications of supermicrosurgery are currently incorporated in different fields Background: Supermicrosurgical simulators and experimental models promote test viability, a faster learning curve, technical innovations, and improvements of the surgical dexterities. The authors aimed to present a systematic review and meta-analysis of preclinical experimental models and simulation platforms used for supermicrosurgery. Methods: An electronic search was conducted across the PubMed MEDLINE, Embase, Web of Science, and Scopus databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data collection included the types of experimental models and outcomes. Pooled estimates were calculated with a random-effect meta-analysis using the DerSimonian-Laird model. Results: Thirty-eight articles were incorporated in the qualitative synthesis. Twenty-three articles reported the use of in vivo models (60.5%), 12 used ex vivo models (31.5%), and three used synthetic models (7.9%). The superficial inferior epigastric system of rats was the most common in vivo model, whereas chicken wings and hindlimbs were the most common methods used in ex vivo models. The most common methods to evaluate patency of anastomoses were gross inspection, passage of nylon thread into the lumen, and intravascular flow of an injected dye. Nineteen studies were incorporated in the meta-analysis. The overall rate of a successful anastomosis was 94.9% (95% CI, 92.3 to 97.5%). The success rate of in vivo models using rats was 92.5% (95% CI, 88.8 to 96.3%). The success rate of ex vivo models was 97.7% (95% CI, 94.6 to >99%). Conclusion: Simulators that have high fidelity concerning the dissection of the vascular pedicle, flap elevation, supermicrovascular anastomosis, and adequate assessment of a successful anastomosis possess adequate predictive validation to evaluate and simulate the supermicrosurgical technique. (Plast. Reconstr. Surg. 151: 775e, 2023) Clinical Relevance Statement: Supermicrosurgical simulators are designed to reproduce specific clinical scenarios; therefore, these should be implemented sequentially to develop specific competencies. Supermicrosurgical models must be regarded as mutually inclusive learning platforms to optimize the learning curve.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Plastic and Reconstructive Surgery • May 2023mentioning

confidence: 99%

Section: Plastic and Reconstructive Surgery • May 2023mentioning

confidence: 99%

See 2 more Smart Citations

Experimental Models and Practical Simulators for Supermicrosurgery: An Updated Systematic Review and Meta-analysis

Escandón

Ciudad²,

Poore

et al. 2022

Plastic &Amp; Reconstructive Surgery

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show abstract

“…Navia et al [17] carefully dissected the chicken wing, updated the anatomy nomenclature and described smaller vessels. Later Rodríguez et al [18] described the ulnar artery concomitant veins of the chicken wing for advanced supermicrosurgery training, taking advantage of the resemblance of the veins with the lymphatic vessels.…”

Section: Creating New Assessments Models and Going Super Micromentioning

confidence: 99%

Innovations in microsurgery training from Chile

Cifuentes

Leon

2021

ВХ

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Ignacio Cifuentes, MD, is a young plastic surgeon from Chile with high interest in microsurgical simulation and training. This paper summarizes some of the work in which the author has collaborated during his plastic surgery residency under the supervision of Bruno Dagnino, MD, as well as some interesting articles regarding microsurgical education in Chile. Francisca Leon, MD, is a microsurgeon and plastic surgeon from Chile with great interest in lower limb reconstruction who collaborated with the development of this review.

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Ulnar artery concomitant veins of the chicken wing for advanced supermicrosurgery training

Cited by 2 publications

References 5 publications

Experimental Models and Practical Simulators for Supermicrosurgery: An Updated Systematic Review and Meta-analysis

Experimental Models and Practical Simulators for Supermicrosurgery: An Updated Systematic Review and Meta-analysis

Innovations in microsurgery training from Chile

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