Will SCOBY do? An alternative for teaching basic surgical skills of suturing and skin excision

Abstract

Background: Using pork or ethylene-vinyl acetate (EVA) pads to teach suturing and excision skills to medical students can be expensive and lack a degree of realism. This project aimed to ascertain if a symbiotic culture of bacteria and yeast (SCOBY) represented a viable alternative. Methods: Part 1 of this study was designed to identify the descriptors against which SCOBY, pork and EVA pads could be evaluated. Participants in part 1 were asked to identify elements of fidelity that best represented skin when comparing the three models. Part 2 of the study required a second cohort of participants to rank the three models against the descriptors identified. Results: The overall results indicate that, with the exception of odour, respondents rated SCOBY superior to EVA pads and equivalent to pork. There were no significant differences between pork and SCOBY for skin likeness, cutting likeness, and suturing likeness, although both were deemed superior to EVA pads. Qualitative feedback indicated that SCOBY was not as robust as pork and lacked the layers of skin that pork better represents. Cultural and religious impediments to using pork models were also highlighted. Conclusion: SCOBY offers a viable, low-cost alternative to pork to teach suturing and excision with comparable fidelity to pork and a superior fidelity to EVA pads. The smell of SCOBY is mildly vinegary due to the secondary fermentation of alcohol to acetic acid. Ten percent of the participants in part 2 of the study identified cultural or religious barriers to using pork.

Development of a symbiotic culture of bacteria and yeast (SCOBY) farm to manufacture artificial skin for front of neck airway access simulation

“…With the cannula technique, participants valued the ability of SCOBY skin to provide a true negative aspiration until passing into the trachea. The only negative comments made by the participants on the use of SCOBY skin were related to the vinegar-like smell, which is consistent with previous studies, 2 though this was not significant enough an issue to prevent participants from use of the SCOBY.…”

“…Our method differs from that previously described by van Dreven et al. 2 in several ways. We have increased the concentration of tea and sugar, which we believe has resulted in a faster growth rate.…”

“…1 Because of its strength and stability, a SCOBY has been used as an artificial skin for teaching invasive medical procedures: in 2018, van Dreven et al reported the use of a SCOBY to teach medical students suturing and skin excision skills. 2 They found the SCOBY to be superior to ethylene-vinyl acetate (EVA) pads, and equivalent to pig tissue, for this purpose. 2 However, to the authors' knowledge, there have been no further published reports of the use of a SCOBY as artificial skin for training in other medical procedures.…”

“…reported the use of a SCOBY to teach medical students suturing and skin excision skills. 2 They found the SCOBY to be superior to ethylene-vinyl acetate (EVA) pads, and equivalent to pig tissue, for this purpose. 2 However, to the authors' knowledge, there have been no further published reports of the use of a SCOBY as artificial skin for training in other medical procedures.…”

“…The aim of this article is to propose a method for safely producing, storing and reusing the SCOBY in large quantities for medical simulation purposes. We reviewed the method used by van Dreven et al., 2 and consulted the staff at the Manawa Simulation Centre, Waitaha, Canterbury, New Zealand, who were also experimenting with the SCOBY for medical education. We went through a process of trial and error to develop a method that is easily reproducible.…”