Novel and easy curriculum with simulated models for microsurgery for plastic surgery residents: reducing animal use

Microsurgical training is currently limited by high costs, lack of equipment and infrastructure, increasing concerns about patient safety and expectations, which have resulted in a perception of deficit in the training of new surgeons. Therefore, simulated models offer controlled and effective training, minimizing animal use.

A simple and economical protocol was designed and applied in microsurgery training using exvivo models in 11 plastic surgery residents, lasting 40 h, during 13 sessions (3 h each), with a theoretical module and an explanatory video, supervised and given feedback by an expert. The initial assessment (IA) and a final assessment (FA) were recorded on video, subsequently evaluated by two blinded experts according to OSATS regulations, recording the tremor of participants using Apple Watch. A univariate and multivariate analysis were performed.

All participants improved overall performance scores. In non-living models, IA = 19.6 points (CI: 16.2–23.1%) versus FA = 29.6 points (CI: 21.8–32%), and in ex vivo models, IA = 15.5 points (CI: 12.2–18%) versus FA = 23.9 points (CI: 19.3–28.5%), p = 0.005. Greater impact was identified in exercises that involve manipulation of fine elements, dexterity, precise movements, respect for the tissue, use of irrigation, saving sutures, and knotting techniques. No statistically significant improvement was found in tremor. No association was found with better performance for participants who engaged in extracurricular or meditation activities.

This curriculum allows for structured and sequential training in exvivo models, with a statistically significant improvement in global microsurgery performance scores among participants.

Level of evidence: Not ratable.