Abstract
Background Microsuture is an essential material for basic microsurgical training. However, it
is consumable, expensive, and sometimes unavailable in the microsurgical laboratory.
To solve this problem, we developed a microsuture made from human hair and needle
gauge.
Methods Do-It-Yourself (DIY) microsuture is made from human hair and needle gauge 32G (BD
Ultra-Fine Pen Needles 4 mm × 32G). Methods are explained step by step. This DIY microsuture
(labeled as “test microsuture”) and nylon 8–0 (Ethilon suture 8–0, labeled as “standard
microsuture”) were used for teaching orthopaedic residents to perform arterial anastomosis
in chicken thighs. All residents practiced without knowing that “test microsuture”
was made from the DIY method. After completing the training, quality of both microsutures
was evaluated by questionnaire in topics of (1) thread quality (size, strength, elasticity,
handing, knot perform, and knot security), (2) needle quality (size, curve, shape,
sharpness, handling, and strength), (3) needle–thread interface (size, strength, and
smoothness), and (4) overall quality of microsuture. Each category was evaluated by
Likert score (5 = excellent, 4 = good, 3 = fair, 2 = poor, and 1 = very poor).
Results The DIY microsuture was performed in three steps: (1) insert human hair into needle
gauge by microforceps, (2) bend needle into smooth curve, and (3) disconnect needle
and create needle–hair interface. The questionnaire was completed by 30 orthopaedic
residents and showed that thread quality of DIY and standard microsuture had “good”
and “good-to-excellent” quality (mean Likert score: 3.77–4.23 and 3.80–4.27, respectively,
with no statistical difference). Thread–needle interface quality of DIY and standard
microsuture also had “good” and “good-to-excellent” quality (Likert score: 3.73–4.20
and 4.07–4.33, respectively, with no statistical difference). Needle part of DIY microsuture
had lower quality than standard suture (fair-to-good compared with good-to-excellence
quality, score 3.30–3.67 vs. 4.20–4.27, respectively, with a statistically significant
difference, p -value < 0.05). However, overall quality of DIY suture and standard microsuture had
“good” and “good-to-excellent” (mean Likert score: 3.73 and 4.00, respectively, with
no statistical difference).
Conclusion The DIY microsuture from human hair and needle gauge could be an alternative for
basic microsurgical training with lower cost, easy production, and more availability
for use in practice with acceptable quality compared with that of standard microsuture.
Keywords hair - microsuture - microsurgery
