Abstract
Background Perforator dissection and flap elevation are routinely performed for microsurgical
reconstruction; however, there is a steep learning curve to mastering these technical
skills. Though live porcine models have been utilized as microsurgical training models,
significant drawbacks limit their use. We recently developed a latex-perfused, nonliving,
porcine abdomen perforator dissection simulation and described its anatomic similarity
to the human deep inferior epigastric artery flap. The purpose was to assess the change
in resident confidence in performing key operative steps of flap elevation and perforator
dissection and obtain feedback on model realism and utility.
Methods Seventeen plastic and reconstructive surgery resident physicians (postgraduate years
1–6) at a single institution participated in a perforator dissection session utilizing
the simulation model. Each resident completed pre- and postactivity surveys to assess
interval change in confidence in operating. The postactivity survey also asked residents
to answer questions regarding their perception of the model's anatomic and surgical
realism and utility in microsurgical training.
Results Following a practice session using the latex-perfused, nonliving porcine abdomen,
resident confidence was significantly increased in performing all key operative steps
and the procedure overall (p = 0.001). All residents (n = 17, 100%) believed the model would improve “trainees' ability to perform perforator
dissection in the operating room.” Perforator, fascial, and pedicle anatomy were reported
to be “Very” similar to human anatomy, with a median Likert score (MLS) of 4. Additionally,
six out of the eight surgical steps were noted to be “Very” realistic, with only “Flap
Design” and “Fascial Closure” found to be “Moderately” realistic with an MLS of 3.
Conclusion The latex-infused porcine abdominal model is a novel, realistic simulation for microsurgical
trainee perforator dissection practice. This model offers a suitable substitute for
perforator dissection practice, as its implementation within a microsurgery training
course improves resident comfort and confidence.
Keywords
surgical simulation - surgical education - perforator dissection
