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大鼠数字再植教学模型

Digital replantation teaching model in rats.

作者信息

Ad-El D D, Harper A, Hoffman L A

机构信息

Departemnt of Plastic Surgery, Hadassah University Hospitals, Jerusalem, Israel.

出版信息

Microsurgery. 2000;20(1):42-4. doi: 10.1002/(sici)1098-2752(2000)20:1<42::aid-micr8>3.0.co;2-4.

Abstract

Replant surgery is a complex procedure that requires advanced microsurgical skills and is usually performed as an emergency operation, lasting many hours. For these reasons, teaching replantation is difficult. Although teaching models exist, they are often too general or complicated for routine use and do not simulate the stages and the pitfalls of human replant surgery. We have designed a model that is simple and imitates human replant surgery. After reviewing the rat anatomy, students dissect and replant a rat hind limb that has been sharply amputated by the instructor. They follow the same principles of "real" surgery like debridement, minimizing ischemia time, and stable fixation before anatomosis of vessels. After marking the structures, bony fixation followed by vessel and nerve anastomosis are performed. Muscle is reattached to the skin and limb vascularity evaluated. After we designed this model, plastic surgery residents performed the technique on 10 rats. An 80% limb viability rate was achieved. This model is simple to perform, simulates all the relevant structures and pitfalls of human surgery, and the rats are relatively cheap and can be used for other parallel projects.

摘要

再植手术是一个复杂的过程,需要先进的显微外科技术,通常作为急诊手术进行,持续数小时。由于这些原因,再植手术的教学很困难。虽然存在教学模型,但它们通常过于笼统或复杂,不适合常规使用,也无法模拟人体再植手术的各个阶段和陷阱。我们设计了一个简单的、模仿人体再植手术的模型。在复习大鼠解剖结构后,学生们解剖并再植由教师锐性截肢的大鼠后肢。他们遵循“真实”手术的相同原则,如清创、尽量缩短缺血时间以及在血管吻合前进行稳定固定。在标记结构后,进行骨固定,随后进行血管和神经吻合。将肌肉重新附着于皮肤,并评估肢体血运情况。我们设计这个模型后,整形外科住院医师在10只大鼠上进行了该技术操作。实现了80%的肢体存活率。这个模型操作简单,模拟了人体手术的所有相关结构和陷阱,而且大鼠相对便宜,可用于其他并行项目。

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