Schöffl Harald, Froschauer Stefan M, Dunst Karin M, Hager Dietmar, Kwasny Oskar, Huemer Georg M
Department of Trauma Surgery, Allgemeines Krankenhaus Linz, Linz, Austria.
Altern Lab Anim. 2008 May;36(2):153-60. doi: 10.1177/026119290803600206.
Education and training in microsurgical techniques have historically relied on the use of live animal models. Due to an increase in the numbers of microsurgical operations in recent times, the number of trainees in this highly-specialised surgical field has continued to grow. However, strict legislation, greater public awareness, and an increasing sensitivity toward the ethical aspects of scientific research and medical education, emphatically demand a significant reduction in the numbers of animals used in surgical and academic education. Hence, a growing number of articles are reporting on the use of alternatives to live animals in microsurgical education and training. In this review, we report on the current trends in the development and use of microsurgical training models, and on their potential to reduce the number of live animals used for this purpose. We also share our experiences in this field, resulting from our performance of numerous microsurgical courses each year, over more than ten years. The porcine heart, in microvascular surgery training, and the fresh chicken leg, in microneurosurgical and microvascular surgery training, are excellent models for the teaching of basic techniques to the microsurgical novice. Depending on the selected level of expertise of the trainee, these alternative models are capable of reducing the numbers of live animals used by 80-100%. For an even more enhanced, "closer-to-real-life" scenario, these non-animated vessels can be perfused by a pulsatile pump. Thus, it is currently possible to provide excellent and in-depth training in microsurgical techniques, even when the number of live animals used is reduced to a minimum. With these new and innovative techniques, trainees are able to learn and prepare themselves for the clinical situation, with the sacrifice of considerably fewer laboratory animals than would have occurred previously.
从历史上看，显微外科技术的教育和培训一直依赖于使用活体动物模型。由于近年来显微外科手术数量的增加，这个高度专业化外科领域的受训人员数量持续增长。然而，严格的立法、更高的公众意识以及对科学研究和医学教育伦理方面日益增强的敏感性，强烈要求大幅减少外科手术和学术教育中使用的动物数量。因此，越来越多的文章报道了在显微外科教育和培训中使用活体动物替代品的情况。在这篇综述中，我们报告了显微外科培训模型开发和使用的当前趋势，以及它们在减少用于此目的的活体动物数量方面的潜力。我们还分享了我们在这个领域的经验，这些经验来自于我们在十多年里每年举办众多显微外科课程的实践。在微血管外科手术培训中使用的猪心脏，以及在显微神经外科和微血管外科手术培训中使用的新鲜鸡腿，是向显微外科新手传授基本技术的优秀模型。根据受训人员所选的专业水平，这些替代模型能够将使用的活体动物数量减少80%至100%。为了营造一个更加逼真、“更接近现实生活”的场景，可以用脉动泵为这些无生命的血管灌注。因此，即使将使用的活体动物数量减少到最低限度，目前也能够提供出色且深入的显微外科技术培训。通过这些新的创新技术，受训人员能够为临床情况进行学习和准备，而牺牲的实验动物数量比以前要少得多。
