Cooper Lilli, Sindali Katia, Srinivasan Karthik, Jones Martin, Nugent Nora
Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, United Kingdom.
Department of Plastic Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
J Reconstr Microsurg. 2019 Jan;35(1):15-21. doi: 10.1055/s-0038-1657791. Epub 2018 Jul 11.
Microsurgery is increasingly relevant, and is difficult to learn. Simulation is relied upon ever more in microvascular training. While living models provide the ultimate physiological feedback, we are ethically obliged to optimize non-living models to replace, refine, and reduce the use of animals in training. There is currently no three-layered synthetic vessel available for microsurgical training.
A three-layered synthetic vessel was designed with a simulation company. One anastomosis was performed by 14 microsurgical experts at one center. The realism of the vessel was assessed via user questionnaires and the construct validity using objective, validated task scores to assess the anastomosis performance and the final product. Videos were obtained, which were anonymized and marked remotely by a consultant plastic surgeon.
The synthetic vessel intima and media displayed reasonable realism, while the adventitia was less realistic. Areas for improvement were identified. Both the task specific assessment score and the final product assessment appropriately identified experts.
A three-layered synthetic model for microvascular training is a hygienic and useful intermediate-level alternative to commonly used synthetic and ex vivo alternatives.
显微外科手术的应用越来越广泛，但学习难度较大。在微血管训练中，模拟技术的应用越来越多。虽然活体模型能提供最终的生理反馈，但从伦理角度出发，我们有义务优化非活体模型，以取代、改进并减少训练中动物的使用。目前尚无用于显微外科训练的三层合成血管。
与一家模拟技术公司合作设计了一种三层合成血管。由14位显微外科专家在一个中心进行了一次吻合操作。通过用户问卷评估血管的逼真度，并使用客观、经过验证的任务分数来评估吻合性能和最终产品，以此评估结构效度。获取了视频，由一位整形顾问外科医生进行匿名远程评分。
合成血管的内膜和中膜显示出合理的逼真度，而外膜的逼真度较低。确定了需要改进的方面。特定任务评估分数和最终产品评估都能恰当地识别出专家。
用于微血管训练的三层合成模型是一种卫生且有用的中级替代方案，可替代常用的合成模型和离体模型。
