Homma Hiroshi, Oda Jun, Sano Hidefumi, Kawai Kentaro, Koizumi Nobusato, Uramoto Hidetaka, Sato Norio, Mashiko Kazuki, Yasumatsu Hiroshi, Ito Masayuki, Fukuhara Tomomi, Watanabe Yo, Kim Shiei, Hayashi Shogo, Kawata Shinichi, Miyawaki Makoto, Miyaso Hidenobu, Itoh Masahiro
Department of Emergency and Critical Care Medicine Tokyo Medical University Tokyo Japan.
Department of Cardiovascular Surgery Tokyo Medical University Tokyo Japan.
Acute Med Surg. 2019 Jan 20;6(2):123-130. doi: 10.1002/ams2.390. eCollection 2019 Apr.
Senior surgeons in Japan who participated in "cadaver-based educational seminar for trauma surgery (CESTS)" subsequently stated their interest in seminars for more difficult procedures. Therefore, we held a 1-day advanced-CESTS with saturated salt solution (SSS)-embalmed cadavers and assessed its effectiveness for surgical skills training (SST).
Data were collected from three seminars carried out from September 2015 to January 2018, including a 10-point self-assessment of confidence levels (SACL) questionnaire on nine advanced surgical skills, and evaluation of seminar content before, just after, and half a year after the seminar. Participants assessed the suitability of the two embalming methods (formalin solution [FAS] and SSS) for SST, just after the seminar. Statistical analysis resulted in < 0.0167 comparing SACL results from seminar evaluations at the three time points and < 0.05 comparing FAS to SSS.
Forty-three participants carried out surgical procedures of the lung, liver, abdominal aorta, and pelvis and extremity. The SACL scores increased in all skills between before and just after the seminar, but were decreased by half a year after. However, SACL scores of each skill did not change significantly, except for external fixation for pelvic fracture at just after and half a year after. The SSS-embalmed cadavers were evaluated as being more suitable than FAS-embalmed cadavers for each procedure.
Advanced-CESTS using SSS-embalmed cadavers increased the participants' self-confidence just after the seminar, which was maintained after half a year in each skill, except external fixation for pelvic fracture. Therefore, SSS-embalmed cadavers are useful for SST, particularly for surgical repairs.
参与“创伤外科尸体解剖教育研讨会(CESTS)”的日本资深外科医生随后表示对难度更大手术的研讨会感兴趣。因此,我们举办了为期一天的高级 CESTS,使用饱和盐溶液(SSS)防腐处理的尸体,并评估其在手术技能培训(SST)方面的效果。
收集了 2015 年 9 月至 2018 年 1 月期间举办的三场研讨会的数据,包括一份关于九项高级手术技能的 10 分自信水平自我评估(SACL)问卷,以及在研讨会前、刚结束后和结束半年后的研讨会内容评估。参与者在研讨会刚结束后评估了两种防腐处理方法(福尔马林溶液 [FAS] 和 SSS)对 SST 的适用性。对三个时间点的研讨会评估的 SACL 结果进行统计分析,结果显示 P < 0.0167,比较 FAS 和 SSS 的结果显示 P < 0.05。
43 名参与者进行了肺部、肝脏、腹主动脉、骨盆和四肢的手术操作。研讨会前和刚结束后,所有技能的 SACL 评分均有所提高,但半年后有所下降。然而,除骨盆骨折外固定在刚结束后和半年后的情况外,每项技能的 SACL 评分没有显著变化。对于每项手术,使用 SSS 防腐处理的尸体被评估为比使用 FAS 防腐处理的尸体更适合。
使用 SSS 防腐处理尸体的高级 CESTS 在研讨会刚结束后提高了参与者的自信心,除骨盆骨折外固定外,每项技能在半年后仍保持这种状态。因此,SSS 防腐处理的尸体对 SST 很有用,特别是对外科修复手术。