Jefferson Itisha S, Robinson Shamika Kayo, Surprenant David, Whittington Adam, Arshanapalli Ashish, Tung-Hahn Eleanor, Joyce Cara, Moy Lauren, Lee Kristin, O'Brien Ellie, Tung Rebecca, Alam Murad
Stritch School of Medicine, Loyola University, Maywood, IL, USA.
Division of Dermatology, Loyola University Medical Center, Maywood, IL, USA.
Arch Dermatol Res. 2021 Nov;313(9):793-797. doi: 10.1007/s00403-020-02181-z. Epub 2021 Jan 12.
Since dermatologists routinely perform surgery in an outpatient setting, ensuring that dermatology trainees are provided with opportunities to develop sufficient proficiency in excisional surgery and suture technique is paramount. The objectives of this study are to assess trainee preference for silicone-based synthetic skin compared with porcine skin as a surgical training medium and to assess the ability of trainees to successfully demonstrate basic surgical skills using the simulated skin model. Participants were a convenience sample of dermatology residents from the greater Chicago area, who were asked to perform an elliptical excision and bilayered repair on a silicone-based synthetic skin model. Residents were then surveyed regarding their satisfaction with the model. Four blinded dermatologist raters evaluated digital photographs obtained during the performance of the procedures and graded the execution of each maneuver using a surgical task checklist. Nineteen residents were enrolled. Residents were more likely to prefer pig skin to simulated skin for overall use (p = 0.040) and tissue repair (p = 0.018), but the nominal preference for tissue handling was nonsignificant (p = 0.086). There was no significant difference between satisfaction with pig skin versus synthetic skin with regard to excision experience (p = 0.82). The majority of residents (10/19) performed all surgical checklist tasks correctly. Of those residents who did not perform all steps correctly, many had difficulty obtaining adequate dermal eversion and wound approximation. Synthetic skin may be conveniently and safely utilized for hands-on surgical practice. Further refinement may be necessary to make synthetic skin comparable in feel and use to animal skin.
由于皮肤科医生通常在门诊环境中进行手术，确保皮肤科实习生有机会充分提高切除手术和缝合技术的熟练程度至关重要。本研究的目的是评估实习生对硅基合成皮肤与猪皮作为手术训练介质的偏好，并评估实习生使用模拟皮肤模型成功展示基本手术技能的能力。参与者是来自大芝加哥地区的皮肤科住院医师的便利样本，他们被要求在硅基合成皮肤模型上进行椭圆形切除和双层修复。然后对住院医师进行关于他们对该模型满意度的调查。四位不知情的皮肤科医生评估者对手术过程中拍摄的数码照片进行评估，并使用手术任务清单对每个操作的执行情况进行评分。共有19名住院医师参与。住院医师总体上更倾向于使用猪皮而非模拟皮肤（p = 0.040）以及组织修复（p = 0.018），但在组织处理方面的名义偏好不显著（p = 0.086）。在切除体验方面，对猪皮和合成皮肤的满意度没有显著差异（p = 0.82）。大多数住院医师（10/19）正确完成了所有手术清单任务。在那些没有正确完成所有步骤的住院医师中，许多人在获得足够的真皮外翻和伤口对合方面存在困难。合成皮肤可方便且安全地用于实际手术操作。可能需要进一步改进以使合成皮肤在触感和使用方面与动物皮肤相当。
