Singhal Shaani, Taylor Kim O, Bloom Richard
Re. Plastic Surgery, Melbourne, Victoria, Australia.
Plast Reconstr Surg Glob Open. 2022 May 25;10(5):e4263. doi: 10.1097/GOX.0000000000004263. eCollection 2022 May.
Learning curves can reflect a surgical trainee's rate of progress and competence in acquiring new skills. The INSORB subdermal staple device has been well established to facilitate decreased closure time across various surgical procedures, with similar cosmesis, healing, and consistency as those of standard subdermal sutures. This study is unique, as it demonstrated an observable learning curve with this device when used by a junior surgeon.
Sixty-six patients underwent a cosmetic procedure during the second half of 2019 under the care of a single plastic surgeon in Melbourne, Australia. This corresponded to 254 unique linear incisions. Subdermal closure was done either with interrupted 3-0 Monocryl sutures or with the INSORB device. The consultant closed the incisions on one side, with the contralateral incision closed by the assistant using the same closure method. Data were then compared retrospectively, and closure times were compared over the ensuing 6 months.
Overall, consultant closure speed is 25% faster than assistant speed. When using 3-0 Monocryl, the difference is 33%, whereas the difference is reduced to 21% when using the INSORB. Furthermore, a mild learning curve could be appreciated with the assistant's use of the INSORB over the comparatively short 6-month study period.
In addition to improved speed, cost, outcome, and ergonomics, subdermal absorbable staples may also garner a faster learning curve than standard closure with 3-0 Monocryl. This study supported the learning curve of a surgical device as another innovative benefit and an important aspect of developing surgical technology.
学习曲线能够反映外科实习生掌握新技能的进步速度和能力。INSORB皮下缝合器已被广泛应用于各类手术，可有效缩短缝合时间，其美观度、愈合效果和稳定性与标准皮下缝线相似。本研究具有独特性，因为它展示了一名初级外科医生使用该器械时可观察到的学习曲线。
2019年下半年，在澳大利亚墨尔本的一名整形外科医生的治疗下，66名患者接受了美容手术。这相当于254条独立的线性切口。皮下缝合采用间断3-0单丝可吸收缝线或INSORB器械进行。带教医生缝合一侧的切口，另一侧切口由助手使用相同的缝合方法进行缝合。然后对数据进行回顾性比较，并比较接下来6个月的缝合时间。
总体而言，带教医生的缝合速度比助手快2５%。使用3-0单丝可吸收缝线时，差异为33%，而使用INSORB时，差异降至21%。此外，在相对较短的6个月研究期内，助手使用INSORB可观察到轻微的学习曲线。
除了提高速度、降低成本、改善结果和提升人体工程学性能外，皮下可吸收缝合器相比使用3-0单丝可吸收缝线的标准缝合方法，可能还具有更快的学习曲线。本研究支持将手术器械的学习曲线作为手术技术发展的另一项创新优势和重要方面。
