Davis Greta L, Abebe Metasebia W, Vyas Raj M, Rohde Christine H, Coriddi Michelle R, Pusic Andrea L, Gosman Amanda A
From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, Calif.
Plastic and Reconstructive Surgery, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Plast Reconstr Surg Glob Open. 2024 Feb 12;12(2):e5582. doi: 10.1097/GOX.0000000000005582. eCollection 2024 Feb.
The Plastic Surgery Foundation's Surgeons in Humanitarian Alliance for Reconstruction, Research and Education (SHARE) program seeks to expand surgical capacity worldwide through mentorship and training for local plastic surgeons. This study aims to define the need for microsurgery training among SHARE global fellows and describe results of a pilot course.
Ten participants of the SHARE Virtual Microsurgical Skills Course were asked to complete an anonymous survey. Pre- and post-course response rates were 100% and 50.0%, respectively.
There was a high incidence of microsurgical problems encountered in the clinical setting. Resource availability was varied, with high access to loupes (100%), yet limited access to microsurgery instruments (50%), medications (40%), operating microscope (20%), skilled nursing (0%) and appropriate peri-operative care settings (0%). Participants identified vessel preparation, instrument selection, and suture handling as priority learning objectives for a microsurgery skills course. Post-course satisfaction with learning objectives was high (60% "very good," 40% "excellent"). Participants reported high levels of improvement in suture handling (Likert 4.60±0.55), end-to-end anastomosis (4.40±0.55), instrument selection (4.20±0.45), vessel preparation (4.20±0.45), and economy of motion (4.20±0.45).
This study demonstrates a high frequency of reconstructive problems encountered by global fellows yet low access to appropriate resources to perform microsurgical procedures. Initial results from a pilot virtual microsurgery course demonstrate very high satisfaction and high self-rated improvement in key microsurgical skills. The virtual course is an effective and accessible format for training surgeons in basic microsurgery skills and can be augmented by providing longitudinal opportunities for remote feedback.
整形外科学会的人道主义重建、研究与教育联盟外科医生（SHARE）项目旨在通过指导和培训当地整形外科医生，扩大全球外科手术能力。本研究旨在确定SHARE全球学员对显微外科培训的需求，并描述一个试点课程的结果。
邀请SHARE虚拟显微外科技能课程的10名参与者完成一项匿名调查。课程前和课程后的回复率分别为100%和50.0%。
在临床环境中遇到显微外科问题的发生率很高。资源可用性各不相同，高倍放大镜的获取率很高（100%），但显微外科器械（50%）、药物（40%）、手术显微镜（20%）、熟练护理（0%）和适当的围手术期护理环境（0%）的获取有限。参与者将血管准备、器械选择和缝合操作确定为显微外科技能课程的优先学习目标。课程后对学习目标的满意度很高（60%“非常好”，40%“优秀”）。参与者报告在缝合操作（李克特量表评分为4.60±0.55）、端端吻合（4.40±0.55）、器械选择（4.20±0.45）、血管准备（4.20±0.45）和动作经济性（4.20±0.45）方面有很大程度的提高。
本研究表明，全球学员遇到的重建问题频率很高，但进行显微外科手术的适当资源获取有限。一个试点虚拟显微外科课程的初步结果显示，学员对关键显微外科技能的满意度非常高，自我评估的提高程度也很高。虚拟课程是培训外科医生基本显微外科技能的一种有效且可及的形式，可以通过提供远程反馈的长期机会加以补充。
