Cortellini Lara, Nogueira Antoine, Christen Thierry, Lattion Justine, Durand Sébastien
Department of Hand Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Département des technologies industrielles, Haute Ecole d'Ingénierie et de Gestion du canton de Vaud (HEIG-VD), Yverdon-les-Bains, Switzerland.
Plast Surg (Oakv). 2025 Feb;33(1):164-171. doi: 10.1177/22925503231184267. Epub 2023 Jul 18.
Microsurgical learning is a difficult and stressful process, requiring self-control to achieve relaxation. The purpose of this study is to evaluate peripheral and central nervous system relaxation during microsurgical training. This cohort study included ten medical students with no previous experience in microsurgery. The somatic peripheral nervous system was evaluated by the force applied to a custom-designed microsurgical needle holder. The autonomic peripheral nervous system was assessed by a heart rate monitor. Central nervous system relaxation was evaluated by the State and Trait Anxiety Inventory scores. The quality of the anastomosis was graded by the Microsurgical Anastomosis Rating Scale (MARS10). These data were compared to a group of 5 senior microsurgeons who underwent a single assessment. The time to complete the anastomosis and the force decreased significantly with training after only 2 weeks ( < .05). After 4 weeks of training, no statistical difference was observed between students and experts regarding force while the time of suture was still significantly different at 30 days ( = .001). The maximum heart rate decreased significantly at 2 weeks ( = .01). Anxiety scores decreased significantly between days 1 and 15 ( = .002 and = .036). The MARS10 score demonstrates that the quality of the suture increases significantly during the first 15 days ( = .006). : Peripheral and central nervous system relaxation as well as the quality of the microsurgical anastomosis increase significantly after only 15 days of learning. The force-sensing microsurgical needle holder offers a new tool for the evaluation of relaxation and can function as a learning aid.
显微外科学习是一个困难且充满压力的过程，需要自我控制以实现放松。本研究的目的是评估显微外科训练期间外周和中枢神经系统的放松情况。这项队列研究纳入了10名此前无显微外科经验的医学生。通过施加在定制设计的显微外科持针器上的力来评估躯体外周神经系统。通过心率监测器评估自主外周神经系统。通过状态-特质焦虑量表评分评估中枢神经系统的放松情况。吻合质量由显微外科吻合评级量表（MARS10）进行分级。将这些数据与一组接受单次评估的5名资深显微外科医生的数据进行比较。仅2周训练后，完成吻合的时间和力随着训练显著下降（<0.05）。训练4周后，学生和专家在力方面未观察到统计学差异，而在30天时缝合时间仍存在显著差异（=0.001）。最大心率在2周时显著下降（=0.01）。焦虑评分在第1天和第15天之间显著下降（=0.002和=0.036）。MARS10评分表明，在最初15天内缝合质量显著提高（=0.006）。：仅15天的学习后，外周和中枢神经系统的放松以及显微外科吻合质量显著提高。力感应显微外科持针器为评估放松提供了一种新工具，可作为一种学习辅助工具。
