Structured evaluation of a comprehensive microsurgical training program

Detalhes bibliográficos
Autor(a) principal: Mattar, Tiago Guedes da Motta
Data de Publicação: 2021
Outros Autores: Santos, Gustavo Bispo dos, Telles, João Paulo Mota, Rezende, Marcelo Rosa de, Wei, Teng Hsiang, Mattar Junior, Rames
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/213001
Resumo: OBJECTIVES: This study proposed a structured microsurgical training program and evaluated it with the assistance of a large sample of surgeons. METHODS: The practical course comprised 16 sessions of approximately 4 hours each. This included two sessions for suturing rubber gloves and two sessions for suturing arteries, veins, and nerves in chicken thighs. The other sessions were performed on the femoral vessels of rats: 5 sessions for end-to-end arterial anastomosis, 5 for end-to-end venous anastomosis, 1 for arterial grafting, and 1 for end-to-side anastomosis. We conducted a structured assessment of the microsurgical skills in each training session. RESULTS: In this study, 89 surgeons were evaluated. The mean scores for the different procedures were as follows: glove suturing, 33.3±0.59; chicken nerve end-to-end anastomosis, 40.3±0.49; chicken artery suturing, 40.9±0.36; chicken vein suturing, 42.3±0.36; graft interposition, 44.8±0.7; and end-to-side anastomosis, 43.7±0.63 (p<0.05 for all). The chicken thigh suturing scores were significantly higher than the rubber gloves suturing scores (p<0.01). There were no differences between scores of the rat artery and chicken thigh suturing procedures (p=0.24). The rat venous anastomosis scores were higher than the rat arterial anastomosis scores (p=0.02), as were graft interposition scores when compared with end-to-end venous anastomosis scores. The end-to-side anastomosis scores did not differ significantly from the grafting scores (p=0.85). The most common errors were inadequate knotting technique and suture rupture due to inadequate technique (both n=88 [98.9%]). CONCLUSION: We propose a 16-step, progressive microsurgical training program to learn the basic microsurgical techniques comprehensively and reliably. The program was evaluated in a large sample of trainees, and it demonstrated the adequacy of the training sequence and results.
id USP-19_6a08ca244b7c73e2d474e1ea2191dbf0
oai_identifier_str oai:revistas.usp.br:article/213001
network_acronym_str USP-19
network_name_str Clinics
repository_id_str
spelling Structured evaluation of a comprehensive microsurgical training programMicrosurgeryCurriculumReconstructive Surgical ProceduresEducationMedicalOBJECTIVES: This study proposed a structured microsurgical training program and evaluated it with the assistance of a large sample of surgeons. METHODS: The practical course comprised 16 sessions of approximately 4 hours each. This included two sessions for suturing rubber gloves and two sessions for suturing arteries, veins, and nerves in chicken thighs. The other sessions were performed on the femoral vessels of rats: 5 sessions for end-to-end arterial anastomosis, 5 for end-to-end venous anastomosis, 1 for arterial grafting, and 1 for end-to-side anastomosis. We conducted a structured assessment of the microsurgical skills in each training session. RESULTS: In this study, 89 surgeons were evaluated. The mean scores for the different procedures were as follows: glove suturing, 33.3±0.59; chicken nerve end-to-end anastomosis, 40.3±0.49; chicken artery suturing, 40.9±0.36; chicken vein suturing, 42.3±0.36; graft interposition, 44.8±0.7; and end-to-side anastomosis, 43.7±0.63 (p<0.05 for all). The chicken thigh suturing scores were significantly higher than the rubber gloves suturing scores (p<0.01). There were no differences between scores of the rat artery and chicken thigh suturing procedures (p=0.24). The rat venous anastomosis scores were higher than the rat arterial anastomosis scores (p=0.02), as were graft interposition scores when compared with end-to-end venous anastomosis scores. The end-to-side anastomosis scores did not differ significantly from the grafting scores (p=0.85). The most common errors were inadequate knotting technique and suture rupture due to inadequate technique (both n=88 [98.9%]). CONCLUSION: We propose a 16-step, progressive microsurgical training program to learn the basic microsurgical techniques comprehensively and reliably. The program was evaluated in a large sample of trainees, and it demonstrated the adequacy of the training sequence and results.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2021-10-18info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21300110.6061/clinics/2021/e3194Clinics; Vol. 76 (2021); e3194Clinics; v. 76 (2021); e3194Clinics; Vol. 76 (2021); e31941980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/213001/195019Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessMattar, Tiago Guedes da MottaSantos, Gustavo Bispo dosTelles, João Paulo MotaRezende, Marcelo Rosa deWei, Teng HsiangMattar Junior, Rames2023-07-06T13:04:07Zoai:revistas.usp.br:article/213001Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:04:07Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Structured evaluation of a comprehensive microsurgical training program
title Structured evaluation of a comprehensive microsurgical training program
spellingShingle Structured evaluation of a comprehensive microsurgical training program
Mattar, Tiago Guedes da Motta
Microsurgery
Curriculum
Reconstructive Surgical Procedures
Education
Medical
title_short Structured evaluation of a comprehensive microsurgical training program
title_full Structured evaluation of a comprehensive microsurgical training program
title_fullStr Structured evaluation of a comprehensive microsurgical training program
title_full_unstemmed Structured evaluation of a comprehensive microsurgical training program
title_sort Structured evaluation of a comprehensive microsurgical training program
author Mattar, Tiago Guedes da Motta
author_facet Mattar, Tiago Guedes da Motta
Santos, Gustavo Bispo dos
Telles, João Paulo Mota
Rezende, Marcelo Rosa de
Wei, Teng Hsiang
Mattar Junior, Rames
author_role author
author2 Santos, Gustavo Bispo dos
Telles, João Paulo Mota
Rezende, Marcelo Rosa de
Wei, Teng Hsiang
Mattar Junior, Rames
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Mattar, Tiago Guedes da Motta
Santos, Gustavo Bispo dos
Telles, João Paulo Mota
Rezende, Marcelo Rosa de
Wei, Teng Hsiang
Mattar Junior, Rames
dc.subject.por.fl_str_mv Microsurgery
Curriculum
Reconstructive Surgical Procedures
Education
Medical
topic Microsurgery
Curriculum
Reconstructive Surgical Procedures
Education
Medical
description OBJECTIVES: This study proposed a structured microsurgical training program and evaluated it with the assistance of a large sample of surgeons. METHODS: The practical course comprised 16 sessions of approximately 4 hours each. This included two sessions for suturing rubber gloves and two sessions for suturing arteries, veins, and nerves in chicken thighs. The other sessions were performed on the femoral vessels of rats: 5 sessions for end-to-end arterial anastomosis, 5 for end-to-end venous anastomosis, 1 for arterial grafting, and 1 for end-to-side anastomosis. We conducted a structured assessment of the microsurgical skills in each training session. RESULTS: In this study, 89 surgeons were evaluated. The mean scores for the different procedures were as follows: glove suturing, 33.3±0.59; chicken nerve end-to-end anastomosis, 40.3±0.49; chicken artery suturing, 40.9±0.36; chicken vein suturing, 42.3±0.36; graft interposition, 44.8±0.7; and end-to-side anastomosis, 43.7±0.63 (p<0.05 for all). The chicken thigh suturing scores were significantly higher than the rubber gloves suturing scores (p<0.01). There were no differences between scores of the rat artery and chicken thigh suturing procedures (p=0.24). The rat venous anastomosis scores were higher than the rat arterial anastomosis scores (p=0.02), as were graft interposition scores when compared with end-to-end venous anastomosis scores. The end-to-side anastomosis scores did not differ significantly from the grafting scores (p=0.85). The most common errors were inadequate knotting technique and suture rupture due to inadequate technique (both n=88 [98.9%]). CONCLUSION: We propose a 16-step, progressive microsurgical training program to learn the basic microsurgical techniques comprehensively and reliably. The program was evaluated in a large sample of trainees, and it demonstrated the adequacy of the training sequence and results.
publishDate 2021
dc.date.none.fl_str_mv 2021-10-18
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/213001
10.6061/clinics/2021/e3194
url https://www.revistas.usp.br/clinics/article/view/213001
identifier_str_mv 10.6061/clinics/2021/e3194
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/213001/195019
dc.rights.driver.fl_str_mv Copyright (c) 2023 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 76 (2021); e3194
Clinics; v. 76 (2021); e3194
Clinics; Vol. 76 (2021); e3194
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
_version_ 1800222766201307136