Cost-effective models for microsurgical training

INTRODUCTION

Microsurgery is an important surgical field and microsurgery training continues to be fundamental in many surgical subspecialties. For over a century, various models were suggested for microsurgical training.^[1,2] This includes organic and inorganic models and viable and non-viable tissue. We are presenting some cost-effective models that can be useful in training residents and juniors on microsurgery skills and also help surgeons maintain their skills.

It is a perspective article based on literature available in Scopus, PubMed, Google Scholar, and internet. Based on available literature, we have identified the following materials found to be useful in the microsurgical training among the residents.^[3]

1. Surgical gloves

2. Bubble wrap

3. Human umbilical cord.

SURGICAL GLOVES

The surgical gloves are easily and readily available and accessible and can be used for microsurgery training such as suturing and tissue handling.^[4] Gloves are stretched and applied over the plastic frame with a contrast background inside the gloves. The contrast background helps in differentiation of the suturing edges of the incised gloves. Plastic apron and color paper can be used as contrast background. It helps in improving our hand movement practice in microsurgery [Figure 1].

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Figure 1:

Use of surgical gloves in microsurgery training.

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BUBBLE WRAP

The bubble wrap is a cheap and easy-to-find training tool, with a thickness varying from 3/16 to 1-inch big bubbles. For laboratory training, the small-size bubbles are preferred. The bubble wrap comes with a thickness varying from 3/16 to 1-inch big bubbles. For laboratory training, the small-size bubbles are preferred. The very thin upper layer of plastic is very fragile and needs very careful handling during exercise [Figure 2]. In neurosurgery, the bubble wrap have the same fragility of the arachnoid or very small intracranial vessels, such as distal cortical vessels.^[5]

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Figure 2:

Use of bubble wrap in microsurgery training.

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UMBILICAL CORD

The umbilical cord is a lifeline between the fetus and the placenta and contains two arteries and one vein. The vessels lie in a supporting myxomatous tissue derived from the mesoderm, the “Wharton’s Jelly.” In the plastic surgery department at our hospital, we utilized the umbilical cord as a microsurgery-training model after acquiring a written consent from the mothers. The umbilical cord was brought from the obstetric unit and harvested, under strong restrictions regarding human immunodeficiency virus, hepatitis viruses, and other pathological infections to prevent infection transmission.^[6] After harvesting clean with adequate saline to remove the blood clots. Methylene blue dye is used to fill the vessels of umbilical cord with cannula. The coloring of the umbilical cord helps in providing good contrast colors for easier practice [Figure 3].

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Figure 3:

Use of human umbilical cord in microsurgery training.

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CONCLUSION

Microsurgical training is much needed in the super specialty residents all over the world. Microsurgical training materials are not widely available in all centers. The above materials which are easily available help the residents in continuous and consistent training for improving their confidence and skill set in microsurgical training.