Abstract
Since dermatologists routinely perform surgery in an outpatient setting, ensuring that dermatology trainees are provided with opportunities to develop sufficient proficiency in excisional surgery and suture technique is paramount. The objectives of this study are to assess trainee preference for silicone-based synthetic skin compared with porcine skin as a surgical training medium and to assess the ability of trainees to successfully demonstrate basic surgical skills using the simulated skin model. Participants were a convenience sample of dermatology residents from the greater Chicago area, who were asked to perform an elliptical excision and bilayered repair on a silicone-based synthetic skin model. Residents were then surveyed regarding their satisfaction with the model. Four blinded dermatologist raters evaluated digital photographs obtained during the performance of the procedures and graded the execution of each maneuver using a surgical task checklist. Nineteen residents were enrolled. Residents were more likely to prefer pig skin to simulated skin for overall use (p = 0.040) and tissue repair (p = 0.018), but the nominal preference for tissue handling was nonsignificant (p = 0.086). There was no significant difference between satisfaction with pig skin versus synthetic skin with regard to excision experience (p = 0.82). The majority of residents (10/19) performed all surgical checklist tasks correctly. Of those residents who did not perform all steps correctly, many had difficulty obtaining adequate dermal eversion and wound approximation. Synthetic skin may be conveniently and safely utilized for hands-on surgical practice. Further refinement may be necessary to make synthetic skin comparable in feel and use to animal skin.
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References
Roenigk RK (2008) Dermatologists perform more skin surgery than any other specialist: implications for health care policy, graduate and continuing medical education. Dermatol Surg 34:293–300
Lee EH, Nehal KS, Dusza SW, Hale EK, Levine VJ (2011) Procedural dermatology training during dermatology residency: a survey of third-year dermatology residents. J Am Acad Dermatol 64:475–483
Dai J, Bordeaux JS, Miller CJ, Sobanko JF (2016) Assessing surgical training and deliberate practice methods in dermatology residency: a survey of dermatology program directors. Dermatol Surg 42:977–984
Nicholas L, Toren K, Bingham J, Marquart J (2013) Simulation in dermatologic surgery: a new paradigm in training. Dermatol Surg 39:76–81
Reichel JL, Peirson RP, Berg D (2004) Teaching and evaluation of surgical skills in dermatology: results of a survey. Arch Dermatol 140:1365–1369
Todd MM, Miller JJ, Ammirati CT (2002) Dermatologic surgery training in residency. Dermatol Surg 28:547–550
Dimaggio PJ, Waer AL, Desmarais TJ et al (2010) The use of a lightly preserved cadaver and full thickness pig skin to teach technical skills on the surgery clerkship—a response to the economic pressures facing academic medicine today. Am J Surg 200:162–166
Alam M, Nodzenski M, Yoo S, Poon E, Bolotin D (2014) Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: a multirater, blinded study of operating room video recordings. JAMA Dermatol 150(6):608–612
Adams CC, Marquart JD, Nicholas LL et al (2014) Survey of medical student preference for simulation models for basic dermatologic surgery skills: simulation platforms in medical education. Dermatol Surg 40:427–435
Goldberg LH, Alam M (2004) Elliptical excisions: variations and the eccentric parallelogram. Arch Dermatol 140(2):176–180
Alam M, Goldberg LH (2004) Utility of fully buried horizontal mattress sutures. J Am Acad Dermatol 50(1):73–76
Adams B, Levy R, Rademaker AE, Goldberg LH, Alam M (2006) Frequency of use of suturing and repair techniques preferred by dermatologic surgeons. Dermatol Surg 32(5):682–689
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Jefferson, I.S., Robinson, S.K., Surprenant, D. et al. Surgical training tools for dermatology trainees: porcine vs. synthetic skin for excision and repair. Arch Dermatol Res 313, 793–797 (2021). https://doi.org/10.1007/s00403-020-02181-z
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DOI: https://doi.org/10.1007/s00403-020-02181-z