Advertisement

Perforator Dissection Simulation: A High-Fidelity Five-Flap Porcine Training Model

  • Yildirim OezdoganEmail author
  • Charles Yuen Yung Loh
  • Nora Prochnow
  • Marcus Lehnhardt
Technical Note
  • 2 Downloads

Abstract

Introduction

Perforator dissection can be technically demanding with a steep learning curve. Inadvertent perforator damage during dissection can be minimized with practice and familiarity with tissue-handling techniques unique to perforator dissection. There currently lacks a simulation model that mimics the human perforator in size and course. We present a porcine training model with five consistent perforator flaps per side that can be readily harvested and is a reproducible simulation model.

Materials and Methods

Five fresh cadaveric pigs were used in this study to evaluate the feasibility and location of the perforators. Ten perforators were dissected out in each pig (five per side) by the same surgeon. The length of perforator was measured and intramuscular route was noted. The ease of dissection was graded, and its similarity to actual surgery was graded as well.

Results

Five consistent perforators were identified across each side of five fresh cadaveric pigs. The perforators were located, namely in the neck, anterior flank, posterior flank, rectus and hindlimb. They were fasciocutaneous and had an intramuscular course of each (average 2.5 cm length). The perforators were found to be on each side of the pig, giving ten perforators for dissection practice in total.

Discussion

The five perforators named in this porcine model are easily replicated and can be performed for perforator dissection simulation and practice.

Keywords

Flap surgery Porcine perforator flap dissection Pig model Plastic surgery Flap Surgical simulation 

Notes

Author’s Contributions

YO, CYYL, NP, ML were involved in data collection, drafting of the manuscript and analysis of data; YO, CYYL, NP, ML were responsible for the second review of data, statistical analysis, ensuring data fidelity and manuscript review.

Compliance with Ethical Standards

Conflict of interest

The authors have declared that no conflict of interest exists.

References

  1. 1.
    de Blacam C, Tierney S, Shelley O (2017) Experience of plastic surgery registrars in a European Working Time Directive compliant rota. J Plast Surg Hand Surg. 51(4):264–269CrossRefGoogle Scholar
  2. 2.
    Loh CY, Tiong VT, Loh AY, Athanassopoulos T (2014) Microsurgery training: a home do-it-yourself model. Microsurgery 34(5):417–418CrossRefGoogle Scholar
  3. 3.
    Dumestre D, Yeung JK, Temple-Oberle C (2014) Evidence-based microsurgical skill-acquisition series part 1: validated microsurgical models—a systematic review. J Surg Educ 71(3):329–338CrossRefGoogle Scholar
  4. 4.
    Loh CY, Tiong VT, Loh AY, Athanassopoulos T (2014) Microsurgery training: a home do-it-yourself model. Microsurgery 34(5):417–418CrossRefGoogle Scholar
  5. 5.
    Athanassopoulos T, Loh CY (2015) The chicken foot digital replant training model. Hand Surg 20(1):199–200CrossRefGoogle Scholar
  6. 6.
    Loh CY, Gunn E, Pennell DJ, Athanassopoulos T (2014) Pinnaplasty: a porcine training model. J Plast Reconstr Aesthet Surg 67(6):868–869CrossRefGoogle Scholar
  7. 7.
    Hong JW, Kim YS, Lee WJ, Hong HJ, Roh TS, Song SY (2010) Evaluation of the efficacy of microsurgical practice through time factor added protocol: microsurgical training using nonvital material. J Craniofac Surg 21(3):876–881CrossRefGoogle Scholar
  8. 8.
    Stefanidis D, Yonce TC, Green JM, Coker AP (2013) Cadavers versus pigs: which are better for procedural training of surgery residents outside the OR? Surgery 154(1):34–37CrossRefGoogle Scholar
  9. 9.
    Tan SS, Sarker SK (2011) Simulation in surgery: a review. Scott Med J 56:104–109CrossRefGoogle Scholar
  10. 10.
    Loh CYY, Wang AYL, Tiong VTY, Athanassopoulos T, Loh M, Lim P, Kao HK (2018) Animal models in plastic and reconstructive surgery simulation-a review. J Surg Res 221:232–245CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  • Yildirim Oezdogan
    • 1
    Email author
  • Charles Yuen Yung Loh
    • 2
    • 3
    • 5
  • Nora Prochnow
    • 4
  • Marcus Lehnhardt
    • 4
  1. 1.Department of Plastic Surgery, The Royal London HospitalBarts Health NHS TrustLondonUK
  2. 2.St Andrew’s Center for Burns and Plastic SurgeryBroomfield HospitalChelmsfordUK
  3. 3.Department of Neuroanatomy and Molecular Brain ResearchRuhr University BochumBochumGermany
  4. 4.Department of Plastic Surgery, BG University Hospital BergmannsheilRuhr-Universität BochumBochumGermany
  5. 5.Center for Vascularized Composite AllotransplantationChang Gung Memorial HospitalTaoyuanTaiwan

Personalised recommendations