Validating the porcine model for microsurgical perforator training: Can surgeons trained on pig perforator dissection successfully perform human DIEP flap procedures? A pilot study.

IF 0.4 4区 医学 Q4 SURGERY Annales De Chirurgie Plastique Esthetique Pub Date : 2024-10-23 DOI:10.1016/j.anplas.2024.09.008
G A G Lombardo, A Stivala, R Cuomo, V Villani, A Nistor, F Rosatti
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Abstract

Autologous breast reconstruction, especially using the deep inferior epigastric artery perforator (DIEP) flap, is increasingly seen as a reliable, safe, and long-term alternative to implant-based reconstruction. Despite the recognized advantages of the DIEP flap for breast reconstruction, successful realization demands excellent anatomical knowledge, a thorough understanding of autologous breast reconstruction concepts and advanced microsurgical skills. Given that the porcine model is widely employed in microsurgical training, our study aims to assess this model using validated outcomes, with the objective of evaluating the enhancement in a surgeon's learning curve following training with this model. Forty DIEP flaps were harvested on 20 swines by a single surgeon in "Pius Branzeu Center" (Timisoara, RO) and "Drazan Institute" (University of veterinary of Brno, CZ) laboratories for microsurgical training in 6months (January 2015-June 2015). Then we analyzed data from 40 DIEP flaps harvested by the same surgeon on first 20 consecutive patients undergoing DIEP flap breast reconstruction. Perforator dissection time, surgeon-determined dissection difficulty score (DDS) and venous congestion rate were collected for each flap in porcine model and in patients, then compared and analyzed. The mean of DDS score analysis in first and second swines group dissection resulted as statistically significant (P-value 0.0001), while it was not statistically significant between those analyzed in the second group of swines dissected and patients (P-value 0.8037). Reduction in perforator dissection time between the two swines' groups and in venous congestion rates from the first swines groups to the second to the human group resulted statistically significant too (P-value respectively 0.0001 and 0.0079). The porcine model has been used for a long time together with other animal models for microsurgical training. Our study confirms and objective by validated scores that it is a valid and reliable model, comparable to the human one and which mimics the dissection of human perforating vessels.

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验证用于显微外科穿孔器培训的猪模型:接受过猪穿孔器解剖培训的外科医生能否成功实施人类 DIEP 皮瓣手术?一项试点研究。
自体乳房重建,尤其是使用下腹深动脉穿孔(DIEP)皮瓣进行重建,越来越被视为一种可靠、安全、长期的替代假体重建的方法。尽管 DIEP 皮瓣用于乳房重建的优势已得到公认,但要成功实现这一目标,还需要精湛的解剖学知识、对自体乳房重建概念的透彻理解以及先进的显微外科技能。鉴于猪模型被广泛应用于显微外科培训中,我们的研究旨在通过验证结果对该模型进行评估,目的是评估外科医生在接受该模型培训后的学习曲线提升情况。在为期 6 个月(2015 年 1 月至 2015 年 6 月)的显微外科培训中,"Pius Branzeu 中心"(蒂米什瓦拉,罗马尼亚)和 "Drazan 研究所"(布尔诺兽医大学,捷克)的实验室由一名外科医生在 20 头猪身上采集了 40 个 DIEP 皮瓣。然后,我们分析了由同一外科医生对前20名连续接受DIEP皮瓣乳房重建术的患者所采集的40个DIEP皮瓣的数据。我们收集了猪模型和患者每个皮瓣的包膜剥离时间、外科医生确定的剥离难度评分(DDS)和静脉充血率,然后进行了比较和分析。第一组和第二组解剖猪的 DDS 评分平均值分析结果具有统计学意义(P 值为 0.0001),而第二组解剖猪和患者的 DDS 评分平均值分析结果无统计学意义(P 值为 0.8037)。两组猪之间穿孔器解剖时间的缩短,以及从第一组猪到第二组再到人类组的静脉充血率的降低也具有统计学意义(P 值分别为 0.0001 和 0.0079)。猪模型和其他动物模型在显微外科训练中使用已久。我们的研究通过有效评分证实了这是一个有效、可靠的模型,可与人类模型相媲美,并能模拟人类穿孔血管的解剖。
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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
86
审稿时长
44 days
期刊介绍: Qu''elle soit réparatrice après un traumatisme, pratiquée à la suite d''une malformation ou motivée par la gêne psychologique dans la vie du patient, la chirurgie plastique et esthétique touche toutes les parties du corps humain et concerne une large communauté de chirurgiens spécialisés. Organe de la Société française de chirurgie plastique reconstructrice et esthétique, la revue publie 6 fois par an des éditoriaux, des mémoires originaux, des notes techniques, des faits cliniques, des actualités chirurgicales, des revues générales, des notes brèves, des lettres à la rédaction. Sont également présentés des analyses d''articles et d''ouvrages, des comptes rendus de colloques, des informations professionnelles et un agenda des manifestations de la spécialité.
期刊最新文献
[The critique of an artificial intelligence tool in the assessment of peripheral facial paralysis]. Syndactyly release with full-thickness skin graft harvested from the wrist: About 24 webspaces. LIPOPULP. The impact of fat grafting on pulp sensitivity in fingertip injuries: A retrospective study of seven patients. Using 320-slice computed tomography to preoperatively investigate the leg perforator arterial system and design a perforator flap for patients with a soft-tissue defect in the leg. Contents
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