An alternative model for teaching tendon repair and surgical skills in plastic surgery

Abstract

In the article we will describe the use of a simple, reproducible and practical urinary catheter model for tendon repair simulation. The structure of the model gives a satisfactory imitation of a tendon's texture, contour and flexibility. This model is easily stored and disposed of. It is free of any ethical committee restrictions. In addition, it can be reused and is easy to handle. There are no disease transmission risks and one catheter can be divided into multiple segments such that several trainees can use one catheter at any one time, therefore saving on costs. In addition, different techniques can be performed on the same model.Tendon repair is an important surgical skill to be attained by all core surgical trainees; especially in Plastic and Orthopedic Surgery. However, tendon repair simulation materials can be relatively expensive. In the Basic Surgical Skills Course®, trainees learn tendon repair techniques using a pig's trotter. The caveat to this is the difficulty in obtaining animal models, and ethical dilemmas that this presents.A simple, effective and cheap method to practice tendon repair techniques is by dividing a Urinary Catheter into multiple pieces, which can be secured to cardboard or perspex using clips, staples, or pins. The Catheter thus simulates a divided tendon, providing a pragmatic medium for practice. The two ends can be opposed and repaired with various suture techniques.Trainees will be able to practice different repair techniques, surgical skills as well as basic surgical principles. The surgical skills include the handling of tissues and instruments effectively and safely, disposal of sharps, suture choice and use, suturing technique and knot tying and surgical dexterity. Principles that can be demonstrated during the simulation session include planning operative approach and choosing appropriate instruments.