Development of a Haptic Model for Teaching in Reconstructive Surgery—The Radial Forearm Flap

Abstract

The great value of the radial forearm flap (RFF) for reconstructive surgery stresses the importance of developing effective teaching methods. Our aim was to develop a realistic anatomic model that concisely simulates vital surgical steps while offering a haptic and visual experience. It should be cost-effective, easy to use, reusable, and quick to set up. The development commenced by constructing a prototype presenting basic features. Together with photographic surgery documentation, it served as a blueprint for the advanced model. The flap-raising process was condensed into the 6 most important steps to illustrate the procedure concisely and chronologically. Our final version consists of polyurethane, and a customized forearm flexor muscle model serves as the basic structure. Diverse plasticizers give different degrees of hardness to mimic anatomic structures. Special didactic features of the model include a movable elastic ramus superficialis nervi radialis. The flap island is attachable/detachable by a patrix/matrix mechanism. The brachioradialis muscle is elastic and detachable, and the fascia antebrachii is additionally severable. Vessels can be disconnected, and the removable forearm skin features a wave-shaped incision for the flap pedicle. To investigate the didactic benefit of the RFF model, we used it in a teaching course for medical students. The group receiving teaching supported by the RFF model showed a statistically significant improvement of knowledge (P = 0.007) in comparison with the group solely receiving a standard lecture supported by surgery images. In our opinion, the RFF model is an excellent compromise with regard to realism, didactic benefit, and cost-/time-effectiveness and has proven successful in the teaching of medical students.