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Simulating Microsurgery for Plastic Surgey Trainees using boiled pasta - A cost effective, accessible idea preventing De-skilling.

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                Title       Simulating Microsurgery for Plastic Surgey Trainees using boiled pasta - A cost effective, accessible idea preventing De-skilling.        




One of the most challenging skills to learn and master in Plastic Surgery is that of microsurgery. We conducted a national survey asking trainees how they achieved exposure to this skill. Responses highlighted; a) trainees could not get exposure, b) trainers were reluctant to teach on patients during surgery due to the possibility of complications and c) many plastic surgery units didn't have access to microscopes for trainees to practice on. We aimed to solve this training problem with our innovative but simple microsurgery simulation idea.


Description of innovation or topic:


We trialed boiled tubular pasta to act as vessels for anastomosis practice. We anastomosed two tubules under loupe magnification with a 9.0 or 10.0 microsurgical nylon suture. The smaller the tubules the better microsurgical practice that could be achieved. We then asked a sample to 25 plastic and vascular surgery consultants to validate this simulation for effectiveness. All 25 consultants agreed this would be a suitable simulation for trainees to practice microsurgical skills.




After advertising this novel method of simulating microsurgery online we conducted a national questionnaire of trainees who had trailed it. We achieved responses from 50 trainees ranging from Foundation Year 2 doctor to Plastic surgery registrar (ST5) who reported:


1. This method was excellent for simulating microsurgery.


2. It allowed all levels of trainees to practice.


3. It allowed more senior trainees to maintain their skills and teach it to other junior colleagues effectively.


4. It was extremely cost effective and accessible for all to use.


5. It is perceived as an ethical method of practice compared to practicing on live or dead animals.


Take home message:


- Microsurgery skills can be taught using simple, cost effective methods.




- All trainees should have access to learning this skill and our method allows this.





1. Sione P et al. Alternative model for teaching microsurgery. Microsurgery 2001;21(8): 379-382.


2. Miko I et all. Basic teaching in Microsurgery. Microsurgery 2001; 21(4):121-3.