Description and implementation of an ex vivo simulator kit for developing microsurgery skills.

Background: Microsurgical training is an essential part of the plastic surgery training curriculum. Given the emphasis on safety and standardization in surgical training, use of simulators is key. We used a novel microsurgical skills training set to inexpensively, safely, and reproducibly teach and perfect microsurgical skills.

Methods: The microsurgery training set consists of a number of items, including 2- and 3-mm polyvinyl tubes (used to simulate blood vessels), a foam background, and a particulate dye used to test vessel patency after microvascular anastomosis. During a 2-year period, trainees were exposed to the system on at least 3 separate occasions. Qualitative and quantitative performance metrics were recorded at each setting.

Results: Resident performance on the skills exercises improved with each exposure. Composite performance scores and completion times correlated significantly with the number of microsurgical cases each resident performed (P < 0.05). Utilization of the system was positively received by trainees on posttraining interviews.

Conclusions: On the basis of our experience, this system is a cost-effective way to introduce trainees to microsurgical skills. Furthermore, performance on the skills trainer positively correlates with actual microsurgical experience. Use of this system is a valuable alternative, compared to animal-based skills laboratories. Its use as a metric to establish competence in microsurgical skills acquisition is described.