Basic Skin Flaps for the General Surgeon
Basic Skin Flaps for the General Surgeon
Background. Teaching residents the design and creation of skin flaps is challenging because the use of skin flaps is not common enough during the course of a typical residency to provide a broad experience base.
Methods. A 12 x 12-inch board with a /8-inch foam rubber covering was designed to provide for the creation of four flaps and one Z-plasty. A lecture and practical exercise were used to teach basic techniques. Performance was measured by preexamination and postexamination, as well as by a resident satisfaction survey.
Results. Mean scores improved by 45%. The resident survey revealed an average subjective rating was 4.7 on a scale of 1 to 5. All residents rated this format superior to traditional lecture instruction. Total cost to provide laboratory experience for 16 residents was $50. Materials can be recovered and reused at a cost of $0.40 each.
Conclusions. The materials developed provided an effective, inexpensive nonbiologic model for teaching preoperative skills.
Traditional surgical teaching methods rely on lectures and reading to lay a foundational knowledge base and culminate in the operative experience under the direction of an experienced surgeon. The transition from theoretical knowledge learned from lectures and books to the application of this knowledge in the operating room can be a difficult one. The teaching and learning of surgical skin flap skills typify this problem. Successful design and creation of skin flaps requires an understanding of complex geometric concepts and the interaction of these designs with tension and elasticity. While lectures and reading can provide a solid foundation, an adequate understanding can be obtained only by actual creation of the flaps.
Efforts to smooth the learning curve from theory to operative experience have traditionally relied on the use of animal laboratory exercises. Unfortunately, this results in additional logistic hurdles and significant expense, and raises several ethical issues as well. Efforts to avoid biologic models, such as the development of suture boards and the laparoscopic trainer, have been successful in other areas of surgical training. Our goal was to design an inexpensive nonbiologic model for teaching the design and creation of skin flaps. In addition, we sought to integrate the use of this model into a teaching format that could be completed in less than 2 hours. We evaluated the efficacy of this teaching format based on examinations before and after the session, as well as on resident satisfaction.
Background. Teaching residents the design and creation of skin flaps is challenging because the use of skin flaps is not common enough during the course of a typical residency to provide a broad experience base.
Methods. A 12 x 12-inch board with a /8-inch foam rubber covering was designed to provide for the creation of four flaps and one Z-plasty. A lecture and practical exercise were used to teach basic techniques. Performance was measured by preexamination and postexamination, as well as by a resident satisfaction survey.
Results. Mean scores improved by 45%. The resident survey revealed an average subjective rating was 4.7 on a scale of 1 to 5. All residents rated this format superior to traditional lecture instruction. Total cost to provide laboratory experience for 16 residents was $50. Materials can be recovered and reused at a cost of $0.40 each.
Conclusions. The materials developed provided an effective, inexpensive nonbiologic model for teaching preoperative skills.
Traditional surgical teaching methods rely on lectures and reading to lay a foundational knowledge base and culminate in the operative experience under the direction of an experienced surgeon. The transition from theoretical knowledge learned from lectures and books to the application of this knowledge in the operating room can be a difficult one. The teaching and learning of surgical skin flap skills typify this problem. Successful design and creation of skin flaps requires an understanding of complex geometric concepts and the interaction of these designs with tension and elasticity. While lectures and reading can provide a solid foundation, an adequate understanding can be obtained only by actual creation of the flaps.
Efforts to smooth the learning curve from theory to operative experience have traditionally relied on the use of animal laboratory exercises. Unfortunately, this results in additional logistic hurdles and significant expense, and raises several ethical issues as well. Efforts to avoid biologic models, such as the development of suture boards and the laparoscopic trainer, have been successful in other areas of surgical training. Our goal was to design an inexpensive nonbiologic model for teaching the design and creation of skin flaps. In addition, we sought to integrate the use of this model into a teaching format that could be completed in less than 2 hours. We evaluated the efficacy of this teaching format based on examinations before and after the session, as well as on resident satisfaction.
