Portal de Periódicos da CAPES

Fresh cadaver dissection for training in plastic surgery

2005; Elsevier BV; Volume: 58; Issue: 5 Linguagem: Inglês

10.1016/j.bjps.2005.01.012

1465-3087

Alexandra J. Turner, Andrew J. Mellington, Farida Ali,

Surgical Simulation and Training

Sir, An essential requirement in plastic and reconstructive surgery is the art of flap surgery. A number of courses are available for trainees in plastic surgery designed to teach and reinforce surgical principles and operative techniques. In the UK, certain conditions imposed by the Department of Health on the use of fresh cadavers for the purpose of surgical training, mean that such courses invariably use preserved cadavers. The embalming process, however, both alters the normal texture of tissues and disrupts tissues planes. In general, educational value will be improved the more closely an anatomical specimen resembles an operative specimen. This is more significant when tissue planes and fine structures such as perforating vessels are the subject in question. We recently had the opportunity to attend the Second Annual Fresh Cadaver Flap Course at Duke University Medical Centre (DUMC), NC, USA. The course fee, including travel and subsistence expenses, is competitive with other flap courses. Taking place in the recently completed Fresh Tissue Laboratories, this 2-day weekend course, systematically and comprehensively covers the majority of skin, fascial, muscle and myocutaneous flaps. Dissection of the whole body is completed in eight 90-min sessions covering the head and neck, breast, anterior and posterior trunk, upper limb, hand, lower limb and foot regions. The faculty is comprised of internationally renowned surgeons who provide excellent tuition and a wealth of personal experience. On average, three to five participants are allocated to each cadaver, with whom they remain for the duration of the course. The faculty rotate around the dissection groups, with two per table instructing on an anatomical region corresponding to their field of expertise. Less familiar as well as standard flaps are either demonstrated or guided by the instructors. During break periods, there is ample opportunity to practice raising many of the flaps ourselves. Lunch provides a forum for discussion, which includes case presentations, decision-making and debate on reconstructive options. The Duke Fresh Cadaver Flap Course is a well-organised, comprehensive and enjoyable course led by a number of highly motivated and enthusiastic individuals. Our experience has confirmed the clear benefit of fresh cadavers with their close resemblance to living tissue, both in terms of tissue handling and preservation of tissue planes. Plastic surgery residents at DUMC are fortunate to have open access to the laboratory, enabling them to develop and consolidate their skills in a safe environment similar to the operating room. We believe that a Fresh Tissue Laboratory is an invaluable resource for training and research in plastic surgery. The presence of such a facility in the UK would only serve to enhance our training.