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Verfasst von:Böcker, Arne Hendrik [VerfasserIn]   i
 Kornmann, Jonas [VerfasserIn]   i
 Xiong, Lingyun [VerfasserIn]   i
 Harhaus-Wähner, Leila [VerfasserIn]   i
 Aman, Martin [VerfasserIn]   i
 Köpple, Christoph [VerfasserIn]   i
 Fischer, Sebastian [VerfasserIn]   i
 Will-Marks, Patrick [VerfasserIn]   i
 Kneser, Ulrich [VerfasserIn]   i
 Hirche, Christoph [VerfasserIn]   i
Titel:A structured, microsurgical training curriculum improves the outcome in lower extremity reconstruction free flap residency training: the Ludwigshafen Concept
Verf.angabe:Arne Boecker, MD, Jonas Kornmann, Lingyun Xiong, MD, MMSc, MBBS, Leila Harhaus, MD, Martin Aman, MD, Christoph Koepple, MD, Sebastian Fischer, MD, Patrick A. Will, MD, MSc, Ulrich Kneser, MD, Christoph Hirche, MD, FACS
Jahr:2021
Umfang:11 S.
Fussnoten:Online veröffentlicht: 19. November 2020 ; Gesehen am 05.04.2024
Titel Quelle:Enthalten in: Journal of reconstructive microsurgery
Ort Quelle:New York, NY : Thieme Medical Publ., 1984
Jahr Quelle:2021
Band/Heft Quelle:37(2021), 6, Seite 492-502
ISSN Quelle:0743-684X
Abstract:<p> <b>Background</b> Risk stratification, economic pressure, and a flat learning curve make the realization and development of proper microsurgical skills and competences a challenging task in the daily clinical practice. In previous studies, we were able to show that microsurgical procedures, e.g., free flaps and replantations, are safe training procedures and teachable in daily clinical practice in view of certain issues of risk stratification. The present study aims to evaluate further improvements in terms of safety and complication rates for free flaps as a training procedure after introduction and continuous implementation of a structured in-house training curriculum for microsurgical skills and competences and a 24-hour free accessible microsurgical training facility for the plastic surgery resident.</p> <p> <b>Methods</b> This retrospective comparative cohort study was conducted to review whether microsurgical skills for free flaps to the lower extremity can further be improved after implementation of the curriculum and a 24-hour accessible training facility. Therefore, we compared cohort A before (2009-2012) and B after (2014-2017) implementation. Patient demographics, procedural characteristics, and outcome parameters for free tissue transfer of the lower extremity were evaluated.</p> <p> <b>Results</b> The comparison of both cohorts showed a significantly reduced postoperative complication rate for cohort B (<i>p</i> <0.05). Furthermore, operation time was shorter, and the hospital stay could be significantly decreased (<i>p</i> <0.01). Workhorse flaps for plastic surgical training were the anterior lateral thigh (ALT) flap or the musculus latissimus dorsi (LD) flap. However, even more complex procedures with arteriovenous loops could be safely performed by plastic surgery residents under the supervision of the senior surgeon in exceptional cases.</p> <p> <b>Conclusion</b> The implementation of a regularly held, microsurgical in-house training curriculum with 24-hour accessible training facility improves procedural and outcome parameters for free flaps to the lower extremity for surgical residents and is an elementary part of skills and competency training. However, risk stratification, repeated surgical exposure, expertise, and institutional infrastructures are essential and must be taken into consideration.</p>
DOI:doi:10.1055/s-0040-1720960
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1055/s-0040-1720960
 Volltext: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1720960
 DOI: https://doi.org/10.1055/s-0040-1720960
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1885081693
Verknüpfungen:→ Zeitschrift

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