A Structured, Microsurgical Training Curriculum Improves the Outcome in Lower Extremity Reconstruction Free Flap Residency Training: The Ludwigshafen Concept
A Structured, Microsurgical Training Curriculum Improves the Outcome in Lower Extremity Reconstruction Free Flap Residency Training: The Ludwigshafen Concept
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DOI：
10.1055/s-0040-1720960
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发表时间：
2020-11-19
影响因子：
2.1
通讯作者：
Hirche, Christoph
中科院分区：
文献类型：
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作者：
Boecker, Arne;Kornmann, Jonas;Hirche, Christoph
背景 风险分层、经济压力和平坦的学习曲线使得实现和发展适当的显微外科技能和能力成为日常临床实践中的一项具有挑战性的任务。在之前的研究中，我们能够证明，鉴于某些风险分层问题，显微外科手术（例如游离皮瓣和再植）是安全的培训程序，并且可以在日常临床实践中进行教学。本研究旨在评估在引入并持续实施显微外科技能和能力的结构化内部培训课程以及为整形外科住院医师提供 24 小时免费使用显微外科培训设施后，游离皮瓣作为培训程序的安全性和并发症发生率的进一步改善。方法进行这项回顾性比较队列研究，旨在探讨实施课程和24小时无障碍培训设施后，下肢游离皮瓣显微外科技能是否可以进一步提高。因此，我们比较了实施前的A组（2009-2012年）和实施后的B组（2014-2017年）。对下肢游离组织移植的患者人口统计、手术特征和结果参数进行了评估。结果 两个队列的比较显示，队列 B 的术后并发症发生率显着降低 (p
Background 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. Methods 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. Results The comparison of both cohorts showed a significantly reduced postoperative complication rate for cohort B (p