Validation of Animal Models for Simulation Training in Pediatric Laryngotracheal Reconstruction

2019 ◽  
Vol 129 (1) ◽  
pp. 46-54 ◽  
Author(s):  
Saleh Okhovat ◽  
Thomas D. Milner ◽  
William A. Clement ◽  
David M. Wynne ◽  
Thushitha Kunanandam
Keyword(s):  
Animal Models ◽  
Simulation Training ◽  
Ex Vivo ◽  
Skills Training ◽  
Level Of Evidence ◽  
Laryngotracheal Reconstruction ◽  
Surgical Skills Training ◽  
The Face ◽  
Practical Model ◽  
Comparative Validation

Objectives: To assess and compare the face (FV) and content validity (CV) of three ex vivo animal models for simulation training in pediatric laryngotracheal reconstruction (LTR). Methods: Feasibility of performing LTR was assessed on the head and neck of three different animals (lamb/suckling-pig/rabbit) and laryngeal dimensions and qualitative observations were recorded. A 19-item five-point Likert scale questionnaire was completed for each model to assess FV and CV. Data was prospectively collected and analyzed using descriptive and nonparametric statistics. Results: All three models were suitable for LTR simulation with laryngeal dimensions corresponding to 0-2 years (rabbit), 5-10 (pig) and >10 years (lamb model). Five trainees and five expert pediatric otolaryngologists performed LTR on each model. The overall median FV score was 5 for the lamb model (IQR 4-5), 3 for the rabbit (IQR 2-3), and 4 for the pig (IQR 4-4). The overall median CV score was 5 for the lamb (IQR 5-5), 2 for the rabbit (IQR 2-3), and 4 for the pig model (IQR 4-4). Comparison of the models demonstrated the lamb to be favored as the most realistic and practical model for simulation training in pediatric LTR, with both the lamb and the porcine model attaining validation thresholds. Conclusion: Our study is the first comparative validation assessment of animal models for use in pediatric LTR simulation and it supports the use of ex vivo lamb and porcine models for use in LTR surgical skills training. The lamb model was the favored simulation model while the rabbit was considered inferior for simulation training in pediatric LTR. Level of Evidence: 3b

scholarly journals A novel three-in-one silicone model for basic microsurgery training

2020 ◽  
Vol 43 (5) ◽  
pp. 621-626
Author(s):  
Osaid Alser ◽  
Gehad Youssef ◽  
Simon Myers ◽  
Ali M. Ghanem
Keyword(s):  
Animal Models ◽  
Surgical Training ◽  
Face Validity ◽  
Level Of Evidence ◽  
The Face ◽  
Advanced Stages ◽  
Spss Software ◽  
Silicone Model ◽  
Synthetic Models ◽  
Suturing Skills

Abstract Background Microsurgery simulation is an important aspect of surgical training. Animal models have been widely used in simulation training, but they have some limitations including ethical restrictions, cost and availability. This has led to the use of synthetic models that can reduce reliance on animals in line with the 3R (refinement, reduction and replacement) principles. The aim of this paper was to evaluate the face validity of Surgitate™ three-in-one (artery, vein and nerve) silicone model. Methods Fourteen candidates performed one end-to-end anastomosis on artery, vein and nerve. The face validity of the vessel was assessed via questionnaires detailing their previous microsurgical experience and their feedback of using this model using the Likert scale. Data management and analysis were performed using IBM SPSS software (25.0). Results Participants tended to value this model in the earlier stages of microsurgical training particularly in the acquisition of basic microsurgical skills. It could be particularly useful in enhancing suturing skills as a replacement or reduction in the use of chicken models. The model has some drawbacks preluding its utilization into more advanced stages of surgical training. Further studies are needed to validate the model using more objective measures. Conclusion We present a novel synthetic model that can be potentially introduced to early stages of microsurgery training. The model would be ideal to meet the 3R principles of the use of animal models and as an alternative to the commonly used synthetic models. Level of evidence: Not ratable.

scholarly journals Use and Effectiveness of the Cadaver-Lab in Orthopaedic and Traumatology Education: An Italian Survey

Joints ◽  
2017 ◽  
Vol 05 (04) ◽  
pp. 197-201 ◽  
Author(s):  
Michele Losco ◽  
Filippo Familiari ◽  
Francesco Giron ◽  
Rocco Papalia
Keyword(s):  
Skills Training ◽  
Surgical Anatomy ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Survey Study ◽  
Level Of Evidence ◽  
Surgical Skills Training ◽  
Upper Limb Surgery ◽  
Skills Laboratory ◽  
Lower Limb Surgery

Purpose The purpose of this study is to provide basic information on the availability and current use of cadaver laboratories in the education of orthopaedic residents and trainees and to determine the interest for the implementation of this type of training. Methods All Orthopaedic residents and trainees who attended a cadaver laboratory organized by SIGASCOT (Italian Society of the Knee, Arthroscopy, Sports Traumatology, Cartilage and Orthopaedic Technology) between 2013 and 2016 were asked to complete a survey on the availability and current use of cadaver laboratories in the education of Orthopaedic residents and trainees. The survey was sent via e-mail to 102 Orthopaedic residents and trainees. All data were analyzed and all responses are presented as counts, percentages, or means. Results Thirty-eight (37.2%) Orthopaedics and traumatology residents and trainees completed the survey and were included in this analysis. Eighteen trainees (18/38; 44.3%) attended a cadaver laboratory focused on lower limb surgery, whereas 20 (20/38; 52.7%) on upper limb surgery. Twenty participants (55.7%) perceived skills laboratory sessions as extremely beneficial to the understanding and becoming familiar with the normal surgical anatomy; moreover, 16 (45.7%) participants considered the cadaver laboratory extremely beneficial to the understanding of a specific surgical technique and very beneficial (44.4%) to become confident with arthroscopic or other specific surgical instruments. Over 60% of participants perceived cadaver laboratory to be very to extremely beneficial to increase confidence and speed in the operating room (OR), and more than a half of them considered skills laboratory sessions to be extremely beneficial to increase participation and decrease the occurrence of damages in the real surgical activity. Conclusion Orthopaedic residents and trainees found the addition of a cadaver laboratory for teaching surgical skills a significant benefit to both their overall education and surgical skills training. Level of Evidence Level IV, survey study.

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

scholarly journals Electrochemical treatment of ex vivo human abdominal skin and potential use in scar management: A pilot study

2021 ◽  
Vol 7 ◽  
pp. 205951312098853
Author(s):  
Dana M Hutchison ◽  
Amir A Hakimi ◽  
Avin Wijayaweera ◽  
Soohong Seo ◽  
Ellen M Hong ◽  
...  
Keyword(s):  
Color Change ◽  
Ex Vivo ◽  
Low Cost ◽  
Histological Evaluation ◽  
Ph Change ◽  
Level Of Evidence ◽  
Abdominal Skin ◽  
Electrochemical Therapy ◽  
Mean Width ◽  
Scar Management

Introduction: Scar treatments aim to address pathologic collagen deposition; however, they can be expensive or difficult to control. Electrochemical therapy (ECT) offers a simple alternative treatment. The purpose of this study is to examine the acid-base and histological changes in ex vivo human abdominal skin following ECT. Methods: Forty-two ex vivo human panniculus tissue sections collected from six individuals were tumesced with normal saline. ECT was performed by inserting two platinum needle electrodes connected to a DC power supply into each specimen. Voltage was varied (3–6 V) and applied for 5 minutes. Each specimen was sectioned across both electrode insertion sites and immediately stained with pH sensitive dye. The width of dye color change for each dosimetry pair was calculated. Hematoxylin and eosin staining was used to evaluate samples. Results and Discussion: ECT caused a spatially localised and dose-dependent increased area of acidic and basic pH around the anode and cathode, respectively. A significantly greater mean width of pH change was generated at the cathode compared to the anode in all treatment groups. Histological evaluation displayed broad condensation and hyalinisation of dermal collagen. Conclusion: ECT triggered dermal pH alterations and changed the underlying structural framework of the specimen. This technology may serve as a low-cost, minimally invasive local soft-tissue remodeling technique with potential application in scar management. Level of Evidence: 5 Lay Summary Electrochemical therapy is a novel treatment that causes spatially selective dermal injury in areas of interest. This study measures the effects of electrochemical therapy when applied to abdominal skin. Electrochemical therapy appears to have beneficial effects by causing a highly localised reduction in collagen content or local softening of tissue, which is consistent with other studies on scar therapies, including chemexfoliation, radiofrequency technologies, and lasers. However, electrochemical therapy can be performed at a fraction of the costs of these aforementioned modalities.

scholarly journals 934 Remote one-to-one virtual surgical skills training: Evolving the delivery of operative skills training in the UK

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Christian Asher ◽  
Ibrahim Ibrahim ◽  
Eyfrossini Katsarma
Keyword(s):  
Surgical Training ◽  
Wound Closure ◽  
Cost Effective ◽  
Skills Training ◽  
Training Programme ◽  
Surgical Skills ◽  
Wound Closure Techniques ◽  
Surgical Skills Training ◽  
Speciality Training ◽  
One To One

Abstract Introduction COVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills. Methods Enrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion. Results 5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020. Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent. Conclusions The COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.

scholarly journals Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sally Byford ◽  
Sarah Janssens ◽  
Rachel Cook
Keyword(s):  
Early Pregnancy ◽  
Confidence Level ◽  
Simulation Training ◽  
Systematic Approach ◽  
Transvaginal Ultrasound ◽  
Skills Training ◽  
Ultrasound Simulation ◽  
Learning Gap ◽  
Assessment Scores ◽  
Simulation Based

Abstract Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.

Abstract 3680: Transfusion-Induced Tissue Hypoxia is Ameliorated by S -nitrosohemoglobin Repletion of Stored Red Blood Cells

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Diana L Diesen ◽  
Jonathan S Stamler
Keyword(s):  
Animal Models ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Tissue Oxygenation ◽  
Ex Vivo ◽  
Tissue Hypoxia ◽  
Mouse Blood ◽  
Mortality And Morbidity ◽  
Stored Blood ◽  
Related Mortality

Transfusion of stored red blood cells (RBCs) is associated with a decrease in tissue oxygenation in animal models and with increased mortality and morbidity in patients. Recent studies have demonstrated that stored RBCs are deficient in vasodilatory ability and depleted of S -nitrosohemoglobin (SNO-Hb), and that renitrosylation ex vivo can increase SNO-Hb levels and restore vasoactivity. We have examined in a mouse model the extent to which transfusion impairs tissue oxygenation and whether SNO-Hb repletion can ameliorate that impairment. We report here that transfusion of (mouse) RBCs stored for 1 day or 1 week results in tissue hypoxia that is largely prevented by SNO-Hb repletion prior to transfusion ( 1 day stored blood : % decrease in oxygenation 58+/−10% untreated vs. 92+/−0.7% SNO-Hb repleted, p<0.05, n=3– 6; 1 week stored blood : % decrease in oxygenation 66+/−10% untreated vs. 91+/−2.8% SNO-Hb repleted, p<0.05, n=3– 6). Storage of mouse blood beyond human expiration-equivalents (1 month) resulted in substantial lysis and the death of all mice transfused (native and SNO-Hb repleted blood, n=5). In conclusion, repletion of SNO-Hb ameliorates the decrease in tissue oxygenation that results from transfusion of untreated stored blood. Therefore, SNO-Hb repletion may provide a simple and efficacious method to reduce transfusion-related mortality and morbidity.

A systematic review of simulated laryngotracheal reconstruction animal models

2018 ◽  
Vol 129 (1) ◽  
pp. 235-243 ◽  
Author(s):  
Thomas D. Milner ◽  
Saleh Okhovat ◽  
William A. Clement ◽  
David M. Wynne ◽  
Thushitha Kunanandam
Keyword(s):  
Systematic Review ◽  
Animal Models ◽  
Laryngotracheal Reconstruction

scholarly journals Large Animal Models of Vascularized Composite Allotransplantation: A Review of Immune Strategies to Improve Allograft Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Abraham J. Matar ◽  
Rebecca L. Crepeau ◽  
Gerhard S. Mundinger ◽  
Curtis L. Cetrulo ◽  
Radbeh Torabi
Keyword(s):  
Animal Models ◽  
Ex Vivo ◽  
Solid Organ Transplantation ◽  
Tolerance Induction ◽  
Large Animal ◽  
Solid Organ ◽  
Large Animal Models ◽  
Large Animals ◽  
And Function ◽  
Made In

Over the past twenty years, significant technical strides have been made in the area of vascularized composite tissue allotransplantation (VCA). As in solid organ transplantation, the allogeneic immune response remains a significant barrier to long-term VCA survival and function. Strategies to overcome acute and chronic rejection, minimize immunosuppression and prolong VCA survival have important clinical implications. Historically, large animals have provided a valuable model for testing the clinical translatability of immune modulating approaches in transplantation, including tolerance induction, co-stimulation blockade, cellular therapies, and ex vivo perfusion. Recently, significant advancements have been made in these arenas utilizing large animal VCA models. In this comprehensive review, we highlight recent immune strategies undertaken to improve VCA outcomes with a focus on relevant preclinical large animal models.

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