814 No Animals Were Harmed in The Making of This Microsurgical Model. A Novel Microsurgery Practice Model

Introduction Microsurgery forms the cornerstone of plastic and reconstructive surgery. Traditionally this is taught and practiced using anaesthetised rats or the chicken leg model. Whilst these models described provide useful training opportunities for surgeons, they present their own logistical difficulties. The rat model requires a license to utilise animal tissue. There are potential infection risks of using raw chicken for microsurgery practice We present a novel model to overcome the problems discussed above and allow microsurgery practice. Method A surgical glove is gently stretched over a gallipot. Two parallel longitudinal incisions are made using a scalpel. The warmup stage involves tubularising the section of surgical glove. The created tube is then divided, and anastomosis is performed. Multiple anastomoses can be performed along the length of the tube. Results The model has been used for warm up and anastomosis practice. It removes the barriers that make regular microsurgery practice difficult - namely access to anaesthetised animals (licensed facility required) and raw chicken (messy and potential infection risk) Conclusions We introduce a novel and accessible microsurgical practice model. It is used for learning and maintaining microsurgical skills and circumvents the barriers of previously described models.

Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

(1) Background: The sterile latex surgical glove is an important part of protecting both the patient and the surgical team from infections. However, mechanical stress can damage the integrity of the glove material and thus may lead to infections. (2) Method: A total of 896 gloves from 448 surgeries were tested and evaluated by the water tightening test according to EN455 and ASTM D5151-19. (3) Results: From 448 surgeries, 18.8% of the interventions showed glove damage. In vascular surgery, gloves were damaged in 20.8%, in thoracic surgery 9.1%, in laparoscopic interventions 21.7%, in the subgroup hernia surgeries (TAPP) 17.6% and in open interventions 17.6%. A total of 101 damages were found on 896 gloves; one glove could have several damages. During vascular surgery, 60% of the damages were on the subordinated hand of the surgeon, and 73.3% of the damages had a size of 1 mm. In laparoscopic procedures, the subordinated hand was also more frequently affected (61.3%) than the dominant hand; 64.5% of the damages were 1 mm in size. In the hernia surgery subgroup (TAPP), no damage was larger than 1 mm; 66.7% were in the subordinated hand area. The duration of surgery had no influence on the lesion rate. (4) Conclusion: The damage rate in low impact procedures is high and represents an underestimated problem in soft tissue surgery. The use of single gloving can therefore lead to the risk of infection. EN455 and ASTM D5151-19 does not take into consideration the risk of intraoperative lesions. Double gloving and glove change algorithms should be established.

Surgical glove perforation during oral and maxillofacial surgical procedures: An experimental study

Propouse: surgical teams sometimes neglect surgical glove perforation. The aim of this study was to determine the prevalence of sterile glove perforation in maxillofacial surgical procedures. Methods: Two studies were performed. The first one evaluated 200 pairs of surgical gloves (50 in each group) used by first, second, and third-year residents (R1,R2,R3). In the second study, 150 pairs of surgical gloves were evaluated: 100 pairs were used by a third-year resident, including 50 pairs in oral surgery procedures and 50 pairs in trauma surgeries, and 50 pairs of unused gloves were tested as control. The gloves were examined for perforations by filling them with water and testing for leaks. Results: In the first study, 29 pairs (19.3%) were perforated. Of the 50 pairs of control gloves, 7 pairs (14%) showed perforations on either side. The thumb and index finger and the right-hand (dominant hand) gloves, were the most frequently perforated sites. In the second study, 6% of the gloves in the control group, 6% of the gloves used in oral surgeries, and 10% of the gloves used in trauma surgeries showed perforations. The index finger and thumb were the most affected sites. Conclusion: The perforation rate was higher for the dominant right hand. In both studies, the frequency of perforation of unused gloves was significant, indicating the need for better quality control of the gloves evaluated in this study.