Abstract

Perforator based soft tissue flaps for lower limb soft tissue defect cover � evaluation of a novel training model

Author(s): Mr Duncan Avis,Mr Peter Drew,Mr Ian Pallister,Mr Duncan Avis

Lower limb soft tissue non-viability and loss is a recognised complication of both trauma, metabolic and infective processes. The degree and site of loss may pose complex problems with regards to treatment planning and surgical care. Rotation flaps are a recognised method of such defect cover. Training in this technique is difficult and the potential problems severe. In the UK training is further compromised by decreased junior doctor clinical exposure as a consequence of altered training patterns and working hour directives. Clinically relevant simulation may enhance training and assure better understanding of this approach both in plastic surgery and trauma & orthopaedics. We have developed a model as a teaching aid to develop surgical skills with regards to defect recognition, perforator detection, flap planning, dissection of a fasciocutaneous flap and subsequent defect cover. Questionnaires were given to surgical registrars attending our MSc Trauma Surgery Course pre- and post-model use. The results demonstrate the teaching model is an effective educational tool and significantly improves assessment of these problems and the appropriate planning for this procedure.