Download PDF
J Reconstr Microsurg 2015; 31(06): 442-449
DOI: 10.1055/s-0035-1549443
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Influence of Microsurgical Training on the Practice of Hand Surgeons

Thomas J. Christensen
1   Reno Orthopaedic Clinic, Reno, Nevada
,
William Anding
2   Department of Orthopedics and Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Alexander Y. Shin
2   Department of Orthopedics and Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Allen T. Bishop
2   Department of Orthopedics and Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Steven L. Moran
2   Department of Orthopedics and Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

12 November 2014

28 February 2015

Publication Date:
20 April 2015 (online)

    Permissions and Reprints

Abstract

Background The study aims to determine the effect of formal training on the long-term practice of microsurgery.

Methods Hand surgeons completing a 1-year hand fellowship and a 5-day microsurgery rat-model training course from a single institution over a 15-year period (1996–2011) were surveyed. Patency rates (at 24 hours), additional days spent in the laboratory, and training (orthopedic [OS] vs. plastic surgery [PS]) were correlated with the questionnaire responses regarding microsurgical confidence and practice spectrum.

Results Data were obtained for 100% (61/61) of former fellows. PSs were 4.7 and 7.6 times more likely to perform replants and free flaps than OSs, respectively. Training patency rates and days in the laboratory were fair predictors of current practice of free flaps and replants.

Conclusion PSs are more likely to perform replants and free flaps than OSs. Successful completion of a microsurgical skills course can be used as a predictor of those who will ultimately practice microsurgery. Broader application of microsurgical skills labs may be a technique to increase the practice of microsurgery among all hand surgeons.

Keywords

education - free flap - laboratory training - microsurgery - microsurgical training - replantation
 

  • References

  • 1 Elliott RM, Baldwin KD, Foroohar A, Levin LS. The impact of residency and fellowship training on the practice of microsurgery by members of the American Society for Surgery of the Hand. Ann Plast Surg 2012; 69 (4) 451-458
    CrossrefPubMedGoogle Scholar
  • 2 Nissenbaum M, Meckler R, Acland R. Hand position in microsurgery. J Hand Surg Am 1979; 4 (2) 118-120
    CrossrefPubMedGoogle Scholar
  • 3 Payatakes AH, Zagoreos NP, Fedorcik GG, Ruch DS, Levin LS. Current practice of microsurgery by members of the American Society for Surgery of the Hand. J Hand Surg Am 2007; 32 (4) 541-547
    CrossrefPubMedGoogle Scholar
  • 4 Chen MW, Narayan D. Economics of upper extremity replantation: national and local trends. Plast Reconstr Surg 2009; 124 (6) 2003-2011
    Google Scholar
  • 5 Sears ED, Larson BP, Chung KC. A national survey of program director opinions of core competencies and structure of hand surgery fellowship training. J Hand Surg Am 2012; 37 (10) 1971-1977.e7
    CrossrefPubMedGoogle Scholar
  • 6 Sears ED, Larson BP, Chung KC. Program director opinions of core competencies in hand surgery training: analysis of differences between plastic and orthopedic surgery accredited programs. Plast Reconstr Surg 2013; 131 (3) 582-590
    CrossrefPubMedGoogle Scholar
  • 7 Kakar S, Bakri K, Shin AY. Survey of hand surgeons regarding their perceived needs for an expanded upper extremity fellowship. J Hand Surg Am 2012; 37 (11) 2374-80.e1 , 3
    CrossrefPubMedGoogle Scholar
  • 8 Acland R. Signs of patency in small vessel anastomosis. Surgery 1972; 72 (5) 744-748
    PubMedGoogle Scholar
  • 9 Friedrich JB, Poppler LH, Mack CD, Rivara FP, Levin LS, Klein MB. Epidemiology of upper extremity replantation surgery in the United States. J Hand Surg Am 2011; 36 (11) 1835-1840
    CrossrefPubMedGoogle Scholar