title: Eight free flaps in 24 hours: a training concept for postgraduate teaching of how to raise microvascular free flaps.
abstract: Microvascular free flaps are complex but important tools in oral and maxillofacial surgery (OMFS), and though techniques to raise flaps are challenging surgeons often have little structured training. In this study we have evaluated a structured, three-day, hands-on, practical training course on raising flaps. Five human, Thiel-embalmed cadavers were used for training in how to raise the following flaps: radial forearm, anterolateral thigh, lateral arm, fibular, latissimus dorsi, scapular, iliac crest, and rectus abdominis. The total duration of the course was 24 hours over three days. All participants were asked to evaluate the design and conduct of the course, their own learning curve, and general questions about their knowledge of how to raise flaps and microsurgery. There was a significant increase in participants' assessments of how they raised all free flaps, except the lateral arm flap (4.74 (0.68) compared with 2.42 (0.81); p=0.052) before and after the course. The radial forearm flap was thought to be the most relevant in clinical practice (n=40; 75%), followed by the anterolateral thigh (n=5; 9%) and fibular (n=4; 8%) flaps. Comparisons between residents and consultants showed unsurprising differences in experience with microsurgery and self-assessment in raising particular free flaps before the course. We have shown that a structured, hands-on course using a well-established simulation model can significantly improve postgraduate surgeons' skills in raising free flaps.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: florian.jm.bauer@tum.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Bauer
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Koerdt
authors.affiliation: Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hölzle
authors.affiliation: Maxillofacial Unit, Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA, Great Britain.
authors.forename: David A
authors.initials: DA
authors.lastname: Mitchell
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
authors.forename: Klaus-D
authors.initials: KD
authors.lastname: Wolff
mesh_terms: D004502:Education, Medical, Continuing; D005360:Fibula; D058752:Free Tissue Flaps; D006801:Humans; D008866:Microsurgery; D019651:Plastic Surgery Procedures; D017568:Rectus Abdominis; D013848:Thigh
keywords: Free flap; Postgraduate training; Surgical education