Frozen-thawed Abdominal Flap Remnant as an education material for a Medium Group Surgical Skills Education Workshop

Abstract

Purpose: Residents' duty-hour regulations and the evolution of minimally invasive surgical techniques require more effective and efficient surgical skill teaching models. We used frozen-thawed human tissue remnants harvested during abdominoplasty or abdominal tissue-based breast reconstruction to allow for a medium-sized group workshop program, simulating a realistic surgical environment and visual/haptic feedback.

Methods: Full-thickness abdominal tissue (skin and subcutaneous fat) were donated from patients who underwent autologous breast reconstruction and gave consent to use their tissue for comprehensive research and medical educational purposes. Anonymized tissue was frozen-preserved and then thawed the day of the surgical skills workshop. A total of 53 residents completed 50-minute hands-on training in 3-to-5 person modules in four sessions of the workshop program.

Results: Thawed tissue regained almost normal texture and consistency. Structural integrity was also histologically confirmed. All participants were generally satisfied with the program, especially regarding the suture material provided.

Conclusion: Frozen-thawed tissue remnants from abdominoplasty or autologous breast reconstruction could be preserved and used as a suture education material in medium-group workshops for surgery residents or medical students given anonymity and with proper consent guaranteed. This approach provided an excellent model maintaining relatively real anatomic structure and consistency with minimal cost.

Keywords: Education; Residency; Sutures; Teaching; Training support.

Fig. 1. (A) Abdominal flap (about 42 cm × 14 cm) was harvested from the patient's lower abdomen. (B) Fluorescence image demarcated the distal nonperfused part that should be discarded. (C) Excised distal part before freezing. Scarpa's fascia was marked with ink for photographic identification.

Fig. 2. (A) Five frozen-thawed human derivatives were tacked onto the plywood board for a module. (B) Two plastic surgeons participated in 50-minute hands-on modules. Each workshop program consisted of three such modules, teaching 13 to 14 residents in one day. A total of 53 residents completed training in 4 workshop days. (C) Suture education was performed with virtually real visual and haptic feedback.

Fig. 3. Hematoxylin and eosin (A) and Masson's trichrome stain (×100) (B, C) after freezing-thawing. All tissue layers (epidermis, dermis, and subcutaneous fat) maintained structural integrity (×40).