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. 2024 Aug 1;9(8):464.
doi: 10.3390/biomimetics9080464.

Pilot Evaluation of Silicone Surrogates for Oral Mucosa Simulation in Craniofacial Surgical Training

Mitchell D Cin  1 , Krishna Koka  2   3 , Justin Darragh  3 , Zahra Nourmohammadi  2   4 , Usama Hamdan  5 , David A Zopf  2   4
Affiliations

Pilot Evaluation of Silicone Surrogates for Oral Mucosa Simulation in Craniofacial Surgical Training

Mitchell D Cin et al. Biomimetics (Basel). .

Abstract

Surgical simulators are crucial in early craniofacial and plastic surgical training, necessitating synthetic materials that accurately replicate tissue properties. Recent critiques of our lab's currently deployed silicone surrogate have highlighted numerous areas for improvement. To further refine our models, our group's objective is to find a composition of materials that is closest in fidelity to native oral mucosa during surgical rehearsal by expert craniofacial surgeons. Fifteen platinum silicone-based surrogate samples were constructed with variable hardness and slacker percentages. These samples underwent evaluation of tactile sensation, hardness, needle puncture, cut resistance, suture retention, defect repair, and tensile elasticity. Expert craniofacial surgeon evaluators provided focused qualitative feedback on selected top-performing samples for further assessment and statistical comparisons. An evaluation revealed surrogate characteristics that were satisfactory and exhibited good performance. Sample 977 exhibited the highest performance, and comparison with the original surrogate (sample 810) demonstrated significant improvements in critical areas, emphasizing the efficacy of the refined composition. The study identified a silicone composition that directly addresses the feedback received by our team's original silicone surrogate. The study underscores the delicate balance between biofidelity and practicality in surgical simulation. The need for ongoing refinement in surrogate materials is evident to optimize training experiences for early surgical learners.

Keywords: craniofacial; education; mucosa; otolaryngology; silicone; simulation; surgery.

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Conflict of interest statement

D.A.Z. is a co-founder of MakeMedical, LLC. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1
Silicone surrogate testing components: (A) surrogate mold; (B) surrogate testing stand; (C) computer-aided design (CAD) render of resultant silicone-based surrogate sample; (D) image of resultant silicone-based surrogate sample. All measurement citations are in millimeters (mm).
Figure 2
Figure 2
Top-performing surrogate samples following surgical handling evaluation by expert surgeons: (A) surrogate sample 153; (B) surrogate sample 925; (C) surrogate sample 977.
Figure 3
Figure 3
Evaluation scores of our original and top-performing surrogate samples.
See this image and copyright information in PMC

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