Silicone-based simulation models for peripheral nerve microsurgery
Gül, Burçin and Kılıç, Deniz and Aslan, Dilan and Bayramiçli, Mehmet and Akbulut, Özge (2019) Silicone-based simulation models for peripheral nerve microsurgery. Journal of Plastic Reconstructive & Aesthetic Surgery, 72 (3). pp. 477-483. ISSN 1748-6815 (Print) 1878-0539 (Online)
Official URL: https://dx.doi.org/10.1016/j.bjps.2018.10.025
Background: There is a need for a peripheral nerve model on which surgeons-intraining can simulate the repair of nerve injuries at their own pace. Although practicing on animal models/cadavers is considered the "gold standard" of microsurgical training, the proposed model aims to provide a platform for improving the technical skills of surgical trainees prior to their practice on cadaver/animal models. In addition, this model has the potential to serve as a standardized test medium for assessing the skill sets of surgeons. Methods: Several formulations of silicone were utilized for the design and fabrication of a model which realizes the hierarchical structure of peripheral nerves. The mechanical properties were characterized via the Universal Testing Machine; the damage caused by the needle on the entry sites was assessed through scanning electron microscopy (SEM). Results: Mechanical properties of the formulations of silicone were tested to mimic human peripheral nerves. A formulation with 83.3 wt% silicone oil and 0.1 wt% cotton fiber was chosen to be used as nerve fascicles. Both 83.3 wt% silicone oil with cotton fiber and 66.6 wt% silicone oil without fiber provided a microsuturing response similar to that of epineurium at a wall thickness of 1 mm. SEM also confirmed that the entry of the needle did not introduce significant holes at the microsuturing sites. Conclusions: The proposed peripheral nerve model mimicked human tissues mechanically and cosmetically, and a simulation of the repair of a fifth-degree nerve injury was achieved. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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