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Fulltext Microgrids: A Model for Basic Microsurgery Skills Training

Gunasagaran J, Rasid RJ, Mappiare S, Devarajooh C, Ahmad TS

Malays Orthop J, 2018 Jul;12(2):37-41.
PMID: 30112127 MyJurnal DOI: 10.5704/MOJ.1807.007

Introduction: Microsurgery is a subspecialised field which requires high technical skill. Laboratory training offers good opportunity for novice surgeons to learn and repetitively practise their skills prior to hands-on clinical practice. Commonly, the training programme consists of models in a stepwise increase in fidelity: from latex sheet to anaesthetised rat. We introduce microgrids model as a daily warm up procedure in a 5-day basic microsurgery course. The purpose of this study is to evaluate the correlation between microgrids colouring under magnification with microsuturing proficiency among novice surgeons. Materials and Methods: Participants were required to fill in microgrids under magnification everyday during their 5-day training as a starter test. The number of completely filled in microgrids in 20 seconds was recorded. A simulated cut on latex sheet was sutured and the time taken to apply five sutures was recorded. The sutures were evaluated with modified Global Rating Scale (GRS). Data was analysed with SPSS. Results: There was a statistically significant correlation between the number of microgrids coloured and the time taken to apply five sutures (p<0.01). An increase in number of microgrids coloured was significantly associated with the increase in quality of the suturing technique (p< 0.01). During the 5-day basic microsurgery skills training for novice surgeons, microsuturing skill improvement correlated with microgrid colouring. Conclusion: Microgrids colouring reflected microsuturing proficiency. It is an inexpensive, readily available, and simple model of 'warm up' for hand dexterity. The microgrids model can function as a starter test for initial training and a quick screening measure to assess microsurgical skill.
Biomechanical comparison of new Achilles tendon rupture repair technique the "Giftbox" versus the Krackow technique in New Zealand white rabbits: An experimental animal study

Hashim MH, Teo SH, Al-Fayyadh MZM, Mappiare S, Ng WM, Ali MRM

Injury, 2022 Feb;53(2):393-398.
PMID: 34740441 DOI: 10.1016/j.injury.2021.10.016

INTRODUCTION: To compare the strength between the Achilles tendons repaired with the "Giftbox" and the Krackow techniques in New Zealand white rabbits post six weeks of tendon healing.
MATERIALS AND METHODS: Eight rabbits were randomized into Giftbox and Krackow groups. Tenotomy was performed on the Achilles tendon of one side of the lower limb and repaired with the respective techniques. The contralateral limb served as control. Subjects were euthanized six weeks post-operative, and both repaired and control Achilles tendons were harvested for biomechanical tensile test.
RESULTS: The means of maximum load to rupture and tenacity in the Giftbox group (156.89 ± 38.49 N and 159.98 ± 39.25 gf/tex) were significantly different than Krackow's (103.55 ± 27.48 N and 104.91 ± 26.96 gf/tex, both p = 0.043).
CONCLUSION: The tendons repaired with Giftbox technique were biomechanically stronger than those repaired with Krackow technique after six weeks of tendon healing.

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