plasurВопросы реконструктивной и пластической хирургииIssues of Reconstructive and Plastic Surgery1814-1471АНО "НИИ микрохирургии"10.52581/1814-1471/76/12plasur-15Research ArticleСтатьиОбразование в области микрохирургии в ИспанииMicrosurgery education in Spainhttps://orcid.org/0000-0002-7150-9758БаллестинА.BallestínA.

Альберто Балестин, DVM, MSc, PhD, отделение микрохирургии; Лаборатория микросреды опухолей, UMR3347 / U1021

г. Касерес

Орсе – Париж, Франция

Alberto Ballestín, DVM, MSc, PhD, Microsurgery Department

Cáceres

Orsay – Paris

balles_rodriguez@hotmail.comКуадросМ.CuadrosM.

Мигель Куадрос, MD, PhD, отделение верхних конечностей и микрохирургии, отделение ортопедической хирургии 

г. Малага

Miguel Cuadros, MD, PhD

Málaga

Центр миниинвазивной хирургии им. Хесуса Усона; Исследовательский центр Института КюриИспанияJesús Usón Minimally Invasive Surgery Centre; Tumor Microenvironment Laboratory, UMR3347/U1021, Institut Curie Research CenterSpainГоспиталь ВитасИспанияUpper Limb and Microsurgery Unit, Department of Orthopedic Surgery, Vithas HospitalsSpain20212005202124197102Copyright © Баллестин А., Куадрос М., 20212021Баллестин А., Куадрос М.Ballestín A., Cuadros M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://plasur.elpub.ru/jour/article/view/15

Прежде чем приступить к микрохирургической практике на пациентах, хирургу необходимо получить микрохирургические навыки в смоделированной и контролируемой среде, чтобы повысить вероятность успеха оперативного лечения и снизить риск хирургических осложнений. Благоприятные условия для этого исторически формировались в лабораториях микрохирургии. Использование экспериментальных животных позволило хирургам-стажерам изучать анатомические структуры и физиологические процессы, с которыми микрохирург сталкивается в повседневной клинической практике. В последние десятилетия увеличилось количество методов моделирования, что позволило сократить количество используемых в учебных целях животных.Испания имеет долгую историю практики и преподавания микрохирургии. Данная статья призвана подчеркнуть роль первых преподавателей микрохирургии, а также оценить текущую ситуацию в этой сфере и ее перспективы.

Prior to microsurgery practice on patients, microsurgical skills should be learned in a simulated and controlled environment to increase success rates and reduce surgical complications. These favorable environments have historically been the microsurgery laboratories. The use of the experimental animals has allowed surgical trainees to interact with anatomical structures and physiological processes that a microsurgeon has to face in daily clinical scenarios. In recent decades, there has been an increase in simulation methods to reduce the number of animals used for training purposes and thus meet animal welfare criteria.Spain has a long history in the practice and teaching of microsurgery, this manuscript aims to highlight the importance of first educators, as well as to evaluate the current situation and future perspectives.

микрохирургияобучениеобразованиеИспаниямоделированиеанастомозоценкаMicrosurgerytrainingeducationSpainsimulationanastomosisassessmentThe authors acknowledge support and data sharing from Dr. Daniel Camporro, Dr. Jesús Usón Casaús, Dr. Pedro Marquina, Dr. José María Lasso, Ms. Marisa Sanz and Dr. Santos Palazzi. Authors also appreciate the comments and friendly discussion of this manuscript with the current Board of Directors of the Spanish Association for Microsurgery.ReferencesCarrel A. La technique opératoire des anastomoses vasculaires et de la transplantation des visceres. Lyon: Association typographique. 1902.Carrel A. La technique opératoire des anastomoses vasculaires et de la transplantation des visceres. Lyon: Association typographique. 1902.Nylen C.O. The microscope in aural surgery, its first use and later development. Acta Otolaryngol Suppl. 1954;116:226-240.Nylen C.O. The microscope in aural surgery, its first use and later development. Acta Otolaryngol Suppl. 1954;116:226-240.Couch N.P. About heparin, or ... whatever happened to Jay McLean? J Vasc Surg. [Biography Historical Article Portraits]. 1989 Jul;10(1):1-8.Couch N.P. About heparin, or ... whatever happened to Jay McLean? J Vasc Surg. [Biography Historical Article Portraits]. 1989 Jul;10(1):1-8.Jacobson J.H., Suarez E.L. Microsurgery in anastomosis os small vessels. Surgical forum. 1960;11:243-245.Jacobson J.H., Suarez E.L. Microsurgery in anastomosis os small vessels. Surgical forum. 1960;11:243-245.Malt R.A., McKhann C. Replantation of Severed Arms. Jama. 1964 Sep 7;189:716-722.Malt R.A., McKhann C. Replantation of Severed Arms. Jama. 1964 Sep 7;189:716-722.Buncke H.J., Buncke G.M., Kind G.M. The early history of microsurgery. Plast Reconstr Surg. [Comment Historical Article Letter]. 1996. Nov;98(6):1122-3.Buncke H.J., Buncke G.M., Kind G.M. The early history of microsurgery. Plast Reconstr Surg. [Comment Historical Article Letter]. 1996. Nov;98(6):1122-3.Uson J., Calles M.C. Design of a new suture practice card for microsurgical training. Microsurgery. [Evaluation Study]. 2002;22(8):324-8.Uson J., Calles M.C. Design of a new suture practice card for microsurgical training. Microsurgery. [Evaluation Study]. 2002;22(8):324-8.Fanua S.P., Kim J., Shaw Wilgis E.F. Alternative model for teaching microsurgery. Microsurgery. 2001;21(8): 379-382.Fanua S.P., Kim J., Shaw Wilgis E.F. Alternative model for teaching microsurgery. Microsurgery. 2001;21(8): 379-382.Olabe J. Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol. 2009. Dec;72(6): 695-699.Olabe J. Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol. 2009. Dec;72(6): 695-699.Ghanem A., Kearns M., Ballestin A., Froschauer S., Akelina Y., Shurey S, et al. International microsurgery simulation society (IMSS) consensus statement on the minimum standards for a basic microsurgery course, requirements for a microsurgical anastomosis global rating scale and minimum thresholds for training. Injury. 2020 Dec;51 Suppl 4:S126-S30.Ghanem A., Kearns M., Ballestin A., Froschauer S., Akelina Y., Shurey S, et al. International microsurgery simulation society (IMSS) consensus statement on the minimum standards for a basic microsurgery course, requirements for a microsurgical anastomosis global rating scale and minimum thresholds for training. Injury. 2020 Dec;51 Suppl 4:S126-S30.Ramachandran S., Ghanem A.M., Myers S.R. Assessment of microsurgery competency-where are we now? Microsurgery. [Review]. 2013. Jul;33(5):406-415.Ramachandran S., Ghanem A.M., Myers S.R. Assessment of microsurgery competency-where are we now? Microsurgery. [Review]. 2013. Jul;33(5):406-415.Ghanem A.M., Al Omran Y., Shatta B., Kim E., Myers S. Anastomosis Lapse Index (ALI): A Validated End Product Assessment Tool for Simulation Microsurgery Training. J Reconstr Microsurg. [Research Support, NonU.S. Gov’t Validation Study]. 2016, Mar;32(3):233-241.Ghanem A.M., Al Omran Y., Shatta B., Kim E., Myers S. Anastomosis Lapse Index (ALI): A Validated End Product Assessment Tool for Simulation Microsurgery Training. J Reconstr Microsurg. [Research Support, NonU.S. Gov’t Validation Study]. 2016, Mar;32(3):233-241.Satterwhite T., Son J., Carey J., Echo A., Spurling T., Paro J., et al. The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment. Ann Plast Surg. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. 2014, May;72 Suppl 1:S84-8.Satterwhite T., Son J., Carey J., Echo A., Spurling T., Paro J., et al. The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment. Ann Plast Surg. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. 2014, May;72 Suppl 1:S84-8.Shaughness G., Blackburn C., Ballestin A., Akelina Y., Ascherman J.A. Predicting Thrombosis Formation in 1-mm-Diameter Arterial Anastomoses with Transit-Time Ultrasound Technology. Plast Reconstr Surg. [Comparative Study]. 2017, Jun;139(6):1400-5.Shaughness G., Blackburn C., Ballestin A., Akelina Y., Ascherman J.A. Predicting Thrombosis Formation in 1-mm-Diameter Arterial Anastomoses with Transit-Time Ultrasound Technology. Plast Reconstr Surg. [Comparative Study]. 2017, Jun;139(6):1400-5.Yamamoto T., Yamamoto N., Ishiura R. Thirty-micron needle for precise supermicrosurgery. Microsurgery. [Letter]. 2017, Sep;37(6):735-736.Yamamoto T., Yamamoto N., Ishiura R. Thirty-micron needle for precise supermicrosurgery. Microsurgery. [Letter]. 2017, Sep;37(6):735-736.Masia J., Olivares L., Koshima I., Teo T.C., Suominen S., Van Landuyt K., et al. Barcelona consensus on supermicrosurgery. Journal of reconstructive microsurgery [Consensus Development Conference]. 2014. Jan;30(1):53-58.Masia J., Olivares L., Koshima I., Teo T.C., Suominen S., Van Landuyt K., et al. Barcelona consensus on supermicrosurgery. Journal of reconstructive microsurgery [Consensus Development Conference]. 2014. Jan;30(1):53-58.Koshima I., Yamamoto T., Narushima M., Mihara M., Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg. [Case Reports]. 2010, Oct;37(4):683-689, vii-iii.Koshima I., Yamamoto T., Narushima M., Mihara M., Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg. [Case Reports]. 2010, Oct;37(4):683-689, vii-iii.Ballestin A., Casado J.G., Abellan E., Vela F.J., Alvarez V., Uson A., et al. Adipose-Derived Stem Cells Ameliorate Ischemia-Reperfusion Injury in a Rat Skin Free Flap Model. J Reconstr Microsurg. 2018 Oct;34(8):601-609.Ballestin A., Casado J.G., Abellan E., Vela F.J., Alvarez V., Uson A., et al. Adipose-Derived Stem Cells Ameliorate Ischemia-Reperfusion Injury in a Rat Skin Free Flap Model. J Reconstr Microsurg. 2018 Oct;34(8):601-609.Ballestin A., Casado J.G., Abellan E., Vela F.J., Alvarez V., Uson A., et al. Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study. PLoS One. [Research Support, Non-U.S. Gov’t]. 2018;13(12):e0209624.Ballestin A., Casado J.G., Abellan E., Vela F.J., Alvarez V., Uson A., et al. Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study. PLoS One. [Research Support, Non-U.S. Gov’t]. 2018;13(12):e0209624.Ballestin A., Casado J.G., Abellan E., Vela F.J., Campos J.L, Martinez-Chacon G., et al. A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery. J Vis Exp. [Research Support, Non-U.S. Gov’t Video-Audio Media]. 2019 Nov 8(153).Ballestin A., Casado J.G., Abellan E., Vela F.J., Campos J.L, Martinez-Chacon G., et al. A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery. J Vis Exp. [Research Support, Non-U.S. Gov’t Video-Audio Media]. 2019 Nov 8(153).Masa I., Casado-Sanchez C., Crespo-Lora V., Ballestin A. Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model. J Reconstr Microsurg. 2020 Sep 24.Masa I., Casado-Sanchez C., Crespo-Lora V., Ballestin A. Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model. J Reconstr Microsurg. 2020 Sep 24.Najjar M., Lopez M.M., Jr., Ballestin A., Munabi N., Naides A.I., Noland R.D., et al. Reestablishment of Lymphatic Drainage after Vascularized Lymph Node Transfer in a Rat Model. Plast Reconstr Surg. 2018 Oct;142(4):503e-8e.Najjar M., Lopez M.M., Jr., Ballestin A., Munabi N., Naides A.I., Noland R.D., et al. Reestablishment of Lymphatic Drainage after Vascularized Lymph Node Transfer in a Rat Model. Plast Reconstr Surg. 2018 Oct;142(4):503e-8e.

The authors declare that there are no conflicts of interest present.