AB131. SOH24AB_091. Training surgeons in real-time complex microvascular reconstructive techniques: do patient outcome differ in the hand of the novice versus the master?
Head & Neck Session

AB131. SOH24AB_091. Training surgeons in real-time complex microvascular reconstructive techniques: do patient outcome differ in the hand of the novice versus the master?

Kasie O’Reilly1, Ciaran Hurley1, Christoph Theopold2, Roisin Dolan1, Fiachra Martin1, Shirley Potter3, Jemima Dorairaj4

1Plastic and Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; 2Plastic and Reconstructive Surgery, St. James’ Hospital, Dublin, Ireland; 3Plastic and Reconstructive Surgery, Misericordiae University Hospital, Dublin, Ireland; 4Plastic and Reconstructive Surgery, Cork University Hospital, Wilton, Cork, Ireland

Background: Reconstruction of the head and neck defect endeavours to overcome the variety of functional and aesthetic challenges that present to plastic surgeons1 Research lacks consensus on whether involvement of trainee surgeons results in greater complications and inadequate patient outcomes. Acquisition of technically demanding skills and accurate self-assessment of limitations is paramount to progression and continuous development of trainees. The aim of this study is to compare consultant versus trainee flap raising and consultant versus trainee microvascular anastomosis in head and neck reconstruction.

Methods: Through multi-site Irish Association of Plastic Surgery data base, all head and neck free flap reconstruction between the years 2020 to present. Data available on 311 flaps were analysed.

Results: Overall, when there was any trainee involvement in raising a flap, there was no statistically significant difference in ischaemic (P=0.956) or total operative time (P=0.326). Free flap partial loss, total loss, and complete survival was similar across all groups (P=0.731). When a consultant raised the flap, the consultant was more likely to complete the arterial anastomosis (P<0.001) and vein anastomosis (P<0.001) themselves compared to when there was any trainee involvement in raising the flap.

Conclusions: The lack of statistical difference in post-operative complications supports studies that support the safety of trainee involvement. Interestingly, the results demonstrate that when the consultant alone raised the flap, trainee involvement in microvascular reconstruction decreased. Thus, these results reinforce evidence that surgical training in microvascular reconstructive techniques provides satisfactory outcomes, however their participation in real-time complex reconstruction requires continuous encouragement.

Keywords: Microvascular; head and neck reconstruction; free flap; anastomosis; surgical training

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab131
Cite this abstract as: O’Reilly K, Hurley C, Theopold C, Dolan R, Martin F, Potter S, Dorairaj J. AB131. SOH24AB_091. Training surgeons in real-time complex microvascular reconstructive techniques: do patient outcome differ in the hand of the novice versus the master? Mesentery Peritoneum 2024;8:AB131.

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