Learning microsurgical suturing and knotting techniques: comparative data

TLDR

Correctly performed surgical sutures are essential for surgical safety, yet none of the students had prior microsurgical instruction. The study proposes that individualized microsurgical training, with tutor guidance on each stitch and knot, is preferable to mass training. A retrospective survey of 263 graduate and postgraduate participants assessed suturing placement, knotting time, knot safety, and knot stability. The course reduced knotting times from 6.8 min to 3.28 min for graduates and from 5.02 min to 1.54 min for postgraduates, while initial thread damage was 90–95 %, leading authors to argue that mass training is ineffective. © 2006 Wiley‑Liss, Inc., Microsurgery 26: 4–7, 2006.

Abstract

Abstract Correctly performed surgical sutures are the basis of surgical safety. This retrospective survey was conducted among participants (n = 263) taking graduate and postgraduate courses between 2000–2004. Placement of sutures, time to perform knotting, safety of knots, and quality of knot stability were tested. None of the students had been previously instructed in microsurgical techniques. At the beginning of the training program, 90–95% of participants damaged the suturing thread at several places. By the end of the course, knotting times significantly decreased in both groups. Graduates decreased their time from 6.8 ± 2.34 min to 3.28 ± 0.71 min (mean ± standard error of the mean), and postgraduates decreased their time from 5.02 ± 3.25 min to 1.54 ± 0.54 min (mean ± standard error of the mean). In our opinion, “mass training” to teach the basics of microsurgery is not a good approach. Instead, individual training should be provided, as tutors offer invaluable advice, and adjust almost each stitch and knot during teaching sessions. © 2006 Wiley‐Liss, Inc. Microsurgery 26: 4–7, 2006.