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Validation of a novel simulated tendon model for core suture tendon repair

Abstract:
Introduction
Simulation training can develop surgical procedural skills in a safe environment. Able to offer high-intensity exposure, simulation is increasingly important as working time for surgeons becomes more protected. Materials used in simulated tendon repair play a critical role in the fidelity and face validity of the model. Although organic materials like porcine tendon are commonly used, non-organic materials offer advantages such as accessibility, reproducibility, cost-effectiveness and ease of use without the need for special licences or facilities. This study aims to establish the face, content and concurrent validity of using a novel silicone material in a simulated tendon repair model.

Methods
Three tendon models, bathroom silicone sealant, DragonSkin® silicone and organic porcine tendons, were evaluated for concurrent validity through mechanical load to failure testing. Face and content validity were assessed, following participant repair of a DragonSkin® tendon, using a 5-point Likert scale for five clinically relevant parameters.

Results
Significant differences in load to failure were observed among bathroom sealant, DragonSkin® and porcine tendon (11.1N, 31.7N and 56.2N; p < 0.001). Participant feedback on the DragonSkin® tendon indicated that it was suitably representative, easy to use and useful for training (agreement rates 58%, 75% and 83%, respectively). However, participants noted that the model did not handle or glide like human tendon (both 8% agreement).

Conclusion
DragonSkin® silicone is an adaptable and valid material for simulated tendon repair models. It is low cost, widely available and shows promise as a training tool. Future research will focus on exploring its effectiveness in training settings.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1308/rcsann.2024.0064

Authors

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Institution:
University of Oxford
Division:
MSD
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Oxford college:
Pembroke College
Role:
Author
ORCID:
0000-0003-1818-5800
More by this author
Institution:
University of Oxford
Division:
MSD
Role:
Author


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Funder identifier:
https://ror.org/0187kwz08
Grant:
NIHR202367/554066


Publisher:
Royal College of Surgeons of England
Journal:
Annals of The Royal College of Surgeons of England More from this journal
Volume:
107
Issue:
5
Pages:
364-368
Place of publication:
England
Publication date:
2024-09-24
Acceptance date:
2024-06-25
DOI:
EISSN:
1478-7083
ISSN:
0035-8843
Pmid:
39316372


Language:
English
Keywords:
Pubs id:
2033063
Local pid:
pubs:2033063
Deposit date:
2025-05-16
ARK identifier:

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