A model of penetrating ilio-caval trauma in perfused embalmed cadavers

Hattam, Andrew, Wu, Roxanne, Hartslief, Merwe, and de Costa, Alan (2021) A model of penetrating ilio-caval trauma in perfused embalmed cadavers. In: [Presented at the Australasian College of Surgeons Annual Scientific Congress]. From: RACS ASC 2021: Royal Australasian College of Surgeons Annual Scientific Congress, 10-14 May 2021, Melbourne, VIC, Australia.

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Abstract

Cadaver-based open surgical exposure courses are limited in their ability to realistically & reproducibly, model traumatic vascular injury and haemorrhage. Previous models of vascular perfusion have utilised fresh cadavers, which have limited longevity. In contrast, embalming cadavers is cheap, prevents decay & increases specimen longevity. Therefore, we sought to develop a model of perfused ilio-caval venous trauma in an embalmed cadaver. Methodology & Results: One cadaver embalmed with a formaldehyde-based solution was utilised. Laparotomy & right medial visceral rotation (MRV) exposed the inferior vena cava (IVC), bilateral common & right external & internal iliac veins. The right saphenofemoral junction (SFJ) was exposed via an infra-inguinal incision. Both renal veins & the supra-renal IVC were ligated. The femoral vein & all identifiable tributaries to the right ilio-caval venous segment were ligated. The SFJ was cannulated & connected to a pressurised fluid giving set. A customised water-based red-dye solution was used to perfuse the right ilio-caval system under low pressure via the giving set. A stab injury to the IVC was then created. Injury pattern & associated fluid extravasation rate were assessed by experienced Surgeons to ensure IVC injury & haemorrhage was accurately modelled. The right MVR was then closed. Penetrating injuries were then created with n=6 senior surgical trainees performing the ilio-caval venous exposure and injury repair in an informal ‘Direct Observation of Procedural Skills’ assessment style. Conclusion: The model described introduces a realistic and reproducible training simulation to prepare surgical trainees for exposure and management of penetrating IVC trauma.

Item ID: 68568
Item Type: Conference Item (Poster)
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Date Deposited: 02 Jul 2021 00:56
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320226 Surgery @ 50%
39 EDUCATION > 3999 Other Education > 399999 Other education not elsewhere classified @ 50%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50%
16 EDUCATION AND TRAINING > 1603 Teaching and curriculum > 160303 Teacher and instructor development @ 50%
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