• Dhalia Masud, Nadine Haram, Margarita Moustaki, Whitney Chow, Samer Saour, and Pari Naz Mohanna.
• Microsurgery Institute 4 (MI4), Guys & St Thomas' Hospital, London SE1 7EH, UK. Electronic address: Dhalia.masud@gmail.com.
• J Plast Reconstr Aesthet Surg. 2017 Jul 1; 70 (7): 893-900.

IntroductionMicrosurgical techniques are essential in plastic surgery; however, inconsistent training practices, acquiring these skills can be difficult. To address this, we designed a standardised laboratory-based microsurgical training programme, which allows trainees to develop their dexterity, visuospatial ability, operative flow and judgement as separate components.MethodThirty trainees completed an initial microsurgical anastomosis on a chicken femoral artery, assessed using the structured assessment of microsurgical skills (SAMS) method. The study group (n = 18) then completed a 3-month training programme, while the control group (n = 19) did not. A final anastomosis was completed by all trainees (n = 30).ResultsThe study group had a significant improvement in the microsurgical technique, assessed using the SAMS score, when the initial and final scores were compared (Mean: 24 SAMS initial versus 49 SAMS final) (p < 0.05, Wilcoxon's rank test). The control group had a significantly lower rate of improvement (Mean: 23 SAMS initial versus 25 SAMS final). There was a significant difference between the final SAMS score of the study group and that of senior surgeons (Mean: 49 study final SAMS versus 58 senior SAMS).ConclusionThis validated programme is a safe, cost-effective and flexible method of allowing trainees to develop microsurgical skills in a non-pressurized environment. In addition, the objectified skills allow trainers to assess the trainees' level of proficiency before operating on patients.Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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