The galliform (Turkey thigh) model for resident training in facial plastic surgery

Learning the subtleties of dissection and tissue rearrangement requires study and practice. Students with prior exposure to soft tissue techniques are most likely to benefit from teaching in the operating room. Soft tissue simulation allows necessary repetition and facilitates understanding of complex flap procedures. It also permits objective assessment of skill level. Educators have employed numerous materials and models to facilitate acquisition of cutaneous surgical skills. These include pigs’ feet, synthetic multilayered skin pads, stretched animal skins, human cadavers, live mice, and virtual reality simulators. Each has its limitations. Pigs’ feet are widely used in surgical training as a model for human skin. Although structurally similar to the skin of human extremities, pig skin is thick and inflexible, making it a poor stand-in for human facial tissues. Multilayer commercial synthetic models simulate epidermal, dermal, and fat layers. They allow for undermining and subcuticular closure techniques and carry no risk of infection or contamination. However, these models are expensive, and plastic layers imitate the feel of tissue poorly. Stretched animal skins require considerable setup time and lack deep tissue layers. Live animals play an important role in the development of microvascular technique, but are expensive and ethically questionable when nonviable alternatives are available. Formalin-fixed cadavers have rigid soft tissues that do not handle well. Fresh human parts are technically ideal but are rare, expensive, and pose a significant infection risk. Computer-based virtual reality simulators featuring tissue deformation and haptic feedback are not yet fully developed. We present a facial soft tissue surgery model using defeathered fresh turkey thighs. It is inexpensive, readily available, and carries a low risk of zoonotic infection. We describe the histologic structure of galliform skin and compare its operative handling characteristics to human tissue and the more commonly used porcine limb model.