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Anatomy in the performance of a lower extremity fasciotomy before and after training
Author(s) -
Garofalo Evan,
Shackelford Stacy,
Shalin Valerie,
Pugh Kristy,
Chen Hegang,
Pasley Jason,
Sarani Babak,
Henry Sharon,
Bowyer Mark,
Mackenzie Colin
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.691.12
Subject(s) - fasciotomy , medicine , decompression , compartment (ship) , surgery , surgical decompression , cadaver , physical medicine and rehabilitation , physical therapy , oceanography , geology , adverse effect
With shorter training hours, acquiring trauma surgical skills on‐the‐job is challenging for civilian and military surgeons. We hypothesize that a training course including lower extremity fasciotomy will improve knowledge of surgical landmarks, anatomical structures, and procedure time. Specifically, improved knowledge of surface landmarks will correlate with faster and successful 4 compartment decompression. Surgical residents (n=34) were tested with validated metrics performing a 2 incision 4 compartment fasciotomy on a cadaver before and after the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Surface landmarks, incision placement, surgical procedure steps, and procedure time were compared before and after training with Linear mixed models and Pearson correlation. After training, residents improved in landmark identification (+33%), incision placement (+34%), and successful 4 compartment decompression ( p <0.001). More compartments were completely opened in less time (ANCOVA p <0.05; fig). Correct landmarks and incisions correlated with successful decompression (r=0.42‐0.5; p <0.001). Improved surface anatomic knowledge increased successful fasciotomy. This knowledge is normally acquired on the job during residency but specific training may help accelerate the acquisition of fasciotomy skills to compensate for reduced training hours.