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The e-mémoires of the Académie Nationale de Chirurgie

Interest of Simlife Model in Teaching the Damage Control Surgery to Military and Civilian Surgeons

PONS F | BODDAERT G | HORNEZ E

Seance of wednesday 11 march 2020 (L'Académie reçoit la SFCU)

DOI number : 10.26299/reww-8854/emem.2018.3.016

Abstract

Objective: Damage control surgery is a surgical tactic used for unstable bleeding trauma patient. The initial surgical stage consists of rapid hemostasis and contamination control (without definitive repair). Its teaching is essential for military surgeons, for civilian surgeons in Trauma Centers, but also (as reminded by the Terror Attacks in 2015) for any surgeon, whatever his specialty or place of practice. Practical teaching in clinics is difficult because this type of injury is relatively rare. Therefore, Simulation Models, should be very useful.
Methods: The SimLife model (bodies donated to Science, ventilated and perfused) developed at the University of Poitiers has been used to teach elective surgical procedures. Since 2017 we used it to teach Damage Control surgery and we compared it with other simulation models.
Results: 7 sessions for 46 French and foreign civilian and military surgeons were organized. This has shown us the relevance of this system compared to other models. Animal models: more realistic bleeding, but very different anatomy and uncertain availability in the future. Synthetic simulation models: some of them are very realistic for vascular procedures, but very expensive and still very far from reality for thoracic and abdominal models. Compared to "static" cadavers, the SimLife model reproduces much more realistic conditions, especially in the chest and abdomen: liquid in the pleural or peritoneal cavity, appearance and consistency of the organs hemorrhage in case of vascular injury which allows the exposure and hemostasis procedures to be carried out properly and the students experience to be appreciated. Moreover, we could formalize the procedure and the sequences of a session and try to develop evaluation scales.
Conclusion: SimLife seems to be very relevant for teaching every procedure (chest, abdomen, vascular, extremities) of damage control surgery with only one model.