Learning microsurgical suturing and knotting techniques: comparative data.

Abstract

Correctly performed surgical sutures are the basis of surgical safety. This retrospective survey was conducted among participants (n = 263) taking graduate and postgraduate courses between 2000-2004. Placement of sutures, time to perform knotting, safety of knots, and quality of knot stability were tested. None of the students had been previously instructed in microsurgical techniques. At the beginning of the training program, 90-95% of participants damaged the suturing thread at several places. By the end of the course, knotting times significantly decreased in both groups. Graduates decreased their time from 6.8 +/- 2.34 min to 3.28 +/- 0.71 min (mean +/- standard error of the mean), and postgraduates decreased their time from 5.02 +/- 3.25 min to 1.54 +/- 0.54 min (mean +/- standard error of the mean). In our opinion, "mass training" to teach the basics of microsurgery is not a good approach. Instead, individual training should be provided, as tutors offer invaluable advice, and adjust almost each stitch and knot during teaching sessions.