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Overcoming the Learning Curve: A Novel Approach to Teaching Zone II Flexor Tendon Repairs

Overcoming the Learning Curve: A Novel Approach to Teaching Zone II Flexor Tendon Repairs. A. Sina Bari, M.D.; Colin YL Woon , M.D.; Brian C Pridgen , B.S.; James Chang, M.D. Stanford Division of Plastic & Reconstructive Surgery Nothing to Disclose. Introduction.

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Overcoming the Learning Curve: A Novel Approach to Teaching Zone II Flexor Tendon Repairs

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  1. Overcoming the Learning Curve: A Novel Approach to Teaching Zone II Flexor Tendon Repairs A. Sina Bari, M.D.; Colin YL Woon, M.D.; Brian C Pridgen, B.S.; James Chang, M.D. Stanford Division of Plastic & Reconstructive Surgery Nothing to Disclose

  2. Introduction • Increasing liability, time & cost sensitivities of OR • Models & Simulators have been used successfully in other high risk industries • Zone II Flexor Tendon Repair is a complex, evolved technique

  3. Objectives • Standardize Technique for Zone II Flexor Tendon Repair • Create and Validate a Teaching Model for Zone II Flexor Tendon Repairs

  4. Methods I • PGY 1-6 Plastic SurgeryResidents (n=14) • Randomized, matched L & R segments of HumanCadaveric FDP & FPL Tendons • Pre- & Post-Test Questionnaire • Pre- & Post-Tutorial Zone II Flexor Tendon Repair • Follow up retestingat 6 months

  5. Methods II • Anatomy • Clinical Presentation • Repair • Suture & Needle Type • Repair Technique • Placement of Knots • # of Strands • Locking vs. Grasping • Suture Caliber • Purchase • Epitendinous Suture • Rehabilitation

  6. Methods III

  7. Methods IV

  8. Results

  9. Results

  10. Results

  11. Results

  12. Results

  13. Discussion • Wepresent a new model for teachingflexor tendon repair • Incorporates a practical model & didactic curriculum • Standardizes Zone II Flexor Tendon Repairbased on the best evidence • Is outside the time- and error- sensitive confines of the OR • Our data suggest value to all levels of resident training and persistance over time

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