Current status of simulation and training models in microsurgery: A systematic review
Systematic review published in Microsurgery (2019)
Abstract
With the prolific uptake of simulation-based training courses, this systematic review aims to identify the available microsurgical simulation and training models, their status of validation, associated studies, and levels of evidence (LoE) for each training model, thereby establishing a level of recommendation (LoR). MEDLINE, Embase, and the Cochrane Library databases were searched for English language articles, describing microsurgery simulators and/or validation studies. All studies were assessed for LoE, and each model was subsequently awarded a LoR using a modified Oxford Centre for Evidence-Based Medicine classification, adapted for education, with 1 being the highest and 4 the lowest score. A total of 86 studies were identified describing 64 models and simulators ranging from bench models, cadaveric animal tissue, cadaveric human tissue, live animal models, virtual reality simulators, and training curricula. Of these, 49 simulators had at least one validation study. Models were assessed for face (n = 42), content (n = 31), construct (n = 25), transfer (n = 10), and concurrent validity (n = 1) by these studies. The most commonly identified modality was bench models (n = 28) followed by cadaveric animal tissue (n = 24). The cryopreserved rat aorta model received the highest LoR followed by chicken wing, chicken thigh and practice cardboard models. Microsurgery simulation is a growing field and increasing numbers of models are being produced. However, there are still only a few validation studies with a high LoE. It is therefore imperative that training models and/or programs are evaluated for validity and efficacy in order to allow utilization in microsurgical skills acquisition.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Systematic review of 86 studies on 64 microsurgery simulators including bench, cadaveric animal/human tissue, live animal, virtual reality and curricula; cryopreserved rat aorta received highest LoR.
Why This Matters for Hirudotherapy
This systematic review identified and evaluated 86 studies describing 64 microsurgical simulation and training models, ranging from bench models and cadaveric tissues to virtual reality simulators and training curricula, assessing their levels of evidence and validation status. The review found that only 49 simulators had at least one validation study, with the cryopreserved rat aorta model receiving the highest level of recommendation. This article has no direct relevance to hirudotherapy, the leech secretome, or ASH's domain—it concerns surgical skills training methodology and does not mention leeches, leech therapy, or leech-derived substances in any context. Its inclusion in an ASH research library would not be warranted based on the abstract content.
Citation
Current status of simulation and training models in microsurgery: A systematic review.
Javid P et al. · Microsurgery, 2019
Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026