Surgical residents typically train on pig skin. Is there a better material?

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Eleanor Tung-Hahn, now a USF College of Public Health (COPH) health sciences student, was a volunteer research assistant at Loyola University in Chicago when she was tasked by her mentors in the school’s dermatology department to help find an alternative to porcine (pig) skin for surgical training.

Doctor suturing. (Photo source: Canva)

“Trainees often complained that [porcine skin] was a less than ideal model [for surgical techniques like excising and suturing],” Tung-Hahn said. “In my limited experience helping out during their surgical-skill labs, I saw learners struggle firsthand with this single-use, animal-based, rigid model.”

Tung-Hahn and her then colleagues at Loyola, who had teamed with other schools/dermatology centers around the country, decided to assess surgical residents’ preference for and skill at using silicone-based synthetic skin versus porcine skin. 

They published their findings, “Surgical training tools for dermatology trainees: porcine vs. synthetic skin for excision and repair,” in the January 2021 Archives of Dermatological Research. By developing new hands-on training methods for health professionals, the research, Tung-Hahn said, has far-reaching public health implications.

Participants in the study compared their graded “on camera” silicone-based skin model experiences with recollected prior pig skin experiences and said they preferred porcine skin for suturing and overall use. This even though the synthetic skin was scent-free, vegan friendly, was not a biohazard and likely posed no ethical or religious conflicts.

“It’s possible that the inelasticity and density of the lower layer of the prototype skin could have made tissue repair challenging for some participants,” Tung-Hahn said. “Modification of these design features in future synthetic models could certainly improve ease of use and satisfaction.”  

Screenshot of suturing on synthetic skin. (Photo courtesy of Tung-Hahn)

But preferences aside, most of the residents were able to perform all suturing checklist tasks correctly when using the silicone model. 

“This bodes well for [the residents’] future ability to perform well in live patients, who have skin of various thicknesses and elasticities. Residents who can utilize simulated-learning opportunities to practice and hone their skills are better able to protect their patients’ health from harm and provide safe, accessible health services and procedures in an efficient way,” Tung-Hahn noted. “I hope this small study inspires developers to create refined synthetic models that closely mimic the features and handling of real skin. Such models will afford learners the best possible simulated experience to enhance their skills and ultimately provide outstanding care for their patients.”

Story by Donna Campisano for USF College of Public Health