4.4 Review

Microsurgical suturing assessment scores: a systematic review

Journal

NEUROSURGICAL REVIEW
Volume 45, Issue 1, Pages 119-124

Publisher

SPRINGER
DOI: 10.1007/s10143-021-01569-3

Keywords

Microsuturing; Microsurgery; Neurosurgery; Simulation; Skills; Training

Funding

  1. Department of Biotechnology-DBT, Ministry of Science and Technology, Govt. of India [BT/PR13455/CoE/34/24/2015]
  2. Department of Health Research, Ministry of Health and Family Welfare, Govt. of India [DHR-ICMR/GIA/18/18/2020]
  3. Department of Science and Technology-DST, Ministry of Science and Technology, Govt. of India [SR/FST/LSII-029/2012]

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This study reviewed various scoring scales for microsurgical skills assessment and identified key parameters that can be universally utilized in all neurosurgical training centers. The most widely used and validated assessment scales were found to be OSATS and NOMAT, while newer scales like UWOMSA and SAMS were notable for their skill division. Knot strength, suture separation, and suture intervals were identified as crucial parameters in all scales.
Several scoring scales for the assessment of microsurgical skills have been established and validated with the same basic parameters. The study aims to review the existing scales to highlight those parameters, which can be utilized uniformly across all neurosurgical training centers. An online search was conducted and all the surgical scores pertinent to microsurgical suturing were reviewed. The scales were compared to identify parameters, which were important for skill development and assessment in neurosurgical trainees. Seven assessment scales were identified which assessed the trainee's proficiency in microsurgical suturing. The objective structured assessment of technical skills (OSATS) and Northwestern Objective Microanastomosis Assessment Tool (NOMAT) were identified as the most widely used and validated assessment scales. The newer scales University of Western Ontario microsurgical skills acquisition/assessment (UWOMSA) and structured assessment of microsurgery (SAMS) were notable for the division of the skills. The knot strength, suture separation, and suture intervals were the most important parameters in all scales. Each scale has its strength in the assessment of the microsurgical proficiency of neurosurgical trainees. However, a more uniform scale that can be applied as per the level of the neurosurgical trainee is necessary.

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