Wound care a stitch for medicine

Monday, 24 April 2000

Synthetic human flesh, made from plastic and marked for injury, is being used in an innovative new kit to teach the skills of wound care.

The kit, developed by Mr Rod Cooter, from Adelaide University's Department of Surgery, is the latest product to emerge from the Cooperative Research Centre (CRC) for Tissue Growth and Repair.

Called Practical Skin Wound Management, the kit is an interactive multi-media educational aid. It includes a CD-ROM covering 8 modules of demonstrations and self instruction, a comprehensive manual, and facilities for self-testing. Topics include skin anatomy and biology, anaesthesia and surgery, suturing, dressing and scar management.

A feature of the kit is its suturing pad. Manufactured in Australia to reproduce the texture of human flesh, it is marked so that it can be incised to simulate various wounds. The pad is accompanied by surgical instruments and materials so that students can practice suturing and hand tying, copying examples presented on the CD-ROM.

Traditionally, medical and nursing students learn about skin anatomy, pathology, anaesthesia and surgery at different times in their training, but Mr Cooter, who is the Director of Plastic and Reconstructive Surgery at the Royal Adelaide Hospital, has found from experience that this does not always produce the best results in wound management.

"We needed a product that students could interact with;' said Mr Cooter, "one that covered aspects of wound treatment that are not formally taught at present, but which health practitioners need to know."

"The idea grew from workshops where we trained general practitioners in wound management," said Mr Cooter. "We took the feedback sheets and used the comments to help develop a package which used an integrated approach."

The kit does so in a way believed to be unique. It has been extensively trialled, with 80 medical students recording outstanding benefits from using it. Mr Cooter sees the package offering other advantages, apart from the health of patients.

"We are trying to produce some standardisation of suturing techniques which is necessary for accreditation," said Mr Cooter. "Suturing has largely been a skill learnt through apprenticeship, or from 2-dimensional diagrams," he said. "This approach, offering 3-dimensional examples on the CD-ROM and integrated techniques, can offer a standardised approach to the treatment of wounds, from cleaning them to suturing and dressing them and ultimately to the management of scar tissue"

The success of this initial program has prompted the CRC to form a new enterprise, Innovative Surgical Technologies. 'Practical Skin Wound Management' is their first venture, but others are to follow, each embracing the concept of integrated teaching and practice in aspects of surgical procedure.

The program's effectiveness has now seen it incorporated into a distance-learning program of the Royal Australasian College of Surgeons but, apart from its role in the education of medical students, surgical specialists, nurses and veterinarians, the program will assist health practitioners in remote locations.

"A number of companies have shown interest," said Dr Cooter. "It offers benefits to the military, as it should make it possible to treat soldiers in remote areas when they can not readily be returned to base," he said.

"The Flying Doctor service took an early interest and there are many parts of Asia in which a package like this could help," said Mr Cooter.

The Flying Doctor came into being to serve the needs of remote, rural Australian communities. The pedal radio, an essential part of that story, became an invaluable electronic tool which linked remote patients to medical expertise. Multi-media resources follow that tradition, and their benefits need no longer be confined to Australia, as they are a simple way of exporting expertise to other countries where the inaccessibility or expense of medical help poses problems for thousands of people.

The CRC is now developing a website through which demonstration modules can be accessed. It is expected to be online in July, and will be accessible through the CRC's homepage.

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