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Brush up on minor surgery

Why practice on a pig's trotter when you could use a set of lifelike latex pads, asks Dr Nigel Stollery.

If you want to offer your patients in-house minor surgery, this kit from Limbs and Things, described on the label as 'a comprehensive "hands-on" skills kit for traditional minor surgery procedures', could be just what you are looking for.

The kit comes in a tough and very portable plastic case, which, when opened, reveals everything you need to get back up to speed.

In the top half of the case is a full set of instruments including a scalpel handle, curette, forceps, needle holders, artery forceps and straight and curved scissors. These appear to be made of good-quality stainless steel, although the kit does recommend that they are for practice only.

In the bottom half lie the components which to me make this set so appealing.

Skin pads
First, there are the four skin pads, complete with a 'skin pad jig' which has sucker pads to fix it to the table and hold the skin pads steady.

The latex pads are quite lifelike. The first is basic skin measuring 7.5 by 12cm, the surface of which even has the appearance of skin with hundred of tiny pores. This, in just the same way as a pig's trotter, can be scored and re-sutured. Admittedly, there is nothing too special there.

But this is not the case with the other three pads. The second, described on the label as a 'curettage, snip excision and shave excision pad', contains six lesions ready for removal. It will also fit into the jig. Once there, the instruments can be used to excise and suture just like in real life.

The third pad is the lipoma pad, which contains two lipomas ready for removal. The fourth has two sebaceous cysts for removal.

Once the pads and jigs have been removed, below you will find two scalpel blades, a single 4/0 Ethilon suture and a CD-ROM.

Placed into a CD drive, the program starts automatically and you are presented with a front page, split into four sections: 'Using Minor Skin Procedures'; 'Instruments and Techniques'; 'Procedures'; and 'Practising on a Model'.

Each section is very detailed. For example, the section on the scalpel includes videos on how to remove correctly the blade and dispose of correctly.

Once familiar with the instruments, each procedure can be viewed on a real patient and then tried on the simulated skin by following the detailed onscreen animated videos. These also include advice on local anaesthesia and how exactly to infiltrate in each case.

Lifelike cysts
I was impressed by the lifelike contents of the sebaceous cysts. The shave excisions were particularly lifelike, with the skin having a tougher, less spongy feel.

Overall I found the kit very good, its best point being the excellent CD with its clear, easy-to-follow instructions,its great flexibility with regard to pausing and repeating sections, its clear animated guides and useful real-life footage. The pads were lifelike and the lesions far better than a pig's trotter. The instruments were the same as I would use on patients and of good quality.

So, whether you are an absolute beginner or a GP who wants a refresher course in minor surgery, then this is an easy-to-follow and cost-effective way in which to learn. The manufacturers state that this is not intended to be in any way a substitute for supervised clinical experience and this is obviously true.

- An independent review by Dr Nigel Stollery, GP in Kibworth, Leicestershire and clinical assistant in dermatology at The Leicester Royal Infirmary

- Equipment provided by Williams Medical Supplies

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