TissueDB/Simulators/Suture Simulator (Almeida)
General Information
Basic surgical suturing simulator for pre-clinical medical students learning simple interrupted stitch technique on a single-layer skin substitute.[1] A 6 cm circular pad — 20 g acetic silicone mixed with 11 g maize starch and air-dried for 48 hours — provides the suturable surface. Each pad costs less than US$0.30 (R$1.53, FX 0.1976 USD/BRL at 2023-10-13, BCB) and takes 9 minutes to produce. Almeida et al. validated the model with 20 fifth-semester students at Universidade do Estado do Pará (UEPA, Belém, Brazil) across 10 sessions over 5 weeks; mean GRS score rose from 10.1 to 32.9 (p < 0.001 all domains) and held at 30.1 four weeks later. The authors classify the model as low fidelity — single-layer pad with no skin, subcutaneous, or fascial differentiation.
| Field | Details |
|---|---|
| General Information | Standalone suture pad with no structural frame, housing, or base. Designed for fifth-semester medical students with no prior surgical-skills coursework or operative-synthesis exposure. The 6 cm diameter accommodates a 4 cm longitudinal incision and five simple interrupted stitches per incision. Expert evaluation found mononylon 4-0 provided the best edge coaptation and tensile resistance; smaller-diameter sutures (6-0, 5-0) caused edge tearing under higher-intensity traction. The authors note the pad also allows practice of other suture patterns including continuous stitches. Average build time 9 minutes (range 7–13 minutes). |
| Features and Basic Operation | Not stated in source |
| Current Development Status | Expert face validity confirmed by a surgeon with more than 8 years of experience, who assessed the pad using three suture types (mononylon 6-0, 5-0, and 4-0). Training validation with n=20 medical students (5th semester, UEPA) over 10 sessions across 5 weeks (twice weekly). GRS (7-domain adapted global rating scale, 0–35 points) improved from mean 10.1 on Day 1 to mean 32.9 on Day 33 (p < 0.001 all domains, ANOVA repeated measures with Tukey post hoc). Suturing time decreased from mean 08:11 to 03:17 (p < 0.001). Skills retained at 4-week follow-up (Day 61): GRS 30.1, time 03:47, no significant decay from Day 33. Satisfaction questionnaire (13 statements, 4-point Likert, 3 domains): Goals 99%, Structure 97.2%, Satisfaction 98.7%; total approval 98.3%. Cronbach alpha 0.899.[1] |
| Estimated Build Time and Cost | Approximately 9 minutes per pad on average; range 7–13 minutes.[1], Less than US$0.30 per pad (R$1.53, FX 0.1976 USD/BRL at 2023-10-13, BCB). Acetic silicone 250 g tube US$3.26 (R$16.50, FX 0.1976 USD/BRL at 2023-10-13, BCB; 20 g used = US$0.26 / R$1.32). Maize starch 200 g package US$0.77 (R$3.90, FX 0.1976 USD/BRL at 2023-10-13, BCB; 11 g used = US$0.04 / R$0.21). Total material purchased for batch: US$4.03 (R$20.40, FX 0.1976 USD/BRL at 2023-10-13, BCB).[1] |
| Specialized Tools and Equipment | Not stated in source |
| Version | Not stated in source |
| Development Team Contact Information | Not stated in source |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Skin and Subcutaneous Tissue | 1 pad per session | Silicone+Maize Starch (20 g acetic silicone + 11 g maize starch, 6 cm circular pad)[1] | ~US$0.30[1] | Homogeneous single-layer pad; provides suturable surface but no skin layer differentiation[1] |
Build Instructions
Phase 1: Pad Fabrication
- Weigh 20 g of acetic silicone and 11 g of maize starch using a digital scale.
- Place both ingredients on a flat non-stick surface.
- Mix by hand until the silicone and starch form a homogeneous mass.
- Mold the mixture into a circular shape with a 6 cm diameter.
- Leave the pad in contact with ambient air for 48 hours to cure.
- Verify: The pad is firm, holds its circular shape, and can sustain a 4 cm longitudinal incision without crumbling.
Not Suitable For
- Multi-layer tissue identification training — the pad is a single homogeneous layer with no skin, subcutaneous, or fascial differentiation[1]
- Knot security testing under high tension — pad edges tear with higher-intensity manual traction when using mononylon 6-0 and 5-0 sutures[1]
- Assessment of tissue layer depth perception — authors identify this as the primary limitation of the model[1]
References
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Suture Simulator (Almeida)". Appropedia. Retrieved June 3, 2026. |