TissueDB/Tissues/Skin
License: CC-BY-SA-3.0 by Madhero88, M.Komorniczak
Skin is the outermost tissue layer of the body, providing the initial barrier encountered during surgical approaches.
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| Felt | Trocar Placement Trainer | Felt sheet skin layer | ||
| Gelatin | — | — | Z-Plasty Simulator | Stocking substrate; set time 1 hour; colour amounts vary by desired skin tone |
| Glycerine | Z-Plasty Simulator | Co-ingredient with Gelatin in epidermis-dermis recipe (gelatin:glycerine:water 10:4:20); stocking substrate; set time 1 hour. | ||
| Foam Fabric | Z-Plasty Simulator | Traditional Felt variant; 2 pieces 12×12×2 mm, two colours for flap visibility | ||
| Pork Belly | Calvo Cricothyrotomy Simulator, Kei REAL CRIC Trainer | Porcine skin incision surface | ||
| Bicycle Inner Tube | D'Auria Cricothyrotomy Simulator, White UW Cricothyrotomy Simulator | Cuttable sensor-concealing skin | ||
| Pork Belly | Muller Cricothyrotomy Simulator | Section of porcine skin placed externally over the laryngeal structures of the Strategic Operations 3-in-1 TCCC manikin; provides the scalpel incision surface for the vertical skin incision of the scalpel–finger–bougie technique (Muller et al. 2020, p. e1781). Exact cut (belly, shoulder, or other) not disambiguated in source. | ||
| Extra-firm foam mattress | Man-O-War Chest Tube Simulator | 60 × 30 × 5 cm "extra dur" (extra-firm) foam mattress anchored to the bucket as the parietal wall; it takes the learner's initial skin incision and the blunt chest-wall dissection that follows, so it stands in for skin and the chest wall together. The source names no polymer. | ||
| Vinyl | Appendectomy Simulator, Open Appendectomy Simulator (Matthews) | Outer vinyl skin layer — the outermost surface of the abdominal-wall stack, the skin the trainee opens first.[1] | ||
| Ioban2 antimicrobial drape | Multipurpose Thoracic Simulator (Carter) | Iodophor-impregnated transparent adhesive drape (3M Health Care, St. Paul, MN) wraps the chest wall module (porcine rib rack + headliner foam + IV-fluid bag) as sealant and outermost traversable layer for Station 1 thoracentesis needle entry and Station 2 chest-tube incision. Source describes Ioban2 as "sealant" and "antimicrobial drape" rather than a skin analogue per se; row represents the outermost-traversed-layer role across both stations.[2] | ||
| External skin overlay (material not specified by Gauger et al. 2018) | Gauger Cricothyroidotomy Trainer | External skin overlay (type unspecified by Gauger 2018) for emergency needle cricothyroidotomy training. | ||
| External skin overlay (material not specified by Bettega et al. 2019) | Chest Tube Simulator (Bettega) | Yellow outer overlay visible in Figure 2 of Bettega 2019; source describes only "various materials" and does not name this layer. Provides incision surface for 1.5 cm skin incision in closed chest drainage procedure. | ||
| Fabric | Cricothyrotomy Simulator (Aho) | Outermost layer wrapping the model. Provides cuttable surface for initial skin incision. | ||
| Synthetic skin | Peripheral Intravenous Catheterization Trainer, Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Simulator (Kattan), Pediatric Front-of-Neck Access Simulator (Kovatch) | As tattoo practice skin: the puncture surface (epidermis) over the wrapped pool-noodle armature in the IV cannulation trainer. As a multi-layer flat pad: punctured for needle and dilator passage over the ex-vivo trachea in the Kattan BG-PDT trainer — a commercial 3-layered pad (Training & Competence, Santiago, Chile), 15 × 30 cm, 6 mm, allowing about 9 iterations per pad.[3] As a shaped overlay: the outer neck skin over the embedded silicone airway in the Kovatch pediatric front-of-neck trainer, palpated to find the laryngeal cartilages and cricothyroid membrane — a commercial elastomer overlay (the source used One World DMG); the exact composition is not stated in the source.[4] | ||
| Liquid plastisol (Bait Plastics LLC) with skin-tone pigment — no TissueDB Materials page yet | Emergency Department Thoracotomy Simulator (Misra) | Medium-density liquid plastisol with skin-tone pigment poured into sheets sized 10 in × 18 in / 25.4 cm × 45.7 cm. The thoracotomy incision is made through skin and fat layers between the left 4th, 5th, and 6th intercostal spaces; paired skin/fat sheets are designed for one-use-per-resident replacement (10 pairs per gallon of plastisol).[5] | ||
| Goat or lamb hind leg (skin layer) | Hemorrhage Control Simulator (Malik) | Outer surface of partially defrosted hind leg; receives two stab wounds for hemorrhage control training. | ||
| Synthetic silicone rubber overlay | Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness) | Replaceable silicone skin overlay; it is the consumable part, swapped between trainees. The source rates it 3.88 / 5 for realism.[6] | ||
| Silicone cast over power mesh fabric | Pediatric Inguinal Hernia Repair Simulator (Heo) | Mesh-backed silicone skin sheet | ||
| EVA Foam | - | - | Synthetic Tourniquet Training Model (Souza Lima) | EVA sheet skin layer |
| Elastomeric impression material (light or medium body) | - | - | Suturing Simulator (Kumaresan) | A thin layer of elastomeric impression material smeared on a glass slab forms the skin face; its rubbery texture and tear strength give acceptable resistance to a suture needle, and the set model peels off the slab ready to be incised and sutured.[7] |
| Vinyl doll | - | - | Abdominal Wall Defect Simulator (Medeiros) | 40 cm vinyl baby doll body, giving the neonatal torso shape and the umbilical landmark; a 4 cm circular incision is cut into the abdomen to make the defect — right of the umbilicus for gastroschisis, in the umbilical region for omphalocele, one doll each.[8] |
| EVA Foam + Sponge | Intra-abdominal Bleeding Simulator (Fernandes) | EVA-foam plate over a thin sponge layer (72 × 54 cm) replacing the anterior mannequin panel as the skin and subcutaneous incision surface for laparotomy access.[9] | ||
| Acetic silicone + maize starch | - | - | Suture Simulator (Almeida) | Moldable silicone-and-starch suture pad: 20 g of acetic silicone kneaded with 11 g of maize starch into a homogeneous mass, moulded to a 6 cm circular pad and air-dried for 48 hours. A single homogeneous layer — a suturable skin-like surface that does not reproduce the different layers of skin tissue.[10] |
| Pomelo peel (Citrus Maxima) | - | - | Skin Graft Harvesting Simulator (Cohen) | The fruit's tri-layered pericarp — exocarp, mesocarp and endocarp — mimics human integument, giving the tissue-plane differentiation needed for partial-thickness graft harvesting.[11] |
| Ecoflex 00-30 + Soma Foama 15 + Dragon Skin 10 | – | – | Chest Tube Insertion Simulator (Brannan) | Three-layer cast-silicone laminate: the top skin layer is Ecoflex 00-30, the middle is the expanding silicone foam Soma Foama 15, and the innermost layer is Dragon Skin 10. Layer thicknesses and pour depths are not specified in the source paper.[12] |
| Polyurethane Foam | - | - | Percutaneous Renal Access Simulator (Ewald) | Premium Poly Foam (American Excelsior Company, Arlington TX). Layers of thick, visually opaque foam encase the gelatin block, giving the resistance and the visual obstruction that simulate overlying skin, fat and muscle.[13] |
| Gelatin | - | - | Resuscitative Endovascular Balloon Occlusion of the Aorta Simulator (Keller) | Ultrasound-compatible gelatin block simulating combined groin soft tissue (skin, fat and muscle) |
| Foam, soft | - | - | Lumbar Laminectomy and Dural Closure Simulator (Bakhshi) | |
| Polyurethane Foam (headliner foam) | - | - | Multipurpose Thoracic Simulator (Carter) | Foam chest-wall covering[2] |
References
[edit source]- ↑ Matthews J, Bhatia MB, Thomas C, Okoth P, Martinez CR, Levy JS, Stefanidis D, Hunter-Squires JL, Saruni SI (2022). "AMPATH surgical app: Low-cost simulator for the open appendectomy." Surgery 172(6):1656–1664. DOI: 10.1016/j.surg.2022.07.023. PMID: 36123174.
- ↑ 2.0 2.1 Carter YM, Wilson BM, Hall E, Marshall MB (2010). "Multipurpose Simulator for Technical Skill Development in Thoracic Surgery." Journal of Surgical Research 163(2):186–191. DOI: 10.1016/j.jss.2010.04.051. PMID: 20691997.
- ↑ Kattan E, Vera M, Putz F, Corvetto M, De la Fuente R, Bravo S (2019). "Design and Evaluation of a Low-Cost Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Simulator." Simulation in Healthcare 14(6):415–419. DOI: 10.1097/SIH.0000000000000399. PMID: 31804426.
- ↑ Kovatch KJ, Powell AR, Green K, Reighard CL, Green GE, Gauger VT, Rooney DM, Zopf DA (2020). "Development and Multidisciplinary Preliminary Validation of a 3-Dimensional-Printed Pediatric Airway Model for Emergency Airway Front-of-Neck Access Procedures." Anesthesia & Analgesia 130(2):445–451. DOI: 10.1213/ANE.0000000000003774. PMID: 30234534.
- ↑ Misra A, Chapman A, Watson WD, Bach JA, Bonta MJ, Elliott JO, Dominguez EP (2024). "Use of Low-Cost Task Trainer for Emergency Department Thoracotomy Training in General Surgery Residency Program." Journal of Surgical Education 81(1):134–144. DOI: 10.1016/j.jsurg.2023.09.009. PMID: 37926660.
- ↑ Barsness KA, Rooney DM, Davis LM. The development and evaluation of a novel thoracoscopic diaphragmatic hernia repair simulator. J Laparoendosc Adv Surg Tech 2013;23(8):714–718. DOI 10.1089/lap.2013.0196. PMID 23789735.
- ↑ Kumaresan R, Pendayala S, Srinivasan B, Kondreddy K. A simplified suturing model for preclinical training. Indian J Dent Res 2014;25(4):541–543. DOI: 10.4103/0970-9290.142577. PMID: 25307925.
- ↑ Medeiros GA, Gualberto IJN, da Silva CHND, Diniz AMB, de Santana JBF, Volpe FP, Gadde R, Mazzo A, de Oliveira RC, Sbragia L. Development of a low-cost congenital abdominal wall defect simulator (wall-go) for undergraduate medical education: a validation study. BMC Medical Education 2023;23(1):966. DOI: 10.1186/s12909-023-04929-3. PMID: 38102605.
- ↑ Fernandes CO, Rodrigues LR, Silva do Amaral MLBS, de Morais Rodrigues SJ, Marton-Filho MA. Low-cost simulator for intra-abdominal bleeding. Rev Col Bras Cir 2023;50:e20233512. DOI: 10.1590/0100-6991e-20233512-en. PMID: 37971114. PMC: PMC10618030.
- ↑ Almeida NRC, Braga JP, Bentes LGB, Lemos RS, Fernandes MRN, Andrade GL, Araújo VMM, Santos DRD, Yasojima EY. Low-cost suture simulator to gain basic surgical skills. Acta Cir Bras 2023;38:e384223. DOI: 10.1590/acb384223. PMID: 37851786.
- ↑ Cohen AA, Har-Shai L, Ad-El D, Shay T. "POMELO PROJECT" — a simple and low cost simulator for harvesting skin graft by plastic surgery residents. Burns 2020;46(7):1681–1685. DOI: 10.1016/j.burns.2020.04.038. PMID: 32680662.
- ↑ Brannan V, Dunne CL, Dubrowski A, Parsons MH (2021). "Development of a novel 3D-printed multifunctional thorax model simulator for the simulation-based training of tube thoracostomy." CJEM 2021;23:547–550. DOI: 10.1007/s43678-021-00102-1. PMID: 33783760.
- ↑ Ewald JM, Cheng JW, Engelhart SM, Wilkinson MC, Hajiha M, Wagner H, Baldwin DD. A realistic, durable, and low-cost training model for percutaneous renal access using ballistic gelatin. Turk J Urol 2019;45(1):31–36. DOI: 10.5152/tud.2018.43569. PMID: 30668307.
At a Glance
Overview
[edit source]Synonyms
[edit source]Common names: Skin, skin tissue
Anatomical terms: Dermis, epidermis, integument, cutaneous tissue, dermal layer, epidermal layer
Clinical terms: Soft tissue envelope, cutis
Regional terms: Peau (French), Pelle (Italian), Piel (Spanish), Haut (German), Huid (Dutch)