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. It is layered — the epidermal layer at the surface, the dermis layer beneath it, and the subcutis below that — and several builds on this page cut through the whole stack at once, as skin and subcutaneous tissue.
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| Felt | Trocar Placement Trainer, Soft Tissue Lesion Simulator | 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 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 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. | ||
| 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, 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.[4] | ||
| Liquid plastisol with skin-tone pigment | 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.[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.[12] |
| Polyurethane Foam | - | - | Percutaneous Renal Access Simulator (Ewald) | Premium Poly Foam. 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) | |
| Coated Fabric | - | - | Lumbar Laminectomy and Dural Closure Simulator (Bakhshi) | As rexine covering the book-fold foam block; the trainee enters through a pre-cut slit rather than incising the cover. |
| Polyurethane Foam (headliner foam) | - | - | Multipurpose Thoracic Simulator (Carter) | Foam chest-wall covering[2] |
| Grapefruit rind and pith | Grapefruit Distal Anterior Cerebral Artery Bypass Simulator | Skin analogue[14] | ||
| Castable silicone with power mesh fabric | Adult Proximal Tibia Intraosseous Access Simulator (maxSIMIO) | Dragon Skin 10 NV with skin-coloured Silc-Pig pigment; power mesh fabric embedded for skin strength. Version one of the simulator.[15] | ||
| Castable silicone, power mesh (80% nylon/20% spandex) | Melanoma Excision Simulator (maxSIMhealth) | Ecoflex 00-20 FAST. Power mesh between silicone layers for durability. Pigmented with Silc Pig (various skin tones).[16] | ||
| Castable silicone, power mesh (80% nylon/20% spandex) | Z-Plasty Simulator (maxSIMhealth) | Ecoflex 00-20 FAST. Carries a small scar marking the incision site. Power mesh between the skin layers, in the incision areas, for durability. Pigmented with Silc Pig (skin tone; scar coloured red).[16] | ||
| Clear packing tape | Soft Tissue Lesion Simulator | Over the felt. It gives a firm surface for the incision and holds the layers together, which increased the durability of the model.[17] | ||
| Large sponge | Soft Tissue Lesion Simulator | The source says the sponge represents "wounded skin and tissue". The wound model has no felt, tape or gelatin: the sponge is both the surface and the depth.[17] |
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.
- ↑ Cikla U, Rowley P, Jennings Simoes EL, Ozaydin B, Goodman SL, Avci E, Baskaya MK, Patel NJ. Grapefruit Training Model for Distal Anterior Cerebral Artery Side-to-Side Bypass. World Neurosurgery 2020;138:39–51. Table 1, p. 40. DOI: 10.1016/j.wneu.2020.02.107. PMID: 32109640.
- ↑ Sivanathan M, Micallef J, Clarke KM, Gino B, Joshi S, Abdo S, Buttu D, Mnaymneh M, Siraj S, Torres A, Brock G, Button D, Pereira C, Dubrowski A (2022). "The Development and Initial End-Point User Feedback of a 3D-Printed Adult Proximal Tibia IO Simulator." Cureus 14(5):e25481. DOI: 10.7759/cureus.25481. PMID: 35800805.
- ↑ 16.0 16.1 Selvarajah D, Jolly AK, Pabla T, Thomas J, Dubrowski A. Advancing Surgical Precision in Z-Plasty and Melanoma Excision Through Quality Improvement Initiatives in Rural Settings. Cureus. 2024;16(11). doi:10.7759/cureus.73691. PMC11646166.
- ↑ 17.0 17.1 Wittenberg RE, Bryce-Alberti M, Shimelash NZ, Masimbi O, Kratky LE, Thompson AA, et al. Low-cost simulation models for soft-tissue procedures for medical student education in Rwanda. BMC Medical Education. 2025;25:1271. DOI: 10.1186/s12909-025-07910-4. PMC12487576.