{"id":145446,"key":"TissueDB/Simulators/Z-Plasty_Simulator_(maxSIMhealth)","title":"TissueDB/Simulators/Z-Plasty Simulator (maxSIMhealth)","latest":{"id":1277637,"timestamp":"2026-09-28T05:47:43Z"},"content_model":"wikitext","license":{"url":"https://www.appropedia.org/Appropedia:Copyrights","title":"CC-BY-SA-4.0"},"source":"{{TissueDB Simulator Layout\n| procedure = Z-plasty (scar revision by transposition flap)\n| alternative_names = Z-plasty Simulator (maxSIMhealth)\n| build_time = Not stated in source\n| build_time_cost = $12 per simulator ($240 in materials for 20 simulators). The same paper elsewhere gives about $10 CAD per simulator.\n| lead_paragraph = The '''Z-Plasty Simulator (maxSIMhealth)''' is a low-cost training tool, built using 3D-printed molds and cast silicone, for practising the Z-plasty incision and closure technique on a two-part model representing the skin and muscle layers.<ref name=\"selvarajah2024\">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:[https://doi.org/10.7759/cureus.73691 10.7759/cureus.73691]. PMC11646166.</ref> The simulator is produced in two parts — a muscle layer and a skin layer with a small scar marking where the incision is made — so the skin layer can be manipulated to simulate the procedure. This is a distinct, separately built page from the paper's Melanoma Excision Simulator (maxSIMhealth), which uses the same materials family but a different mold and represents a different procedure; it is also distinct from the live [[TissueDB/Simulators/Z-Plasty Simulator|Z-Plasty Simulator]] page, an unrelated AmoSmile gelatin-glycerine build.\n| features = The user practises the Z-plasty incision and closure technique on a two-part silicone model: a skin layer carrying a small scar at the incision site, and an underlying muscle layer. The skin layer can be manipulated to simulate raising and transposing the Z-plasty flaps.\n| dev_team_contact = maxSIMhealth, Ontario Tech University, Oshawa, Ontario, Canada. Study exempted by the Ontario Tech University Research Ethics Board, reference REB-17296.\n| tissues_rows = <tr><td>[[TissueDB/Tissues/Skin|Skin]]</td><td>1</td><td>[[TissueDB/Materials/Silicone, Castable|Castable silicone]], [[TissueDB/Materials/Power Mesh Fabric|power mesh]] (80% nylon/20% spandex)</td><td>—</td><td>Ecoflex 00-20 FAST (Smooth-On). Carries a small scar marking the incision site. Power mesh inserted between the skin layers, in the incision areas, to increase durability. Pigmented with [[TissueDB/Materials/Ink or Dye|Silc Pig]] (skin tone; scar coloured red).</td></tr>\n<tr><td>[[TissueDB/Tissues/Muscle|Muscle]]</td><td>1</td><td>[[TissueDB/Materials/Silicone, Castable|Castable silicone]]</td><td>—</td><td>Ecoflex 00-20 FAST (Smooth-On). Made and coloured separately from the skin layer (red Silc Pig), then combined with it by sealing the edges with Ecoflex 00-20 FAST silicone.</td></tr>\n| structural_parts_rows = <tr><td>Mold (skin-layer and muscle-layer, two parts)</td><td>2</td><td>[[TissueDB/Materials/PLA|PLA filament]]</td><td>—</td><td>EcoTough PLA (FILAMENTS.CA). 3D-printed molds used only during construction. Designed in Fusion 360: one mold for the skin layer with the incision scar, one for the muscle layer.</td></tr>\n| specialized_tools = UltiMaker S5 3D printer, Fusion 360 CAD software (Autodesk), UltiMaker Cura 3D slicing software\n| build_instructions = === Phase 1: Mold fabrication ===\n\n'''Step 1.''' Design the Z-plasty simulator in Fusion 360, in two parts: a mold for the muscle layer, and a mold for the skin layer with a small scar where the incision is made.\n\n'''Step 2.''' Slice both designs using UltiMaker Cura 3D printing software.\n\n'''Step 3.''' 3D-print both molds with EcoTough PLA filament on an UltiMaker S5 3D printer.\n\n=== Phase 2: Silicone casting ===\n\n'''Step 4.''' Mix Ecoflex 00-20 FAST silicone with Silc Pig pigment (skin tone) for the skin layer, with red Silc Pig applied to the scar.\n\n'''Step 5.''' Pour the skin-layer silicone into its mold. Insert power mesh (80% nylon/20% spandex) between the skin layers, in the areas where incisions will be made, to increase durability.\n\n'''Step 6.''' Mix Ecoflex 00-20 FAST silicone with red Silc Pig pigment for the muscle layer and pour into its mold.\n\n'''Step 7.''' Allow both layers to cure and demold separately.\n\n'''Step 8.''' Combine the skin and muscle layers by sealing their edges together with Ecoflex 00-20 FAST silicone.\n| references = <references />\n| dev_status = Evaluated in one post-workshop survey.<ref>Selvarajah et al. 2024: 14 participants (medical students, residents and doctors) in the SRPC Rural and Remote Medicine Course workshop, April 2023, rated the simulator on the Michigan Standard Simulation Experience Scale: 4.03 of 5 overall, 4.20 for self-efficacy, 3.89 for realism and 4.17 for educational value. Their comments fell under physical resilience, materials science and skills development, and they asked for skin layers, curved surfaces, weight and pliability to improve realism.</ref>\n| version = Version 1\n}}\n\n{{Page data\n| description = Low-cost 3D-printed two-part silicone simulator for practising the Z-plasty incision and closure technique.\n| keywords = Z-plasty, skin closure technique, 3D-printed simulator, silicone simulator, maxSIMhealth, additive manufacturing\n| sdg = SDG03 Good health and well-being\n}}\n\n[[Category:TissueDB]]\n[[Category:TissueDB/Simulators]]"}