Teaching the rhomboidal flap in medical undergraduate

Abstract

Fundamentals: This study proposes a simplified and reproducible method for teaching the rhomboid flap technique in outpatient surgery as part of undergraduate medical education. It explores the planning and experimental execution of this technique, highlighting its potential applications in clinical practice depending on the specific location and characteristics of the defect requiring correction. The importance of providing students with a safe and supervised environment to learn this skin flap technique during their fundamental education is emphasized, as it contributes to the development of essential surgical skills. Objectives: To evaluate the reproducibility of a geometric drawing method applied to the Rhomboid Flap by medical students at a university and to analyze the understanding and execution of the technique by the participants. Methodology: A quantitative observational study conducted at Universidade Positivo involving 4th-year medical students. The students performed the rhomboid flap design and completed it based on the technique demonstrated in class. The reproduction was done on pig feet, a material routinely used in the Outpatient Surgery course at this institution. Those who were present during the technique demonstration and agreed to the terms of the informed consent form (ICF) were included in the study. Data collection and assessment were based on a questionnaire containing a checklist, administered by previously trained evaluators. Data were preliminarily analyzed using descriptive statistics. Main Results: Results show that 97.1% of participants understood the technique well after the professor's demonstration, indicating the effectiveness of the structured teaching method for the rhomboid flap. Most participants correctly followed the steps of the technique (76.5% to 100%), although difficulty in reproducing the design varied: 26.5% faced significant difficulties, 44.1% moderate difficulties, and 29.4% experienced minimal difficulty. Regarding flap tension selection, 79.4% made appropriate choices, but only 32.4% achieved ideal symmetry in the design. The final quality of the flap was rated as good by 79.4% of participants and average by 20.6%, with no cases of poor quality. Active supervision and personalized feedback were crucial in improving students' skills and confidence, highlighting the effectiveness of the methodical approach in teaching and executing the rhomboid flap.Conclusion: The study provided important insights into the technical execution and understanding of the rhomboid flap, highlighting areas that can be improved by educators, which directly influence technical execution. These findings contribute to the development of educational programs in the surgical field, aiming for better outcomes in surgical skills and teaching methodologies.