Animals have been widely used as a training model for teaching microsurgery. However, unlimited access to the animal laboratory is not always possible, and increased scrutiny of the ethical use of laboratory animals is a major factor to consider when teaching microsurgery. In such situations, an alternative method is required for microsurgical training techniques, such as medical grading tubes, and surgical gloves, These alternative teaching tools provide an ideal training model and present an alternative for teaching microsurgical techniques. They are readily available and abundant in the laboratory. In addition, these alternative tools can be used to provide initial training before entering the clinical setting. A practice card designed from surgical gloves and medical grading tube was used to practice simple sutures. The training progressed to a more difficult level, using medical-grade tubing for end-to-end anastomosis, end-to-side anastomosis, side-to-side anastomosis, and free graft placement. This alternative proved challenging for the trainees, but improved hand coordination was observed. The alternative models familiarized trainees with the instruments and with developing a surgical approach before moving on to more clinical settings. The use of surgical gloves and medical grading tubes resulted in a significant reduction in the numbers of laboratory animals used for teaching microsurgery, as well as reduced cost. (C) 2001 Wiley-Liss, Inc.
