はじめに
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マイクロサージャリーは、顕微鏡下で血管や神経を扱う高度な技術であり、形成外科、手外科、整形外科、移植外科など多くの分野で不可欠です。技術習得には繰り返しの練習が必要であり、様々なトレーニング方法が考案・実践されています。
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代表的なマイクロサージャリートレーニング方法：ゴム手袋の指先部分、シリコンチューブ、糸こんにゃく
- 本記事では、手羽元を用いたマイクロサージャリー練習方法を紹介します。
手羽元
手羽元がマイクロサージャリートレーニングに最適な理由
- 手羽元（鶏の前腕部分）は、以下の理由からマイクロサージャリーのトレーニングに非常に適しています。
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安価で入手しやすい：スーパーや精肉店で簡単に購入可能。
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解剖学的類似性：ヒトの小血管・神経に近い太さの動脈・静脈・神経が含まれる。
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練習環境に優しい：動物実験に比べ倫理的ハードルが低い。
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繰り返し練習可能：低コストで大量に確保できるため、初心者から上級者まで段階的に学習可能。
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練習できるスキル
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手羽元を使うことで、以下のスキルを実践的にトレーニングできます。
| 練習内容 | 使用対象 |
|---|---|
| 血管吻合 | 動脈・静脈 |
| 神経縫合 | 筋肉周囲の神経 |
| マイクロ器具操作 | 吻合前の剥離・持針操作 |
| 顕微鏡下の糸結び | 8-0～10-0ナイロン糸 |
準備するもの
-
マイクロ手術用器具セット
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実体顕微鏡
- 縫合糸（8-0～10-0）
手羽元の血管・神経を確認する手順
深筋膜（白い膜）を確認して切除する
筋間を剥離すると動脈・静脈・神経を確認できる
血管吻合や神経縫合の練習をする
まとめ
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「形成外科の武器はマイクロサージャリーである」といわれるように、この技術は形成外科医の大きな強みであり、専門性を高める鍵となります。まずは身近に手に入る手羽元から始め、日々の練習を積み重ねて、臨床現場で自信を持って手技を発揮できるようになりましょう。
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