Journal of Surgical Simulation 2021; 8: 37 - 43

Published: 11 November 2021


Original article

A vascularized emergency trauma amputation simulator for surgical skills training

Abhishek Chandra, Lauren P. Harvey, Sahand Fardi, Eric J. Krohn, Shumaila Anwer and James V. Harmon
Corresponding author: Abhishek Chandra, 2600 University Ave. SE. Unit 205, Minneapolis, MN 55414, USA. Email:


Background: We describe the development of a low-cost lower-extremity amputation model enhanced with simulated pulsatile vasculature (SPV). The vascularized emergency trauma amputation simulator (VETAS) permits students to practice clinical decision-making, prepping and draping, hemostatic knot-tying, and lower-extremity amputation. SPV was achieved using a microcontroller, regulating the flow of artificial blood through a bypass flow system, preventing excessive pressure when the SPV is clamped. The SPV system replicates a pulse of 75 beats/min, a pressure of 120/80 mmHg, and a flow rate of 350 mL/min. We assessed if the model and simulation scenario accomplished our design goals of cost-effective, multidimensional education, with efficient turnover between learners.

Methods: A low-cost VETAS was engineered to simulate the tibia and tibial artery using SPV. A simulation scenario was prepared for medical students’ training. A pre- and post-training survey was completed by 53 attendees to evaluate the experience. Survey responses were ranked using a Likert scale and analyzed using a Wilcoxon signed-rank test.

Results: The VETAS was constructed with inexpensive, readily available materials. The technology allows for efficient, reproducible training. Post-training survey analysis demonstrated statistically significant increases in familiarity with creating a sterile surgical field and with proper instrument handling (P < 0.001). An increased sense of confidence regarding lowerextremity surgical anatomy was also confirmed (P < 0.014).

Conclusion: The VETAS model successfully introduced medical students to the principles of emergency trauma surgery. This novel technology created a cost-effective platform for efficient and effective skills training.


surgical simulation; surgical education; amputation; skills training; vascular surgery; trauma