2017 I/ITSEC - 8250

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High-fidelity Surgical Fasciotomy Simulator for Training Special Operations Medics (Room S320F)

Fascia, a fibrous connective tissue, is responsible for allocating skeletal muscles and corresponding neurovasculature into function-based compartments. Pressure is capable of accumulating within these compartments, initiating the onset of a condition commonly referred to as compartment syndrome. When the pressure within the compartment compromises the arterial supply, it prevents perfusion of oxygen into the surrounding tissues, leading to tissue necrosis, or tissue death. Once diagnosed, a fasciotomy must be performed immediately to prevent severe complications. A recent study evaluated the incidence of fasciotomies performed during Operations Enduring Freedom and Iraqi Freedom and found that of 4,332 casualties to the extremities, 669 (15%) underwent a fasciotomy. According to the Joint Special Operations Medical Training Center (JSOMTC), the current training methods are insufficient for practicing the surgical technique, while other methods, such as cadaveric and live tissue training, are cost-prohibitive for the number of students that require annual training. The U.S. Army Research Laboratory Human Research and Engineering Directorate Advanced Training and Simulation Division (ARL HRED ATSD) identified the requirement to develop a next-generation lower extremity fasciotomy Part-Task Trainer (PTT) in response to JSOMTC’s need for a more realistic, durable, and cost-effective training approach. The paper will describe the research conducted to satisfy these requirements, including identifying, developing, and validating the essential anatomy and physiology required to provide a realistic and effective next-generation surgical PTT. Additionally, the paper will explore how innovations in novel synthetic materials provided realism approaching traditional methods while greatly minimizing cost and maximizing training opportunities. Key words: Fasciotomy, simulation, part-task trainer, lower extremity, compartment syndrome