How I do it: simple ad-hoc pulsatile pump model for realistic microsurgical training under pulsatile flow

Category	Detail
Condition	Simulation of pulsatile blood flow for microsurgical training
Key Mechanisms	Use of adjustable infusion pumps and pressure monitoring to simulate pulsatile flow and systemic pressure in training vessels
Target Population	Microsurgeons and trainees practicing vascular anastomosis and microsurgical techniques
Care Setting	Surgical training laboratories and microsurgical training environments

The pulsatile pump model (PPM) uses two adjustable infusion pumps, pressure transducers, and fluid bags to simulate physiological pulsatile flow.
Systemic pressure is maintained using a fluid bag under pressure cuff, with pressures adjustable between 100 and 200 mmHg correlating well with mean arterial pressure.
Pulsation frequency and flow rate are controlled by infusion pump settings, with flow rates corresponding to heart rates from 60 to 120 bpm.

Not applicable; this model is for training simulation rather than clinical diagnosis.

Prepare the monitoring set by flushing and connecting to pressure transducer and monitor.
Connect the three-way stopcock to the training vessel (synthetic or biological) securely via ligation or Foley catheter.
Use Bag A under pressure cuff connected to infusion pump 1 to maintain systemic pressure and generate pulsatile flow.
Connect Bag C as a fluid return reservoir via infusion pump 2, which remains off during initial setup.
Adjust system pressure using the hand pump on Bag A to achieve desired mean arterial pressure.
Control pulsation frequency by adjusting infusion pump 1 flow rate according to desired beats per minute.

Continuously monitor pressure and pulsatile rate using the connected pressure transducer and monitor.
Ensure hygiene measures when using biological vessels or placenta models.

Potential contamination risk when using animal or placenta vessels; appropriate hygiene measures are necessary.

Not applicable; this model is intended for microsurgical training use only.

The model allows controlled simulation of physiological pulsatile flow to enhance microsurgical training fidelity.

Use appropriate hygiene protocols when handling biological training vessels to prevent contamination.
Ensure secure connection of the training vessel to the monitoring setup to maintain accurate pressure readings.
Calibrate infusion pump flow rates to achieve target pulsation frequencies corresponding to physiological heart rates.
Regularly flush and maintain the monitoring set to ensure accurate pressure monitoring.

Clinical Scorecard: Developing a Basic Pulsatile Pump Model for Enhanced Microsurgical Training with Pulsatile Flow Simulation