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Background and Objective: Simulation-based learning has been a part of teaching in healthcare for a long time; however, in recent decades, simulation-based learning has been adopted by a significant number of healthcare institutes at different levels to improve practical skills, confidence, and preparedness to ensure patient safety and its application in real-life situations towards better patient care. The main objective of this paper was to use existing literature to explore aspects of simulation in healthcare teaching. Methods: It is a narrative review on simulation in healthcare that was conducted by using various search engines for English-language articles published between 2010 and August 2020. The main search terms were simulation, healthcare teaching, and simulation in healthcare. All articles found relevant to the title and/or abstract were retrieved. Searches were conducted using the academic databases PubMed, Google Scholar, MEDLINE, CINAHL, and Athabasca University (AU) library site. The studies were reviewed if they were considered relevant to the search by the primary authors. Results: Thirty-nine articles, which met the pre-set criteria, were analyzed and employed as a reference in this paper to support the idea that simulation is an effective way of learning in healthcare. Conclusion: This paper reviewed various aspects of simulation, including its background, philosophies, and highlighted the advantages and disadvantages of incorporating simulation as a pedagogical approach into current educational curriculums for healthcare students. Furthermore, it presents a brief discussion on the current uses of simulation, followed by the educational strategies related to simulation and the importance of debriefing in simulation activities.
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BACKGROUND: Venous compromise is still the most common cause of free flap failure. The need of a second venous anastomosis to prevent free flap failure is controversial. It is proposed that the use of dual venous anastomoses reduces venous compromise. However, some surgeons suggest that dual venous drainage reduces venous blood flow causing a potential risk of thrombosis. OBJECTIVE: This study aimed to compare the frequency of reexploration secondary to venous thrombosis in free flap surgeries in reconstruction of soft tissue defects with 1-vein versus 2-vein anastomosis. MATERIALS AND METHODS: We performed a retrospective cohort study including 298 flaps. In 180 of these patients, 2-vein anastomosis was done, and in 118, 1-vein anastomosis was done. The study was conducted at Aga Khan University Hospital from January 2017 to December 2018. RESULTS: The number of venous anastomosis was not associated with flap survival. The group with dual anastomosis required more frequent reexploration as compared with 1 venous anastomosis group (8% vs 1.7%).Outcome and salvage rate were better in the 2-vein group as compared with the 1-vein group (64% vs 50%). CONCLUSION: There is no difference in flap survival in single or dual venous anastomosis, but we have noticed higher reexploration rates in the 2-vein group. However, outcome is better in the 2-vein group.