"POMELO PROJECT" - a simple and low cost simulator for harvesting skin graft by plastic surgery residents.

[BACKGROUND] Harvesting partial thickness skin grafts is an important technical skill the training plastic surgeon is required to hone. Historically accomplished via manual dermatome (Humby's knife) or the modern day electric dermatome.

[OBJECTIVE] Presenting a means of practicing the use of Humby's knife for novice surgeons.

[METHODS] 15 plastic surgeons comprising 8 seniors and 7 residents, in a single tertiary center participated. Each utilised a Humby knife to harvest 4 skin grafts from a Pomelo. The graft areas were measured via computerised image processing, comparing measures of graft harvest consistency across groups of surgeons.

[RESULTS] In the resident surgeon group, the average relative difference between exact graft area and encompassing area was 0.45, as compared with 0.15 in the Senior surgeon group, indicating a greater degree of inconsistency in graft harvest. Comparisons across groups yielded significant differences per each of the 4 grafts harvested (p <=0.005).

[LIMITATIONS] single center and small cohort (inherent to the sparsity of plastic surgeons), marginal statistical evidence.

[CONCLUSIONS] Citrus Maxima (Pomelo) is a useful substrate to instruct and practice the use of Humby knife effectively, allowing novice surgeons to practice the manual manoeuvres required therefore as well as increase confidence in its subsequent operative use.