October 11, 2018 / 5:55 PM / in 9 days

Doctors move away from using live animals for trauma surgery training

(Reuters Health) - An initiative to replace the use of live animals with a human simulator for trauma surgery practice got training programs in more than 20 countries to make the switch, saving them money in the process, researchers say.

The simulators are anatomically realistic and allow trainees to practice surgical skills and invasive procedures such as chest tube insertion, airway punctures, and draining fluids from the body, the study authors write in the Journal of Surgical Education.

“There’s no need for surgeons around the world to continue cutting apart and killing thousands of animals each year to learn how to treat traumatic injuries,” said lead study author Shalin Gala of the Laboratory Investigations Department at People for the Ethical Treatment of Animals (PETA) in Norfolk, Virginia.

As the American College of Surgeons’ Advanced Trauma Life Support (ATLS) training program reaches its 40th anniversary, more than 99 percent of its sites in the U.S. and Canada have already ended animal use, the study team writes.

Many programs now use TraumaMan, a human simulation model produced by Simulab Corporation in Seattle, Washington.

The ATLS training program is offered annually in 86 countries, however, many of which still use live animals. To gauge how many international programs have transitioned or want to transition away from animal use, Gala and Marie Crandall of the University of Florida College of Medicine surveyed 56 of these programs between 2012 and 2017.

They found that 18 programs, mainly in Europe, used non-animal training methods, but ATLS programs in 38 countries still used animals for surgical training. Most cited cost as the primary reason for not adopting a human simulation method.

“Superior human simulators have been approved by the American College of Surgeons as full replacements to using animals in this standardized course,” Gala told Reuters Health by email. “A lack of funds for acquiring simulators should not be the reason dogs, pigs, sheep and goats have crude holes cut into their chests, throats, abdomens and limbs during this training.”

“We were struck by the compassion of ATLS program leaders in war-torn regions like Iraq who wanted to spare animals’ lives during training, even while dealing with rampant chaos, massive human injuries, and scarce resources,” Gala added.

In response, PETA partnered with Simulab to purchase and donate 119 TraumaMan models, valued at a total of $3 million, to 22 ATLS programs in developing countries. They also came up with a five-year cost-lowering program to cover the expense of replacement parts for the models.

After the donations, PETA surveys revealed that programs in 42 of the original 56 countries surveyed were no longer using animals in ATLS training, and only 14 still were.

The study team also notes that directors of programs receiving the donated models wrote in offering examples of how it had lowered their costs by around $50-$60 per student compared with the costs of using animals.

PETA is now evaluating the needs of ATLS programs in other countries to move toward human simulators and working with the U.S. military to modernize military trauma training, Gala said.

In 2017, for instance, the U.S. Coast Guard became the first branch to stop using animals entirely in trauma training drills, according to Military.com.

This year, President Donald Trump also signed the John S. McCain National Defense Authorization Act, which includes a PETA-backed provision that requires the Department of Defense to use medical-simulation technology for trauma training “to the maximum extent practicable,” Gala noted.

“Ultimately, this is about the patients. When you’re in a state of vulnerability from a car accident or another trauma situation, you want the hands that are working on you to be as experienced as possible,” said Dr. Anahita Dua, a vascular surgery clinical fellow at Stanford University in California who wasn’t involved with the study.

“Doing a procedure on an animal . . . won’t get you there,” said Dua, who has researched trauma training in Iraq and Afghanistan. “Repetition with human models is key, and with animal models, you can’t get what you need to be the healer you need to be,” she said in a phone interview.

SOURCE: bit.ly/2NBflUu Journal of Surgical Education, online September 20, 2018.

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