Two is better than one: Modeling multicompartmental hemorrhage for penetrating polytrauma simulation in an ultrahigh-fidelity Knowledge Donor model.

BACKGROUND

Trauma remains a leading cause of preventable death worldwide, with hemorrhage accounting for approximately 40% of mortality. Despite advances in trauma care, hemorrhage control training presents significant challenges in surgical education. Traditional simulation models fail to replicate the complexity of multicompartmental bleeding encountered in penetrating polytrauma.

METHODS

This proof-of-concept study describes a novel multicompartmental hemorrhage simulation model using the Knowledge Donor platform with GlobalAnatomiX preservation. The model features concurrent bleeding challenges through specially created vascular access points while maintaining anatomic integrity. Perfusion was established using expired human packed red blood cells circulated through a roller pump system. Simulations were conducted in a fully equipped operating room environment. Participants completed retrospective questionnaires assessing tissue realism, supervision requirements, and educational value.

RESULTS

Fifteen participants (12 surgical residents, 3 attending physicians) completed the survey. Tissue qualities received high realism scores: appearance (8.27 ± 1.62), elasticity (7.33 ± 2.19), and turgor (7.27 ± 2.06). Post-training assessment demonstrated a shift toward increased autonomy, with residents requiring direct supervision decreasing from 41.7% to 25.0%. Nearly all participants (93.3%) validated the educational value, with 80.0% "totally agreeing" that the model was applicable to real-world scenarios.

CONCLUSION

This proof-of-concept multicompartmental hemorrhage model demonstrates feasibility in addressing limitations of current trauma simulation platforms. Despite the small sample size (n = 15), preliminary results suggest the platform provides high-fidelity tissue and realistic bleeding scenarios that may improve resident confidence. Larger controlled studies are needed to definitively assess educational outcomes and skill transfer to clinical practice.