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0031 Adamgel: An economical, easily prepared, versatile, selfrepairing and recyclable tissue analogue for procedural simulation training
  1. Johann Willers,
  2. Gianluca Colucci,
  3. Anna Roberts,
  4. Lucy Barnes
  1. Worthing Hospital, Worthing, UK

Abstract

Background Teaching invasive techniques via simulation requires using phantoms. These teaching aids can be expensive, due in part to the cost of silicone material used. A progression of developments necessitated by lack of resources resulted in the creation of ADAMgel (Aqueous Dietary fibre Antifreeze Mix gel), a material that shows great promise for use in simulation phantoms.

Methodology While developing gelatine based ultrasound phantoms we accidentally discovered that the contrast medium routinely used with this medium the last 20 years (Ispagula husk – a dietary fibre laxative and food thickener) had some interesting properties. It transpired that if prepared at higher temperatures than employed in use as laxative at higher concentrations than used in food processing a gel formed which passed all the criteria for the perfect US medium.1,2 Searching for a suitable preservative among common substances found around the house we discovered preparation, if including antifreeze, is possible at a temperature higher than 100°C. This creates a stronger medium either by changing the already known temperature induced gel structure changes, or by liberating gel fractions known to have higher melting points.3 When using mono ethylene glycol (the commonest antifreeze) it forms a stable elastic polymer even without water.

Results ADAMgel can be prepared using ordinary kitchen utensils for <£2/kilo. It can be cast, folded, hot or cold pressed, layered, cut, moulded and made into thin films or strands. It is self-adherent and a model can be built incrementally incorporating other structures. It is selfrepairing and does not form needle tracts visible under ultrasound up to 18FG dilation. Diathermy or harmonic scalpel can both be used on it. In formal and informal feedback from anaesthetists and surgeons nobody has encountered a more realistic human tissue analogue.

Conclusion ADAMgel could make realistic phantoms for high fidelity simulation training more readily available.

References

  1. Barnes L, Willers J, Hariharan S, Uncles D. Gauging the gel in Fybogel. Anaesthesia 2014;69:33

  2. Sultan S, Shorten G, Iohom G. Simulators for training in ultrasound guided procedures. Med Ultrasound 2013;5(2):125–131

  3. Farahnaky A, Askari H, Majzoobi M, Mesbahi G. The impact of concentration, temperature and pH on dynamic rheology of psyllium gels. J Food Eng 2010;100:294–301

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