• Geoffrey Murphy, Muhammad A Khan, Adil Lathif, and John Preddy.
• University of New South Wales, Sydney, NSW.
• Med. J. Aust. 2021 Dec 13; 215 (11): 536-540.

ObjectivesTo investigate how suturing orange and banana peels, pig skin, and synthetic skin compares with the experience of suturing human skin.DesignInterventional study of simple interrupted, vertical mattress, and subcuticular suturing on the four test materials.Participants, SettingFifteen consultants and six trainees in surgical and emergency medicine specialties at a New South Wales regional teaching hospital.Main Outcome MeasuresThe primary outcome was completion of simple interrupted, vertical mattress, and subcutaneous sutures. Secondary outcomes (assessed in a questionnaire) were similarity of suturing each material to suturing human skin, suitability of each material for practising each suture type, and similarity of each material to human anatomic skin types.ResultsAll 21 participants completed simple interrupted sutures in bananas and pig and synthetic skins, and 15 in orange skin (P = 0.002). All 21 participants completed vertical mattress sutures in pig and synthetic skins, 18 in bananas, and six in oranges (P < 0.001). The numbers of completed subcuticular sutures were lower for the two fruits (orange, zero; banana, two) than for pig and synthetic skins (each, 21; P < 0.001). Banana peel was rated as somewhat similar to human skin and recommended for practising simple interrupted and vertical mattress suturing.ConclusionsBananas are not only useful as healthy snacks between theatre cases, but also for practising and improving simple and vertical mattress suturing skills. However, less portable and nourishing materials are required for subcuticular suturing practice, such as pig skin or synthetic skin.© 2021 AMPCo Pty Ltd.

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