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

•Use of Humby’s knife (manual dermatome) requires skill and is sparsely practiced today.•We devised a low cost means to practice residents using a large citrus fruit (Pomelo).•A cohort of 15 plastic surgeons utilised pomelos for manual graft harvest, comparing across sequential attempts and groups by seniority•Seniors had more consistent results, residents trended improvement but to no statistical significance.•Objective and subjective evidence are presented to the effectiveness of this low cost practice and instruction modality. 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. Presenting a means of practicing the use of Humby’s knife for novice surgeons. 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. 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