A by-product of the fermentation process when brewing kombucha is being put to an innovative new use, and is now enhancing anaesthetists’ ability to perform life-saving procedures at Wellington Regional Hospital.

SCOBY – symbiotic culture of bacteria in yeast – is a substance that forms into progressively thicker layers during the kombucha fermentation process and which, when dry, is surprisingly similar in texture to human tissue.

So similar, in fact, that Wellington’s Department of Anaesthesia now uses SCOBY as replica human tissue in its CICO (Can’t Intubate, Can’t Oxygenate) training for procedures such as cricothyroidotomy – making an incision in a patient’s trachea to allow oxygen flow.

“We previously used commercially-made artificial skin models for this training, but feedback from participants about the skins’ low quality, we began using SCOBY,” said Wellington Regional Hospital Simulation Service Manager Melita Macdonald.

“We first came across the idea of using SCOBY in clinical teaching when talking to simulation colleagues in Waitaha Canterbury, who are using it for suturing skills practice.

“SCOBY as replica human tissue for training provided increased realism, and under ultrasound actually looks far more like human tissue than any of the other models we’ve come across.”

SCOBY has also proved to be a better option than commercial CICO training models when fidelity, cost, and environmental considerations are taken into account.

“With our commercial models costing around $900 each to replace, and also being of poor fidelity, we needed a solution that was both cost-effective and more realistic,” said anaesthetist Dr Raj Palepu who, with fellow anaesthetist Dr Jeremy Young, has been central to the SCOBY project.

“Also, old commercial models largely go to landfill whereas all the SCOBY we use – no matter how many times we use it – can be placed back in the tea, will start to grow again, and is reusable. I don’t think we’ve disposed of any SCOBY we’ve used over the past year.

The Simulation Service is now running trials on different container shapes, sizes, and depths to see how they affect SCOBY growth. In particular, the Service aims to cultivate SCOBYs of varying textures and moisture levels for use in in different training scenarios.

Also being considered is formalised partnerships with universities and other organisations and applying for research funding to learn more about SCOBY’s training potential of SCOBY, the best way to grow it, and the types of models it can be applied to.