Craniofacial and Trauma Rehabilitation —
Training activity: 18

Details

Undertake a surgical plan for auricular craniofacial osseointegrated implants. Discuss the plan with the patient and consultant surgeon as part of consent process for the planned procedure

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Considerations

• Patient centred care and support
• Information requirements to complete the device
• Multi modal imaging and laboratory manufactured medical devices for surgery
• Relevant anatomy
• Use of 2D and 3D imaging and 3D printing in surgical planning
• CAD software for preoperative assessment of the implant position and bone quality
• Different implant systems available
• Selection and use of materials for guides
• Quality assurance procedures
• Retention options for auricular prostheses.
• Manufacturing process for stent/prosthesis
• Use of surgical stents and 3D models in operative planning and use in the operating theatre
• Impact of plan/design on patient quality of life

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What are the key stages involved in planning for osseointegrated implants?
• What is your current understanding of osseointegration principles and their application in craniofacial prosthetics, specifically for auricular prostheses?
• What do you hope to learn about the surgical planning process, including implant placement and prosthetic design considerations, and how to effectively communicate this complex information to both the patient and the surgical team to facilitate informed consent?
• Have you reviewed the relevant imaging and anatomical considerations for auricular osseointegrated implants?
• Have you discussed the surgical planning process and consent procedures with both a prosthetist and a surgeon?
• What are the key aspects of the surgical plan and the potential risks and benefits that need to be clearly communicated?
• What are the advantages and disadvantages of a 1 stage and 2 stage implant procedure and when each is used?

In action

• While developing the surgical plan, what key anatomical landmarks and implant placement considerations are you focusing on?
• When discussing the plan with the patient and surgeon, how are you presenting the information clearly and concisely, addressing potential risks and benefits?
• Are you actively listening to the questions and concerns raised by both the patient and the surgeon and responding appropriately?

On action

• Describe the key elements of the surgical plan you developed for the auricular osseointegrated implants. How did you discuss this plan with the patient and the consultant surgeon?
• What did you learn about the surgical planning process for osseointegrated implants in the craniofacial region, specifically for auricular prostheses? What were the critical considerations for implant placement and prosthetic design? How did the discussions with the patient and surgeon contribute to the consent process?
• How will you approach future surgical planning for osseointegrated implants and the associated discussions for informed consent? What specific aspects of surgical planning or communication will you focus on improving?

Beyond action

• Looking back at this planning and discussion process, how did it develop your skills in communicating effectively with patients and other healthcare professionals?
• How did engaging in the consent process enhance your understanding of patient-centred care and ethical considerations?
• How might this experience of surgical planning for osseointegrated implants contribute to your future work with complex craniofacial reconstructions?

Relevant learning outcomes

#	Outcome
# 1	Outcome Deliver quality patient centred care with the best interests of patients in all elements of practice.
# 2	Outcome Practice in accordance with local and national health and safety policies, regulatory requirements and overall service governance.
# 3	Outcome Communicate effectively with patients, relatives, healthcare professionals and other stakeholders.
# 4	Outcome Apply the principals of a quality management system to their professional practice.
# 5	Outcome Practice in partnership with other clinical specialisms as part of a multidisciplinary team and understand their roles and their impact on patient care and pathway.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 7	Outcome Analyse and interpret patient investigations, multimodal imaging and information.
# 8	Outcome Select appropriate biomedical materials and components used in the treatment of patients and the manufacture of custom-made medical devices.
# 9	Outcome Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements.