Prosthetic Reconstruction, Rehabilitation & Surgical Planning —
Training activity: 5

Details

Plan design and manufacture a custom made deep buried implant for a body contour defect (bone or soft tissue) or a custom implant to support facial palsy/weakness/paralysis

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.

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 specific considerations for deep buried implants regarding biocompatibility and integration?
• What are the sterilisation techniques used for deep buried implants.
• What are the biomechanical requirements for supporting facial palsy?
• What will you learn about the material selection and design principles for these different types of implants?
• What are the surgical considerations for placement of deep buried implants?
• How will you ensure the implant effectively addresses the contour defect or provides adequate facial support?
• Have you researched different types of body contour defects and facial palsy and the prosthetic options available?
• Have you discussed the biomechanical principles and material properties with relevant specialists?
• Have you reviewed imaging and patient assessments for similar cases?

In action

• As you plan, design, and manufacture the deep buried implant or the facial palsy support implant, are you focusing on the unique anatomical and functional requirements of the specific defect or condition? What immediate design and manufacturing decisions are you making to ensure appropriate fit, support, and biocompatibility? Are you drawing upon specific knowledge related to body contouring or facial nerve anatomy as you progress?
• Is your planning process effectively guiding the design and manufacture of an implant suitable for the intended purpose? Are you encountering any unforeseen challenges in achieving the desired implant shape, size, or retention features? What immediate learning is taking place regarding the complexities of these types of custom implants? How does this activity relate to your understanding of soft tissue reconstruction, bone augmentation, or facial nerve rehabilitation?
• If your initial implant design or manufacturing approach encounters difficulties in meeting the functional or aesthetic requirements, what alternative designs or manufacturing techniques are you considering in the moment? Do you need to consult with specialists in this area for advice on the optimal implant design or materials? Are you ensuring that your planning and manufacturing remain within ethical and professional guidelines?

On action

• Describe the specific requirements of the patient for the custom-made implant. What considerations influenced your design and material choices? Describe the planning, design, and manufacturing process for the deep buried implant or the facial palsy support implant. How did the manufactured implant address the patient’s specific needs and the intended outcomes?
• What specific skills or knowledge did you develop or improve in planning, designing, and manufacturing custom implants for body contour defects or facial palsy? What did you learn about the anatomical considerations for deep buried implants and facial structures affected by palsy/weakness/paralysis? Were there any unexpected challenges or successes during the process? What did you learn from these? How well did the final implant meet the initial plan and the patient’s needs?
• What areas for continued development have you identified in the creation of these types of custom implants? How can you apply the knowledge and skills gained to future cases involving body contour defects or facial palsy? What resources or support might you need to further develop in this area?

Beyond action

• Have you revisited experiences involving custom body contour or facial palsy implants? How has your understanding of the anatomical and aesthetic considerations developed?
• How have these experiences impacted upon your current practice in addressing soft tissue defects or facial asymmetry? Have you explored different materials or design approaches since?
• How might these experiences contribute towards your future practice in more complex body contouring or facial reanimation scenarios? What did you learn about implant biocompatibility and integration?

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 Identify patients who need further specialist support and refer to the appropriate healthcare specialist.
# 5	Outcome Analyse and interpret patient investigations, multimodal imaging and information.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 7	Outcome Prepare surgical treatment plans for complex head and neck surgery.
# 8	Outcome Select appropriate biomedical materials and components/instrumentation used in the treatment of patients and the manufacture of custom-made medical devices.
# 9	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.
# 10	Outcome Apply the principals of a quality management system to their professional practice.
# 12	Outcome Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements.