Introduction to Biomedical Prosthetics and Rehabilitation

Module details

Title

Introduction to Biomedical Prosthetics and Rehabilitation

Type

Rotation

Module code

SPE403

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with an introduction to the principles and scope of biomedical prosthetics and rehabilitation in caring for patients with congenital and acquired defects. They will undertake treatment planning and the manufacture of a range of common prostheses. Introduce the trainee to the role of a maxillofacial prosthetist in caring for patients requiring prosthetic reconstruction and rehabilitation, the range of prostheses that can be prescribed and manufactured, and  demonstrate the understanding in the provision of a prosthesis for a patient.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,2,3,4	Competency Apply relevant legal, professional, ethical and patient-centred guidelines when treating patients referred for prosthetic replacement of facial or breast tissues.	Action View
# 2	Learning outcome 1	Competency Use a range of imaging modalities to identify normal and impaired anatomical features.	Action View
# 3	Learning outcome 2	Competency Identify treatment options for patients requiring a nasal prosthesis considering the comfort, safety and wishes of the patient.	Action View
# 4	Learning outcome 2	Competency Identify treatment options for patients requiring an auricular prosthesis, considering the comfort, safety and wishes of the patient.	Action View
# 5	Learning outcome 2	Competency Identify treatment options for patients requiring an orbital prosthesis, considering the comfort, safety and wishes of the patient.	Action View
# 6	Learning outcome 4	Competency Assess patients referred from the breast surgery unit following post- mastectomy reconstruction.	Action View
# 7	Learning outcome 4	Competency Observe the recording of informed consent and how an impression for a nipple areola complex prosthesis is made.	Action View
# 8	Learning outcome 4	Competency Assist in the manufacture a nipple areola complex prosthesis.	Action View
# 9	Learning outcome 4	Competency Assist in the review of the patient after prosthetic rehabilitation for nipple areola complex.	Action View
# 10	Learning outcome 3	Competency Manufacture an adhesive-retained auricular prosthesis.	Action View
# 11	Learning outcome 3	Competency Manufacture an adhesive-retained nasal prosthesis.	Action View
# 12	Learning outcome 3	Competency Manufacture an indwelling ocular prosthesis.	Action View
# 13	Learning outcome 1,2,3,4	Competency Apply relevant legal, professional, ethical and patient-centred guidelines when treating patients referred for prosthetic replacement of facial	Action View
# 14	Learning outcome 5	Competency Plan and manufacture a surgical dressing plate for an edentulous patient undergoing a hemi- maxillectomy for a stage 2 maxillary tumour.	Action View
# 15	Learning outcome 5	Competency Plan and manufacture a surgical dressing plate for a dentate patient undergoing a partial maxillectomy for a stage 1 and 2 maxillary tumour and classify size.	Action View
# 16	Learning outcome 5	Competency Plan and manufacture a maxillary denture with an open box obturator for an edentulous patient.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Wax up a trial ear prosthesis.	DOPS
Take a clinical impression of any part of the head or face.	OCE

Learning outcomes

1. Use a range of imaging modalities, computer modelling and physical examination to recognise both normal and impaired facial anatomy.
2. Identify treatment options for patients requiring facial prostheses referred to a reconstructive science service.
3. Develop skills in the manufacture a range of facial and body prostheses.
4. Assist in the assessment of patients referred from the breast surgery unit and production of a nipple areola complex prosthesis following post- mastectomy reconstruction.
5. Plan and manufacture dentures and palatal obturators for edentulous (without teeth) patients.

Learning outcomes

1. Outline innovative digital imaging and manufacturing technologies in relation to device manufacture.
2. Explain how anatomical knowledge is applied to the planning and design of prostheses.
3. Describe the role of maxillofacial prosthetists and technologists and other colleagues and teams in the care pathways of patients referred for prosthetic rehabilitation.
4. Analyse and criticise design factors for basic facial prostheses.
5. Discuss the range of impression materials, techniques and the factors affecting the clinical choice in the treatment of patients requiring facial/body prostheses.
6. Describe, critically evaluate and undertake the manufacturing procedure for simple ocular, nasal, auricular and nipple prostheses.
7. Explain the usage, design principles and constructional techniques of palatal obturators.
8. Describe impression techniques used for maxillary defects.
9. Classify post-surgical maxillary defects.
10. Explain the potential routes of transmission of infectious agents in clinical practice, mechanisms for the prevention of infection, the scientific principles of decontamination and disinfection and their relevance to health and safety policies.
11. Know current UK legislation applicable to maxillofacial prosthetics and technology.
12. Evaluate the underlying risk, legal and ethical requirements in the manufacture prosthetic devices.

Indicative content

Introduction to prosthetic rehabilitation

• Anatomy of the head and neck
• Ocular anatomy
• Anatomy of the breast
• Reconstructive techniques post mastectomy

Planning and preparing for treatment

• Indications and contraindications
• Adherence to health and safety of patient, public, staff and self
• Basic clinical assessment of patients
• Awareness of psychological effects of cancer, facial disfigurement and body image, and introduction to psychological support these patients
• Monitoring of patients during treatment
• The requirements for accurate patient data
• Patient confidentiality and the Data Protection Act
• Principles of the clinical management of facial prosthetic patients, patient rights, managing patients with disabilities
• Impression technique and materials for nipple prostheses
• Principles of treatment planning
• Sculptured anatomical form to match patients missing anatomical facial/body parts (i.e. ocular, auricular, nasal and nipple prostheses)
• Iris and sclera reproduction
• Colour science and skin colour reproduction
• Introduction to silicone elastomers
• Processing prostheses

In this module trainees will develop detailed learning that underpins the routine practical techniques

• Construction of adhesive-retained auricular prosthesis
• Construction of adhesive-retained nasal prosthesis
• Construction of nipple prosthesis
• Construction of ocular prosthesis

Guidelines

• MHRA (guidance note 9, custom-made medical devices)

Calibration and quality assurance

• Characteristics of measuring equipment and their evaluation
• Definitions of calibration, verification and quality control
• Use of physical quality control

Infection control

• Communicable diseases and microbiological hazards
• Sterilisation and disinfection methods
• Common methods for prevention of cross-infection:
  • hand washing
  • single patient use items
  • disinfection of dental impressions and devices

Activities

• Observe the treatment of patients in a breast clinic and, with permission, talk to a patient about the care they have received, identify their positive and negative experiences, and reflect on the impact of this on your own professional practice and that of the services offered by your department.
• Attend a range of settings where patients are referred for rehabilitation and, taking two patients as case studies, critically reflect on how a structured, supportive rehabilitation programme can help patients requiring facial prostheses.
• Attend a meeting where the output from a research, innovation or service development project is being presented; identify your key learning and how you could use this in your future practice to improve services for patients.