History of Anaplastology. Objectives ANAPLASTOLOGY. Abstract. Conflict of Interest? Types of Prostheses. 2) Enumerate the steps

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1 Abstract ANAPLASTOLOGY Changing Appearances/Changing Lives Sharon Jamison, RN, CORLN We all have imperfections in our faces and bodies that we would like to change. Consider, though, the cancer patient or the trauma victim who must deal with a facial disfigurement that completely changes their appearance, and often, ability to function normally. Anaplastology, which combines art and science through creativity and functionality, can make monumental improvements in the quality of a person s life by giving acceptable appearance back to the patient. Custom-made appliances and prosthetic creations can bring hope and confidence back to the patient. Individualized adaptations can make the prosthetic a true work of art. Nurses work closely with patients who are benefitting from this creative process; and arriving at a successful and pleasing outcome is extremely satisfying for the entire team, the patient, and family. Objectives 1) define the art and science of Anaplastology 2) Enumerate the steps involved in creation of prosthetics and appliances 3) identify the nurse s role in care of the patient undergoing reconstruction and prosthetic/ appliance construction. Conflict of Interest? The author of this presentation has no special interest in any product mentioned in this presentation, there are no unlabeled uses of products identified, nor does she have any conflict of interest to announce. History of Anaplastology Origins Evolution Types of Prostheses Ocular Nasal Auricular Oral

2 Who are Anaplastology Clients? Cancer patients Head/ neck cancers Sinus cancers (maxillo-facial defect) Nasal cancers (partial or total rhinectomy) Auricular cancers Orbital cancers (exenteration with/ without free flap) Traumatic injuries/ amputations Congenital growth deformities/ absences Coordination Disciplines Head-Neck surgery Plastics/ Reconstructive Surgery Oculoplastic Ophthalmology Radiation Oncology Psychiatry Nutrition Social Services Nursing Nursing Assessment Nutrition Psychosocial status Skin integrity Fine motor ability Caregiver intervention Preoperative Assessment Preop meeting with the anaplastologist share photographs with anaplastologist facial features unique to patient Enhanced comfort level with anaplastologist discuss expectations/ goals Identify patient preferences Nurse plays a key role coordination of consults provide preoperative instruction and support Instrumental in postoperative teaching of hygiene, prosthetic care, management of outcomes. Auricular Defects Total prosthesis is easier to accomplish Partial prosthetic requires fine motor skills An auricular prosthesis works best on a flat flap or surface Impressions of both sides are typical Donor models Eyeglass attachment should be considered Auricular Reconstruction

3 Nasal Defects Denture fabrication or revision must be completed before initiating prosthetic process Nasal prostheses are difficult to secure Full midface impression may be necessary facial animation (smiling, laughing, grimacing) compromise adherence of prosthesis Orbital Exenteration Reconstruction post exenteration Free flap Skin graft Dependent on extent of intervention Time frame post exenteration for prosthesis preparation Ideally 6 months Debulking may be necessary Concave surface Criteria Prosthesis must conform to skin contours Reconstructed tissue must be completely healed from surgical intervention/ radiation. There must not be infection or irritation of the involved tissues Nasal Reconstruction Orbital Prosthesis Techniques and Materials Alginates, silicones Flexible, non-toxic, light weight Moulds Rigid support for construction Fixation Adhesives Clips Osseo- integrated implants Magnetic implants may require additional surgeries

4 Metal attachments Fixatives, Conditioners, Cleansers Maintenance Adhesives Removal agents Conditioning Cleansing Case study

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6 Many thanks to Pattii Montgomery, Peggy Wesley and Bita Esmaeli, M.D., F.A.C.S.for their kind assistance References Brown, J. S., Shaw, J. (2010, October). Reconstruction of the maxilla and midface: Introducing a new classification. Lancet. McKinstry, R. (1995). Fundamentals of facial prosthetics. Arlington, VA: ABI Professional Publications MedicineNet.com (October 2003). Definition of anaplastology. articlekey=24556 Thomas, K. (2009). The art of clinical anaplastology. Great Britain: Imprint digital.net