Advanced clinical practice within the diabetes multidisciplinary team: a reflective review

Karl Guttormsen

Citation: Guttormsen K (2022) Advanced clinical practice within the diabetes multidisciplinary team: a reflective review. The Diabetic Foot Journal 25(2): 24–7

Key words

- Advanced clinical practice - Multidisciplinary team - 360-degree feedback

Article points

1. Advanced clinical practice (ACP) is a level of practice delivered by experienced, registered healthcare practitioners

       2. A small, low powered, crosssectional study aimed to demonstrate that multidisciplinary working can help provide sustainable workforce solutions, as well as improve the working of the multidisciplinary team

       3. 360-degree feedback is an excellent adjunct to clinical supervision

       4. Low-powered studies can be scaled up to demonstrate benefit

       5. The lower-limb diabetes MDT is an ideal place for cultivation of ACPs

Author

Karl Guttormsen is Advanced Clinical Practitioner (Diabetes, Endocrinology and General Medicine) North Manchester General Hospital the Manchester Foundation Trust, UK

      Advanced clinical practice (ACP) is a level of practice delivered by experienced, registered healthcare practitioners. It incorporates a high degree of autonomy and complex decision making and is underpinned by a master’s level award or equivalent. Most ACP roles within the UK are undertaken by nurses and it is of vital importance that allied health professionals are actively encouraged to develop their skills and knowledge through the lens of the multidisciplinary framework for advanced clinical practice and to actively seek out apprenticeship opportunities. This small, low-powered, cross-sectional study aims to demonstrate that multidisciplinary working can help provide sustainable workforce solutions and improve the workings of the multidisciplinary team (MDT). A total of 100% of respondents agreed that the ACP was able to demonstrate improved MDT working across the four pillars of advanced clinical practice. 360-degree feedback is an excellent adjunct to clinical supervision and its ability to be scaled up makes it a valuable tool in evidencing the impact of advanced clinical practice.

Three-dimensional Printing in Plastic Surgery: Current Applications, Future Directions, and Ethical Implications

Alex Q. Lynn, BS* Lacey R. Pflibsen, MD† Anthony A. Smith, MD† Alanna M. Rebecca, MD, MBA† Chad M. Teven, MD†

From the *Midwestern University Arizona College of Osteopathic Medicine, Glendale, Ariz; and †Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz.

Received for publication October 4, 2020; accepted January 13, 2021.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/GOX.0000000000003465

Background: Three-dimensional printing (3DP) is a rapidly advancing tool that has revolutionized plastic surgery. With ongoing research and development of new technology, surgeons can use 3DP for surgical planning, medical education, biological implants, and more. This literature review aims to summarize the currently published literature on 3DP’s impact on plastic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE from 2016 to 2020 by 2 independent authors. Keywords used for literature search included 3-dimensional (3D), three-dimensional printing (3DP), printing, plastic, surgery, applications, prostheses, implants, medical education, bioprinting, and preoperative planning. All studies from the database queries were eligible for inclusion. Studies not in English, not pertaining to plastic surgery and 3DP, or focused on animal data were excluded.

Results: In total, 373 articles were identified. Sixteen articles satisfied all inclusion and exclusion criteria, and were further analyzed by the authors. Most studies were either retrospective cohort studies, case reports, or case series and with 1 study being prospective in design.

Conclusions: 3DP has consistently shown to be useful in the field of plastic surgery with improvements on multiple aspects, including the delivery of safe, effective methods of treating patients while improving patient satisfaction. Although the current technology may limit the ability of true bioprinting, research has shown safe and effective ways to incorporate biological material into the 3D printed scaffolds or implants. With an overwhelmingly positive outlook on 3DP and potential for more applications with updated technology, 3DP shall remain as an effective tool for the field of plastic surgery. (Plast Reconstr Surg Glob Open 2021;9:e3465; doi: 10.1097/GOX.0000000000003465; Published online 22 March 2021.)

The use of three-dimensional printing technology in orthopaedic surgery: A review

Tak Man Wong1,2,3, Jimmy Jin3 , Tak Wing Lau1 , Christian Fang1,3, Chun Hoi Yan1,2,3, Kelvin Yeung1,2, Michael To1,2,3, and Frankie Leung1,2,3

Abstract

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

Keywords

3-D printing, additive manufacturing, patient-specific instruments and implants, surgical planning, tissue engineering

Journal of Orthopaedic Surgery Volume: 25(1) 1–7 ª Journal of Orthopaedic Surgery 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/2309499016684077 journals.sagepub.com/home/osj

1Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong 2 Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China 3Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China

Corresponding author: Tak Man Wong, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong. Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

The future application of nanomedicine and biomimicry in plastic and reconstructive surgery

Kavit Amin1,2,3,4, Roxana Moscalu1, Angela Imere1,5, Ralph Murphy1,2, Simon Barr1,2, Youri Tan1,2, Richard Wong1,2, Parviz Sorooshian1, Fei Zhang1,5, John Stone3,4, James Fildes3,4, Adam Reid1,2 & Jason Wong*,1,2

1 Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

2 Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

3Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

4The Transplant Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

5Department of Materials, School of Natural Sciences, Faculty of Science & Engineering Research Institutes, The University of Manchester, MSS Tower, Manchester, UK *Author for correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Plastic surgery encompasses a broad spectrum of reconstructive challenges and prides itself upon developing and adopting new innovations. Practice has transitioned from microsurgery to supermicrosurgery with a possible future role in even smaller surgical frontiers. Exploiting materials on a nanoscale has enabled better visualization and enhancement of biological processes toward better wound healing, tumor identification and viability of tissues, all cornerstones of plastic surgery practice. Recent advances in nanomedicine and biomimicry herald further reconstructive progress facilitating soft and hard tissue, nerve and vascular engineering. These lay the foundation for improved biocompatibility and tissue integration by the optimization of engineered implants or tissues. This review will broadly examine each of these technologies, highlighting areas of progress that reconstructive surgeons may not be familiar with, which could see adoption into our armamentarium in the not-so-distant future.

First draft submitted: 17 March 2019; Accepted for publication: 16 August 2019; Published online: 31 October 2019

Keywords: biointegration • biomimicry • engineered implants • nanomedicine • nanoparticles • nanotechnology • plastic surgery • reconstructive surgery • tissue engineering • tissue regeneration

Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine

P. Andrés-Canoa,∗, J.A. Calvo-Haro b,c, F. Fillat-Gomà d, I. Andrés-Cano e, R. Perez-Ma˜nanes b,c

a Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain

b Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Mara˜nón, Madrid, Spain

c Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

d Unidad de Planificación Quirúrgica 3D, Departamento de Cirugía Ortopédica y Traumatología, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain

e Departamento de Radiodiagnóstico Hospital Universitario Puerta del Mar, Cádiz, Spain

Abstract

      3D printing (I3D) is an additive manufacturing technology with a growing interest in medicine and especially in the specialty of Orthopaedic Surgery and Traumatology. There are numerous applications that add value to the personalised treatment of patients: advanced preoperative planning, surgeries with specific tools for each patient, customised orthotic treatments, personalised implants or prostheses and innovative development in the field of bone and cartilage tissue engineering.

      This paper provides an update on the role that the orthopaedic surgeon and traumatologist plays as a user and prescriber of this technology and a review of the stages required for the correct integration of I3D into the hospital care flow, from the necessary resources to the current legal recommendations.

KEYWORDS

Additive manufacturing; Patient-specific  surgical guide; Custom implants; Bioprinting; Medical 3d printing

PALABRAS CLAVE

Fabricación de aditivos; Guía quirúrgica específica para el paciente; Implantes personalizados; Bioimpresión; Impresión médica en 3D

Resumen

      La impresión 3D (I3D) es una tecnología de fabricación aditiva con un creciente interés en medicina y sobre todo en la especialidad de Cirugía Ortopédica y Traumatología. Hay numerosas aplicaciones que aportan un valor a ˜ nadido al tratamiento personalizado de los pacientes: planificación preoperatoria avanzada, cirugías con herramientas específicas para cada paciente, tratamientos ortésicos a medida, implantes o prótesis personalizadas y un desarrollo innovador en el campo de la ingeniería de tejidos óseos y cartilaginosos.

      En el presente trabajo se realiza una actualización sobre el papel que el cirujano ortopédico y traumatólogo desempe˜ na como usuario y como médico prescriptor de esta tecnología y un repaso a las etapas necesarias para una correcta integración de la I3D en el flujo asistencial hospitalario, desde los recursos necesarios hasta las recomendaciones legales actuales. © 2020 SECOT. Publicado por Elsevier Espa˜na, S.L.U. Este es un art´ıculo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).

3D printing and its applications in orthopaedic trauma: A technological marvel

Hitesh Lal, Mohit Kumar Patralekh*

Central Institute of Orthopaedics, Safdarjung Hospital and VMMC, New Delhi, 110029, India

abstract

Background: With rapid emergence of 3D printing technology, surgeons have recently started to apply this for nearly all areas of orthopaedic trauma surgery. Computed tomography or magnetic resonance images of trauma patients can be utilized for making graspable objects from 3D reconstructed images. Patient specifific anatomical models can thereby be created. They enhance surgeon's knowledge of their patients' precise patho-anatomy, regarding both traumatized bones and soft tissue as well as normal areas, and therefore help in accurate preoperative planning. 3D printed patient specifific instrumentation can help to achieve precise implant placement, and better surgical results. Most importantly, customized implants, casts, orthoses and prosthetics can be manufactured to match an individual's anatomy. Three dimensional (3D) printing, also called as ‘additive manufacturing’ and ‘rapid prototyping’ is considered as the “second industrial revolution”, and this appears to be especially true for orthopaedic trauma surgery.

Methods: A literature search was performed for extracting all papers related to 3D Printing applications in orthopaedics and allied sciences on the Pubmed, and SCOPUS; using suitable key terms and Boolean operators (“3D Printing” OR “3 dimensional printing” OR “3D printed” OR “additive manufacturing” OR “rapid prototyping”) AND (‘‘Orthopaedics” OR “Orthopaedics’’) AND (“Trauma” OR “Injury”)in June 2018. Search was also performed in Web of Science, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews. No limits were set on the time period or evidence level, as 3D printing in orthopaedics is relatively recent and mainly low level evidence is available. Titles and abstracts were screened and all duplicate and unrelated papers were excluded. Papers related to orthopaedic trauma were manually selected for this review.

Results: The search on Pubmed retrieved 144 Papers and similar search on SCOPUS retrieved 94 papers. Additional searches did not reveal more relevant papers. After excluding duplicates and unrelated papers, and on screening of titles and abstracts, 59 papers were considered for review. Papers related to spine fractures only were not included, as they have been covered in another paper in this journal issue.

Conclusion: All over the world, orthopaedic Surgeon's and allied professionals and scientists are enthusiastically using 3D printing technology for designing patient specifific models, instrumentation, implants, orthosis and prosthesis, besides 3D bioprinting of bone and cartilage scaffolding, and the same has been applied for nearly all areas of orthopaedic trauma surgery, from head to foot.

article info

Article history: Received 19 July 2018 Accepted 31 July 2018 Available online 3 August 2018

Keywords: 3D Printing  Rapid prototyping  Additive manufacturing  Orthopaedics Trauma