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ANAPLASTOLOGY
Changing Appearances/C
hanging Liv
es
Sharon Jamison, RN, CORLN
Ab
stract
•W
e a
ll ha
ve im
perfe
ctio
ns in
our fa
ces a
nd
b
od
ies th
at w
e w
ould
like to
cha
ng
e. C
onsid
er,
thoug
h, th
e c
ancer p
atie
nt o
r the tra
um
a v
ictim
w
ho m
ust d
ea
l with
a fa
cia
l disfig
ure
ment th
at
com
ple
tely
cha
ng
es th
eir a
pp
ea
rance, a
nd
ofte
n, a
bility
to fu
nctio
n n
orm
ally
. Ana
pla
stolo
gy,
whic
h c
om
bin
es a
rt and
scie
nce th
roug
h
cre
ativ
ity a
nd
functio
na
lity, c
an m
ake
monum
enta
l imp
rovem
ents in
the q
ua
lity o
f a
cre
ativ
ity a
nd
functio
na
lity, c
an m
ake
monum
enta
l imp
rovem
ents in
the q
ua
lity o
f a
perso
n’s life
by g
ivin
g a
ccep
tab
le a
pp
ea
rance
ba
ck to
the p
atie
nt. C
usto
m-m
ad
e a
pp
liances
and
pro
sthetic
cre
atio
ns c
an b
ring
hop
e a
nd
confid
ence b
ack to
the p
atie
nt. In
div
idua
lized
a
da
pta
tions c
an m
ake th
e p
rosth
etic
a tru
e w
ork
of a
rt. Nurse
s work
clo
sely
with
pa
tients w
ho a
re
benefittin
g fro
m th
is cre
ativ
e p
rocess; a
nd
a
rrivin
g a
t a su
ccessfu
l and
ple
asin
g o
utc
om
e is
extre
mely
satisfy
ing
for th
e e
ntire
tea
m, th
e
pa
tient, a
nd
fam
ily.
Ob
jectiv
es
•1) d
efin
e th
e a
rt and
scie
nce
of A
na
pla
stolo
gy
•2) E
num
era
te th
e ste
ps
involv
ed
in c
rea
tion o
f in
volv
ed
in c
rea
tion o
f
pro
sthetic
s and
ap
plia
nces
•3) id
entify
the n
urse
’s role
in
ca
re o
f the p
atie
nt
und
erg
oin
g re
constru
ctio
n
and
pro
sthetic
/ ap
plia
nce
constru
ctio
n.
Conflic
t of In
tere
st?
•Th
e a
uth
or o
f this p
rese
nta
tion
ha
s no sp
ecia
l inte
rest in
any
pro
duct m
entio
ned
in th
is
pre
senta
tion, th
ere
are
no
pre
senta
tion, th
ere
are
no
unla
bele
d u
ses o
f pro
ducts
identifie
d, n
or d
oes sh
e h
ave
any c
onflic
t of in
tere
st to
announce.
Histo
ry o
f Ana
pla
stolo
gy
•O
rigin
s
•Evolu
tion
Typ
es o
f Pro
sthese
s
•O
cula
r
•N
asa
l
•A
uric
ula
r
•O
ral
•O
ral
Who a
re A
na
pla
stolo
gy C
lients?
Ca
ncer p
atie
nts
Hea
d/ n
eck c
ancers
Sin
us c
ancers (m
axillo
-facia
l
defe
ct)
Na
sal c
ancers (p
artia
l or to
tal
Na
sal c
ancers (p
artia
l or to
tal
rhin
ecto
my)
Auric
ula
r ca
ncers
Orb
ital c
ancers (e
xente
ratio
n w
ith/
with
out fre
e fla
p)
Traum
atic
inju
ries/ a
mp
uta
tions
Cong
enita
l gro
wth
defo
rmitie
s/ ab
sences
Coord
ina
tion
•D
iscip
lines
–H
ea
d-N
eck su
rgery
–Pla
stics/ R
econstru
ctiv
e S
urg
ery
–O
culo
pla
stic O
phth
alm
olo
gy
–O
culo
pla
stic O
phth
alm
olo
gy
–Ra
dia
tion O
ncolo
gy
–Psy
chia
try
–N
utritio
n
–Socia
l Serv
ices
–N
ursin
g
Nursin
g A
ssessm
ent
•N
utritio
n
•Psy
choso
cia
l statu
s
•Skin
inte
grity
•Fin
e m
oto
r ab
ility•
Fin
e m
oto
r ab
ility
•C
are
giv
er in
terv
entio
n
Pre
op
era
tive A
ssessm
ent
•Pre
op
meetin
g w
ith th
e a
na
pla
stolo
gist
�sh
are
photo
gra
phs w
ith a
na
pla
stolo
gist
�fa
cia
l fea
ture
s uniq
ue to
pa
tient
•Enha
nced
com
fort le
vel w
ith
ana
pla
stolo
gist
ana
pla
stolo
gist
�d
iscuss e
xp
ecta
tions/ g
oa
ls
�Id
entify
pa
tient p
refe
rences
•N
urse
pla
ys a
key ro
le�
coord
ina
tion o
f consu
lts
�p
rovid
e p
reop
era
tive in
structio
n a
nd
sup
port
�In
strum
enta
l in p
osto
pera
tive te
achin
g o
f hyg
iene, p
rosth
etic
ca
re, m
ana
gem
ent o
f outc
om
es.
Auric
ula
r Defe
cts
•To
tal p
rosth
esis is e
asie
r to
accom
plish
–Pa
rtial p
rosth
etic
req
uire
s fine m
oto
r sk
ills
•A
n a
uric
ula
r pro
sthesis w
ork
s best
on a
flat fla
p o
r surfa
ce
•A
n a
uric
ula
r pro
sthesis w
ork
s best
on a
flat fla
p o
r surfa
ce
•Im
pre
ssions o
f both
sides a
re
typ
ica
l–
Donor m
od
els
•Eyeg
lass a
ttachm
ent sh
ould
be
consid
ere
d
Auric
ula
r Reconstru
ctio
n
Na
sal D
efe
cts
•D
entu
re fa
bric
atio
n o
r revisio
n m
ust
be c
om
ple
ted
befo
re in
itiatin
g
pro
sthetic
pro
cess
•N
asa
l pro
sthese
s are
diffic
ult to
secure
se
cure
–Full m
idfa
ce im
pre
ssion m
ay b
e
necessa
ry
–fa
cia
l anim
atio
n (sm
iling
,
laug
hin
g, g
rima
cin
g)
com
pro
mise
ad
here
nce o
f
pro
sthesis
Na
sal R
econstru
ctio
n
Orb
ital E
xente
ratio
n
�Reconstru
ctio
n p
ost
exe
nte
ratio
n
�Fre
e fla
p
�Skin
gra
ft
�D
ep
end
ent o
n
exte
nt o
f in
terv
entio
nin
terv
entio
n
�Tim
e fra
me p
ost
exe
nte
ratio
n fo
r p
rosth
esis p
rep
ara
tion
�Id
ea
lly 6
month
s
�D
eb
ulk
ing
ma
y b
e
necessa
ry
�C
onca
ve su
rface
Orb
ital P
rosth
esis
Crite
ria
•Pro
sthesis m
ust c
onfo
rm to
skin
conto
urs
•Reconstru
cte
d tissu
e m
ust b
e
com
ple
tely
hea
led
from
su
rgic
al in
terv
entio
n/
surg
ica
l inte
rventio
n/
rad
iatio
n.
•Th
ere
must n
ot b
e in
fectio
n o
r irrita
tion o
f the in
volv
ed
tissues
Techniq
ues a
nd
Ma
teria
ls
•A
lgin
ate
s, silicones
–Fle
xib
le, n
on-to
xic
, light w
eig
ht
•M
ould
s
–Rig
id su
pp
ort fo
r constru
ctio
n
•Fix
atio
n-
•Fix
atio
n-
–A
dhesiv
es
–C
lips
–O
sseo-in
teg
rate
d im
pla
nts
•M
ag
netic
imp
lants m
ay re
quire
ad
ditio
na
l
surg
erie
s
Meta
l atta
chm
ents
Ma
inte
na
nce
•A
dhesiv
es
•Rem
ova
l ag
ents
•C
ond
itionin
g
•C
lea
nsin
g•
Cle
ansin
g
Fix
ativ
es, C
ond
itioners,
Cle
anse
rsC
ase
Stu
dy
Ca
se stu
dy
Ca
se S
tud
yC
ase
Stu
dy
Ca
se S
tud
yC
ase
Stu
dy
Ca
se S
tud
yC
ase
Stu
dy
Ca
se S
tud
y
Many th
anks to
Pattii
Montg
om
ery, P
eggy W
esle
y a
nd
Montg
om
ery, P
eggy W
esle
y a
nd
Bita
Esm
aeli, M
.D., F
.A.C
.S.fo
r
their k
ind a
ssis
tance
Refe
rences
•Bro
wn, J
. S., S
ha
w, J
. (2010, O
cto
ber).
Reconstru
ctio
n o
f the m
axilla
and
mid
face:
Intro
ducin
g a
new
cla
ssifica
tion. La
ncet.
•M
cKin
stry, R
. (1995). Fundamentals of fa
cial
prosthetics. A
rling
ton, V
A: A
BI P
rofe
ssiona
l
Pub
lica
tions
•M
ed
icin
eN
et.c
om
(Octo
ber 2
003). D
efin
ition o
f
ana
pla
stolo
gy.
http
://ww
w.m
ed
term
s.com
/scrip
t/ma
in/a
rt.asp
?a
rticle
key=24556
•Th
om
as, K
. (2009). Th
e art o
f clinical
anaplastology. G
rea
t Brita
in: Im
prin
t dig
ital.n
et
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