A course in medical device design & commercialization for medical students pursuing surgical fields.

BACKGROUND: The modern surgeon faces an ever-changing landscape of procedural innovation. The demands of present-day healthcare highlight the importance of successfully developing new medical devices and technologies. This effort requires multidisciplinary collaborations of professionals ranging from manufacturers and engineers to researchers and healthcare providers. Surgeons regularly interact with complex equipment and user interfaces without substantial formal education on their design and development. The objective of this study was to ascertain the impact of a 10-week BME course into a medical school curriculum on surgery-bound students' knowledge of product design and gauge their ability to develop an actual product to meet a real need in a surgical field. METHODS: A Medical Device Design and Commercialization co-enrolled elective course was offered to medical students at a single institution. Five students with an expressed surgical and procedural interest were enrolled. At the beginning of the course, they were tasked with developing a product to meet a clinical need they observed. At the conclusion of the course, students filled out a questionnaire about their level of comfort and knowledge of the material using a 5-point Likert scale. This survey was administered to a control group of medical students who did not take the course. RESULTS: The BME student cohort was able to successfully identify a post-operative need, develop a prototype of a novel device, and present their product to attending surgeons. A total of 35 survey entries were received: five from the experimental group and 30 from the comparison group. The experimental group scored higher than the comparison group for all survey questions and reached the level of statistical significance in 13 of the 15 questions (p < 0.05). Survey respondents reported similar degrees of knowledge and comfort in recognizing unmet needs in a hospital setting and formulating a comprehensive statement describing them. CONCLUSION: The principles of biomedical engineering are integral to advancing the field of surgery. Presently, a small cohort of medical students/residents successfully acquired and applied basic BME concepts in a relatively short period of time relative to other training paradigms. Our findings also suggest medical students recognize unmet needs in the hospital setting, and those who completed a BME course felt more able to take steps to meet those needs. Early integration of biomedical engineering principles in medical training may help produce more innovative and well-rounded surgeons.

Preoperative Blood Loss of Isolated Acetabular Fractures.

OBJECTIVE: To quantify preoperative blood loss in isolated acetabular fractures and identify any fracture or patient characteristics associated with increased blood loss or blood transfusion. DESIGN: Retrospective cohort study. SETTING: Two level 1 trauma centers. PATIENTS/PARTICIPANTS: All patients with operative, isolated acetabular fractures from January 2010 to December 2018. INTERVENTION: Operative management of an acetabular fracture. MAIN OUTCOME MEASUREMENTS: Volume of preoperative blood loss and transfusion rates associated with isolated acetabular fracture patterns. RESULTS: A total of 598 patients were included. The mean preoperative blood loss of all fractures was 1172.6 mL. The 3 fracture patterns with the greatest average preoperative blood loss were associated both column (1454.9 mL), T-type (1374.8 mL), and anterior column posterior hemitransverse fractures (1317.7 mL). The acetabular fracture pattern had a significant association with preoperative blood loss and preoperative transfusion. The timing from injury to surgery and body mass index were significantly associated with preoperative blood loss. CONCLUSIONS: In conclusion, operatively treated isolated acetabular fractures surprisingly lose an average of greater than 1 liter of blood in the preoperative setting. Surgeons must carefully assess patient's physiology, ensuring they are adequately resuscitated before surgery and remain aware that increasing body mass index is associated with increased preoperative blood loss. However, as patients await surgery, unreduced acetabular fractures continue to contribute to ongoing blood loss beyond the first 24 hours from injury. We believe the best hemostasis after initial resuscitation is provided by surgical reduction and fixation, and we recommend a continued early surgical intervention to prevent continued bleeding from fracture surfaces. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Novel Use of a Shoulder Spica: Treatment for Midshaft Humerus Fracture in the Presence of Limb Deficiency.

Pediatric midshaft humerus fractures are typically managed with a hanging arm cast, Sarmiento bracing, coaptation splint, or a combination of these treatment options. Here we report a novel use of a shoulder spica cast in the treatment of a midshaft humerus fracture in the presence of limb deficiency. Current treatments proved unsuccessful in maintaining adequate alignment, specifically the varus deformity of the fracture. A shoulder spica was able to successfully maintain acceptable alignment throughout the duration of the patient's healing process. This nontraditional use of a shoulder spica cast shows the practicality of its ability to be utilized for the treatment of unique upper extremity orthopedic obstacles.