A mixed-methods cohort study to determine perceived patient benefit in providing custom breast prostheses.

BACKGROUND: Of all mastectomy patients, 90% will use an external prosthesis where the standard of care uses a stock prosthesis that is purchased "off the shelf." Our objectives were to determine patient demand for and perceived value of a custom breast prosthesis. The information obtained will influence future research and program direction. METHODS: We asked 65 women who had undergone lumpectomy or mastectomy to participate before exploring rehabilitation options. The quantitative outcome measures were the European Organisation for Research and Treatment of Cancer QLQ-C30 general and -BR23 breast cancer-specific quality of life questionnaires, and the Ambulatory Oncology Patients Satisfaction Tool. The QLQ results were analyzed using the Mann-Whitney U-test. Results of the satisfaction tool were compared using the Fisher exact and chi-square tests. A descriptive qualitative approach-involving in-depth interviews exploring the experiences of the women-was used to establish the perceived value of the services to the patients. The analysis of the interview transcripts was conducted using a standardized content method to describe the experiences of the women. RESULTS: All the women had had previous experiences with a conventional prosthesis, and they reported that wearing a custom prosthesis was more satisfying for them. They reported comfort and ease in wearing it, coupled with a sense of feeling less like a victim. Comparison of the QLQ and patient satisfaction scores showed no significant difference between the women wearing the conventional prosthesis and those wearing the custom prosthesis. CONCLUSIONS: The qualitative data provide a strong case in support of the new device. Patient demand, perceived benefit, and experience wearing the prosthesis were documented. Suggestions for improvements in the device and in the program operations were gathered and will influence future development of this service.

Creating an adaptable anterior margin for an implant-retained auricular prosthesis.

Achieving complete adaptation of the anterior margin of an auricular prosthesis often presents a challenge. Conventional solutions to this problem address soft tissue movements at static positions and do not necessarily reflect how the margin will adapt throughout a complete range of motion of the mandible and head. A technique is presented for creating an adaptable margin for an auricular prosthesis throughout a complete range of motion. This technique can be applied once adaptation of the diagnostic wax margin to the master cast is successful.

Impression procedure for creating a partial auricular prosthesis.

Severe anatomic undercuts associated with tissue remnants or a defect site can often be an obstacle in achieving an accurate impression for a facial prosthesis. This article describes a procedure that overcomes the problems encountered in achieving an accurate impression. The distinct properties of 2 impression materials are applied to create a 3-piece impression that can be reassembled to develop an accurate stone master cast.