Sengkang Basic Hospital (SKH) has piloted an modern strategy to diabetic foot care by way of in-house manufacturing of 3D printed customized insoles in a cross-institution collaboration with Singapore Basic Hospital’s (SGH) 3D printing centre. Conventional pressure-relieving insoles, produced abroad, sometimes take as much as two months to achieve sufferers, with prolonged time wanted for changes, as it might contain delivery the insoles backwards and forwards generally. Now, sufferers can obtain exactly custom-made insoles in only one week.
This innovation transforms SKH’s diabetic foot care from a handbook craft right into a exact science. Conventional insoles are created by hand or with assistance from CNC machines, utilizing supplies like EVA foam or different appropriate supplies. This handbook course of not solely takes longer however may also result in variations in high quality and match. Any changes wanted might imply delivery the insoles again abroad, additional extending ready occasions.
In distinction, SKH’s new strategy entails digitally scanning the froth field impressions earlier than designing every insole with various densities and exact topographical changes for various areas of the foot utilizing specialised software program. The next in-house 3D printing ensures these precise specs are manufactured with constant high quality. The digital workflow permits for fast modifications when wanted, making certain optimum match with out the delays of worldwide delivery. This end-to-end course of not solely delivers superior precision but in addition enhances operational effectivity, making custom-made care extra inexpensive and accessible.
For sufferers with diabetes, particularly these with diminished sensation of their toes as a consequence of nerve injury (diabetic neuropathy), custom-made pressure-relieving insoles are important in stopping new ulcers and supporting wound therapeutic. That is much more essential in sufferers who’ve undergone smooth tissue reconstruction, the place altered foot anatomy presents further challenges.
The SKH Podiatry crew spearheaded this multi-disciplinary innovation with the Division of Orthopaedic Surgical procedure and Plastic, Reconstructive & Aesthetic Surgical procedure Providers groups beneath the SKH Diabetic Limb Salvage (DLS) service, in addition to SGH’s 3D printing centre. This initiative combines their distinct experience, demonstrating how cross-institution partnerships and modern mindsets can rework healthcare supply.
The podiatry crew carried out complete affected person assessments, utilizing detailed biomechanical examination and strain mapping evaluation to design exact digital fashions for every affected person’s insoles. The Orthopaedic Surgical procedure crew performed an important function in optimising the printing parameters, materials choice, and creating varied prototypes. The Plastic, Reconstructive & Aesthetic Surgical procedure crew complemented these efforts by bringing their experience in wound therapeutic and tissue reconstruction, making certain the insoles would work in concord with surgical interventions and help optimum therapeutic circumstances.
“Every insole is intricately designed by our podiatrists utilizing specialised software program that enables us to customise the fabric density and topographical contours (floor shapes) in each space. The result is a uniquely crafted product which matches every affected person’s particular foot construction and strain factors – one thing we now have not been in a position to obtain with such precision earlier than. This precision is essential in each wound restoration and ulcer prevention,” mentioned Alvis Leon Timothy Charles, Head of the Division of Podiatry at SKH.
Preliminary outcomes present that SKH’s customized 3D printed insoles can scale back peak strain by as much as 28.5% and enhance strain distribution by 52.7%, in comparison with 23% discount and 40% improved distribution with conventional insoles.
The impression is clear in sufferers like Wong Sia Woon, 53, who had foot ulcers that resulted in three toe amputations in recent times. With the brand new insoles specifically formed to fill within the gaps and supply higher foot help, he can now stroll comfortably for longer durations. This has tremendously improved his every day life, and the sooner entry to those insoles has enabled him to start out his restoration earlier.
“With Singapore going through one of many highest amputation charges within the developed world, early intervention is essential,” mentioned Dr Feng Jiajun, Advisor for Plastic, Reconstructive & Aesthetic Surgical procedure Providers at SKH. “Our crew has seen how delayed therapy can result in devastating outcomes. This innovation represents a major shift in direction of preventive care. By detecting strain factors early and offering exactly custom-made options, we are able to probably scale back ulcer formation and decrease amputation dangers. The flexibility to provide these insoles in-house has reworked our strategy to diabetic foot care.”
The innovation brings a number of advantages: sooner entry to personalized care, enhanced strain distribution for higher wound therapeutic and ulcer prevention, improved affected person mobility, and helps environmental sustainability by way of using recyclable supplies in native manufacturing.
The SKH podiatry crew is at present conducting a complete analysis research to additional validate these preliminary outcomes, with plans to broaden this system past diabetic care.