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We report a case of three-dimensional (3D) printing being used to solve a difficult bedside clinical problem and avoidance of substantial risk associated with alternative solutions. A 15-year-old male with advanced cystic fibrosis developed a small (~1mm) linear tear in his Percutaneous Endoscopic Gastrostomy (PEG) tube, approximately 40 mm from the skin surface. The patient’s advanced condition precluded replacement of the PEG tube under general anaesthetic. Attempts to manage the tear with adhesive tapes yielded limited success. 3D printing was used to create a bespoke sealing device overnight, rectifying the leak and allowing enteral feeding to recommence unimpeded. The device is functioning well, several months post-discharge of the patient.

BackgroundWe report a case of using 3D printing to create a bespoke eye cover for an 18-year-old man with left maxillary alveolar rhabdomyosarcoma. Further, the patient had proptosis causing chemosis and subsequent conjunctival abrasions. This had been managed by taping a large dressing around the eye for a number of weeks previously.MethodsA 3D scanner was used to capture the surface topography of the patients face. The data were imported into a CAD package and used as a guide to create a bespoke eye cover. The final design was 3D printed in a biocompatible material for use by the patient.ResultsThe scan, modelling, and printing of the bespoke cover was completed successfully in less than 72 hours.Conclusion3D printing offers a method to create bespoke solutions for patients in palliative care to meet rare and difficult clinical challenges.

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Background 3D printing (3DP) photosensitive resins are commonly used to produce patient-specific solutions in the fields of medicine and dentistry. These resins are toxic in their liquid state. To ensure that all resin has solidified and parts are safe for use, post-processing must be carried out after printing. Parts are first washed in IPA, allowed to dry, and then post-cured under ultra-violet light (UV), and sometimes heat. As 3DP is commonly utilised for its ability to create custom and rapid solutions, it is expected that a different geometry will be produced almost every time. Currently, post-processing guidance is supplied specific to a material, with the caveat that post-curing times should be extended for larger or complex parts. The aim of this study was to assess the effect of extending post-curing times for photosensitive resin printed parts. Method Two commercially available vat-polymerisation 3DP systems were used to print hollow 60mm diameter spheres. Two opaque white, two opaque black, and two translucent amber resins were used. The spheres were filled with liquid resin, then UV post-cured at intervals of 100, 200, 300, 400 and 500% of the recommended guidance. The spheres were sectioned along the centreline and radial measurements taken of the cured depth. Results The results showed that both translucent amber materials cured to full depth at the 100% interval, whereas none of the white or black opaque materials cured to full depth, even at 500% of the recommended guidance. Conclusions This suggests opacity has a considerable effect on the depth of cure in photosensitive resins, and that the use of opaque resins increases the possibility of uncured resin remaining inside parts.

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