The 3D printing provides the ability to construct complex individualized implants that not only improve patient outcomes but also increase economic feasibility. The technology offers a potential level of accessibility that is paramount for remote and resource-limited locations where health care is most often limited. The 3D printing-based technologies will have an immense impact on the reconstruction of traumatic injuries, facial and limb prosthetic development, as well as advancements in biologic and synthetic implants.
Autologous breast reconstruction has been noted in the literature to provide superior aesthetic outcomes and patient satisfaction. Additionally, free perforator flap tissue transfer has the potential for lower abdominal donor site morbidity. However, it has been noted that the percentage of women who are undergoing autologous breast reconstruction in the United States is decreasing. Factors related to the technical difficulty, prolonged operative times, and decreasing reimbursement have been implicated as the causes. A retrospective review of electronic medical records over a 5-year period was performed with evaluation of 77 autologous breast reconstructions at a single institution. Patient demographics, comorbidities, number of surgeons involved, operative times, length of stay, and postoperative complications were measured. Wilcoxon rank-sum, Pearson's chi-squared, and proportional odds likelihood ratio tests were performed to compare continuous, categorical, and ordinal outcomes, respectively. Propensity score weighting was used to adjust for presurgical covariates and laterality. Operative time and length of stay were both significantly lower in the two- versus the single-microsurgeon groups in the unadjusted setting. When covariates and laterality were adjusted for, operative times still remained significantly shorter in the two-microsurgeon group; there were no differences in complications. Based on our findings, we propose that the two-microsurgeon approach can be utilized in more time-consuming microsurgical cases, such as autologous breast reconstruction, to safely decrease operative times and potentially alleviate surgeon fatigue, reduce operative costs, and thus increase overall surgeon productivity.
A 17-year-old girl with no prior medical or surgical history presented to her primary care physician complaining of sharp epigastric pain and decreased appetite over a period of 1 month. On physical examination, her abdomen was not distended and was without tenderness to palpation. There were no palpable masses, and bowel sounds were audible. On laboratory testing, she had a serum chemistry panel within normal limits, and her serum lipase was 261 U/L. An ultrasound performed at an outside hospital was suggestive of a pancreatic pseudocyst, and a computed tomography scan revealed a complex cystic mass (Fig 1). Endoscopic ultrasound-guided fine-needle aspiration (FNA) biopsy yielded a cellular sample comprising small clusters of cells floating in a background of necrotic debris and scattered siderophages (Fig 2). The cells were small and round with uniform nuclei; some cells exhibited single large vacuoles. No cellular pleomorphism or mitoses were noted. The final cytology interpretation confirmed the presence of atypical cells consistent with benign neoplasm. The patient underwent a distal pancreatectomy, where a 5.0 ϫ 2.8 ϫ 2.9 cm well-circumscribed mass was removed with free margins. Histologic review revealed a well-circumscribed tumor with a thick capsule that was focally penetrated by tumor nests. Necrosis and hemorrhage correlated with the gross and FNA impressions. In viable areas, most of the tumor exhibited a pseudopapillary architecture comprising elongated to round tumor cells radially arrayed around small blood vessels. A small portion of the tumor consisted of D I A G N O S I S I N O N C O L O G Y
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.