The paper outlines the achievements and challenges in the additive manufacturing (AM) application to veterinary practice. The state-of-the-art in AM application to the veterinary surgery is presented, with the focus of AM for patient-specific implants manufacturing. It also provides critical discussion on some of the potential issues design and technology should overcome for wider and more effective implementation of additively manufactured parts in veterinary practices. Most of the discussions in present paper are related to the metallic implants, manufactured in this case using so-called powder bed additive manufacturing (PB-AM) in titanium alloy Ti-6AL-4V, and to the corresponding process of their design, manufacturing and implementation in veterinary surgery. Procedures of the implant design and individualization for veterinary surgery are illustrated basing on the four performed surgery cases with dog patients. Results of the replacement surgery in dogs indicate that individualized additively manufactured metallic implants significantly increase chances for successful recovery process, and AM techniques present a viable alternative to amputation in a large number of veterinary cases. The same time overcoming challenges of implant individualization in veterinary practice significantly contributes to the knowledge directly relevant to the modern medical practice. An experience from veterinary cases where organ-preserving surgery with 3D-printed patientspecific implants is performed provides a unique opportunity for future development of better human implants.
Background. One-stage prepectoral implant-based reconstruction (OSPIBR) using biocompatible synthetic meshes support gained wide popularity in breast cancer surgery. Optimal structure of polypropylene mesh implants (PMI) and methods of its application are actively discussed.Aim. To study the effectiveness and safety of prosthesis support with “heavy” PMI in OSPIBR. Materials and methods. During 2019-2021 18 OSPIBR with "heavy" PMI support were performed after subcutaneous mastectomies in 14 patients. Cancer was indication for surgery in 13 cases (two of them - with BRCA1 mutation) and BRCA1 mutation solely - in 1 case. Foamed polyurethane covered silicone prosthesis (Polytech, Germany) was used for OSPIBR and "heavy" PMI PROLENE™ Polypropylene Mesh (Ethicon/Johnson & Johnson, USA) for prosthesis support by original method.Results. The overall complication rate was 5.6 % (1/18). It was a minor complication: limited aseptic skin necrosis along incision edge, successfully excised under local anesthesia. No cancer recurrences or capsular contracture formation were registrated during follow-up (6 months). The cosmetic outcome (Harvard score) was excellent in 11 of them and good in 3.Conclusions. "Heavy" PMI application by original technique in OSPIBR after subcutaneous mastectomy for breast cancer is a safe and effective method of prosthesis support.
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