3D Volumetric Modeling and Microvascular Reconstruction of Irradiated Lumbosacral Defects after Oncologic Resection

García-Tutor, Emilio; Romeo, Marco; Chae, Michael P.; Hunter-Smith, David James; Rozen, Warren M.

doi:10.3389/fsurg.2016.00066

Cited by 8 publications

(7 citation statements)

References 32 publications

(39 reference statements)

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“…We also recently demonstrated the utility of a 3D-printed biomodel for planning perforator flap reconstruction of a sacral wound defect post-oncologic resection ( 117 ). Likewise, we used Osirix to translate the preoperative sacral CTA data into a CAD file.…”

Section: D Printing In Plastic and Reconstructive Surgerymentioning

confidence: 99%

Emerging Applications of Bedside 3D Printing in Plastic Surgery

et al. 2015

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Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.

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Section: D Printing In Plastic and Reconstructive Surgerymentioning

confidence: 99%

Emerging Applications of Bedside 3D Printing in Plastic Surgery

et al. 2015

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“…An increasing number of studies use MRI for preoperative planning in plastic surgery, such as a study that identified the location of perforated vessels in a PI using MRI 37 and a study of 3D printed haptic analysis of a lumbosacral defect using MRI 38 …”

Section: Discussionmentioning

confidence: 99%

Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series

Kim¹,

Park²,

Nam³

et al. 2021

Adv Skin Wound Care

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OBJECTIVE To establish a preoperative evaluation procedure by measuring the volume of dead space using MRI in patients with ischial pressure injuries. METHODS Patients with spinal cord injury and ischial pressure injuries who underwent treatment between August 2016 and November 2019 were included in the study. Preoperative MRI scan was conducted on all patients. The volume estimation and three-dimensional (3D) reconstruction were performed based on MRI data using a 3D Slicer. Based on the resulting volume, a muscle flap that could fit the dead space was selected. Surgery was performed with the selected muscle flap, and a fasciocutaneous flap was added, if necessary. RESULTS A total of eight patients with ischial pressure injuries were included in the study. The mean patient age was 59.0 ± 11.0 years. The mean body mass index was 26.62 ± 3.89 kg/m2. The mean volume of dead space was 104.75 ± 81.05 cm3. The gracilis muscle was the most selected muscle flap and was used in four patients. In five of eight cases, a fasciocutaneous flap was used as well. The mean follow-up period was 16 months, and by that point, none of the patients evinced complications that required surgery. CONCLUSIONS To the authors’ knowledge, this is the first report on volumetric evaluation of dead space in ischial pressure injuries. The authors believe that the 3D reconstruction process would enable adequate dead space obliteration in ischial pressure injuries. The authors propose that preoperative MRI scans in patients with ischial pressure injury should become an essential part of the process.

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“…Gillis and Morris [2] described the first use of 3D printing to produce perforator vascular anatomy in surgical planning in 2014. Since then, several other authors have described their experience with 3D printed models in complex reconstruction [14][15][16][17].…”

Section: Fig 4 3d Printed Model For Breast Reconstructionmentioning

confidence: 99%

The utility of three-dimensional models in complex microsurgical reconstruction

et al. 2020

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Background Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes.Methods A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction.Results Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group.Conclusions Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.

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3D Volumetric Modeling and Microvascular Reconstruction of Irradiated Lumbosacral Defects after Oncologic Resection

Cited by 8 publications

References 32 publications

Emerging Applications of Bedside 3D Printing in Plastic Surgery

Emerging Applications of Bedside 3D Printing in Plastic Surgery

Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series

The utility of three-dimensional models in complex microsurgical reconstruction

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