A review of the manufacturing process and infection rate of 3D-printed models and guides sterilized by hydrogen peroxide plasma and utilized intra-operatively
Journal Title: 3D Printing in Medicine - Year 2020, Vol 6, Issue
Abstract
3D printing in the context of medical application can allow for visualization of patient-specific anatomy to facilitate surgical planning and execution. Intra-operative usage of models and guides allows for real time feedback but ensuring sterility is essential to prevent infection. The additive manufacturing process restricts options for sterilisation owing to temperature sensitivity of thermoplastics utilised for fabrication. Here, we review one of the largest single cohorts of 3D models and guides constructed from Acrylonitrile butadiene styrene (ABS) and utilized intra-operatively, following terminal sterilization with hydrogen peroxide plasma. We describe our work flow from initial software rendering to printing, sterilization, and on-table application with the objective of demonstrating that our process is safe and can be implemented elsewhere. Overall, 7% (8/114 patients) of patients developed a surgical site infection, which was not elevated in comparison to related studies utilizing traditional surgical methods. Prolonged operation time with an associated increase in surgical complexity was identified to be a risk factor for infection. Low temperature plasma-based sterilization depends upon sufficient permeation and contact with surfaces which are a particular challenge when our 3D-printouts contain diffusion-restricted luminal spaces as well as hollows. Application of printouts as guides for power tools may further expose these regions to sterile bodily tissues and result in generation of debris. With each printout being a bespoke medical device, it is important that the multidisciplinary team involved in production and application understand potential pitfalls to ensuring sterility as to minimize infection risk.
Authors and Affiliations
Graham Ka-Hon Shea, Kenneth Lap-Kei Wu, Iris Wai-Sum Li, Man-Fai Leung, Ada Lai-Ping Ko, Lane Tse, Sherby Suet-Ying Pang, Kenny Yat-Hong Kwan, Tak-Man Wong, Frankie Ka-Li Leung, Christian Xinshuo Fang
Keywords
Related Articles
- EP ID EP680662
- DOI 10.1186/s41205-020-00061-w
- Views 53
- Downloads 0
Fabrication approaches for the creation of physical models from microscopy data
Select models are available for download at https://morgridge.org/designs/. Additional models and datasets are available upon request.
3D Printed replica of articular fractures for surgical planning and patient consent: a two years multi-centric experience
CT scanning with 3D reconstructed images are currently used to study articular fractures in orthopedic and trauma surgery. A 3D-Printer creates solid objects, starting from a 3D Computer representation.
Simulation of semilunar valve function: computer-aided design, 3D printing and flow assessment with MR
The structure of the valve leaflets and sinuses are crucial in supporting the proper function of the semilunar valve and ensuring leaflet durability. Therefore, an enhanced understanding of the structural characteristics...
3D printing in medicine of congenital heart diseases
Congenital heart diseases causing significant hemodynamic and functional consequences require surgical repair. Understanding of the precise surgical anatomy is often challenging and can be inadequate or wrong. Modern hig...
Utilizing a low-cost desktop 3D printer to develop a “one-stop 3D printing lab” for oral and maxillofacial surgery and dentistry fields
Readers interested in the data should contact the authors.