3D-PRINTED HAPTIC "REVERSE" MODELS FOR PREOPERATIVE PLANNING IN SOFT TISSUE RECONSTRUCTION: A CASE REPORT
3D-PRINTED HAPTIC "REVERSE" MODELS FOR PREOPERATIVE PLANNING IN SOFT TISSUE RECONSTRUCTION: A CASE REPORT
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DOI：
10.1002/micr.22293
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发表时间：
2015-02-01
期刊：
影响因子：
2.1
通讯作者：
Rozen, Warren Matthew
中科院分区：
文献类型：
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作者：
Chae, Michael P.;Lin, Frank;Rozen, Warren Matthew
在重建手术中，术前计划对于获得最佳的功能和美观效果至关重要。从二维（2D）成像数据通过快速原型创建三维（3D）模型已经在工业设计中使用了几十年，但直到最近才被引入医疗应用。3D打印就是这样一种快速、方便、相对便宜的技术。在本报告中，我们提出了一个案例，其中一种可重复的方法，用于生产代表皮肤伤口缺陷的3d打印反向模型，用于皮瓣设计和收获。这包括一名82岁的男性，在伤口感染的一系列软组织清创后暴露了踝关节假体。采用前臂复合桡骨游离皮瓣（RFFF）进行软组织覆盖和死区填充。对供体部位（左前臂）、受体部位（右脚踝）和左脚踝进行计算机断层血管造影（CTA）。使用计算机软件对CTA的2D数据进行3D重建，并使用左脚踝的3D图像作为对照。通过叠加左右脚踝图像创建3D模型，以创建缺陷的反向图像，并使用3D打印机打印。因此，卢旺达紧急援助部队得到了有效的规划和执行，没有出现任何复杂情况。据我们所知，这是关于计算软组织伤口缺陷的机制和产生可能对手术计划有用的3D模型的第一份报告。3D打印，特别是逆向建模可能是重建规划的通用选择，并具有广泛应用的潜力。(c) 2014 Wiley期刊公司显微外科，2015。
In reconstructive surgery, preoperative planning is essential for optimal functional and aesthetic outcome. Creating a three-dimensional (3D) model from two-dimensional (2D) imaging data by rapid prototyping has been used in industrial design for decades but has only recently been introduced for medical application. 3D printing is one such technique that is fast, convenient, and relatively affordable. In this report, we present a case in which a reproducible method for producing a 3D-printed reverse model representing a skin wound defect was used for flap design and harvesting. This comprised a 82-year-old man with an exposed ankle prosthesis after serial soft tissue debridements for wound infection. Soft tissue coverage and dead-space filling were planned with a composite radial forearm free flap (RFFF). Computed tomographic angiography (CTA) of the donor site (left forearm), recipient site (right ankle), and the left ankle was performed. 2D data from the CTA was 3D-reconstructed using computer software, with a 3D image of the left ankle used as a control. A 3D model was created by superimposing the left and right ankle images, to create a reverse image of the defect, and printed using a 3D printer. The RFFF was thus planned and executed effectively, without complication. To our knowledge, this is the first report of a mechanism of calculating a soft tissue wound defect and producing a 3D model that may be useful for surgical planning. 3D printing and particularly reverse modeling may be versatile options in reconstructive planning, and have the potential for broad application. (c) 2014 Wiley Periodicals, Inc. Microsurgery 35:148-153, 2015.