Annals of 3D printed medicine最新文献

From simple cleaning to metagenomic studies and now the detection of the SARS-2 virus, swabs are absorbent pads with handles that hold significant promise in several applications and properties. Furthermore, the swab is now used for a wide range of medical purposes, such as the collection of bacteria and other pathogens such as influenza and H1N1. Various designs and materials used for the tip have led to a wide range of applications. In this review, we discuss the characteristics of essential tip materials such as rayon, polyester, nylon, and polyurethane in the context of specimen collection from various substrates. Further, this article reviews swab manufacturing techniques, including injection molding and calendar roll pressing, among others. In recent years, advances in additive manufacturing technology have made it possible to produce swabs in a fast and efficient manner. Furthermore, the design for additive manufacturing (DfAM) is given for the production of swabs. We also examine how 3-D printing of bio-resin swabs has revolutionized the manufacturing process, making it autonomous, quicker, more efficient, and environmentally friendly. Additionally, a shortage of medical devices for testing the SARS-2 virus has zealously motivated the medical industry to revolutionize through additive manufacturing of swabs, thus revolutionizing the medical industry. In conclusion, the limitations of the current techniques and future directions for swabs are discussed.

Surgical simulation models are becoming increasingly more prevalent, complex and niche within the medical industry, yet there has been nothing developed to date that focuses specifically on scapholunate interosseous ligament (SLIL) injuries, which are common amongst a large range of ages and demographics. This study seeks to present the design process of a surgical practice rig designed to support care for the ruptured SLIL. The novelty of this practice rig is apparent, because it explores multiple 3D printing technologies in order to evaluate which is the most suitable for a medical practice rig of this nature. User feedback indicated that hybrid manufacturing applications utilising traditional fabrication techniques and 3D printing technologies was superior when accounting for the requisite movement capabilities and modularity the rig needed to process. Throughout the design process, a user-centred approach was used to translate the needs of the surgeon into a functional product. An emergent design methodology was used to incorporate feedback from medical professionals and engineers. These two methodological approaches were used to ensure the end-product fulfilled several functions: aiding surgeons to understand a new surgical implant, providing reasonable bio-fidelity in wrist function to enable surgical practice, and remaining simple enough to be understood by a patient undergoing a complex procedure. Following user tests with a variety of hand and wrist surgeons, we found this rig suitable for several applications. The rig functioned as expected, providing surgeons with a means to experiment with a new surgical implant, and proved an effective tool for patient education.

Presented are four cases involving urgent interventions to repair PEG tube failures in PEG dependent patients. We report on the practical utility of 3D printed devices designed for contingency repair of pediatric PEG tubes when other options, including surgical approaches or manufacturer supplied repairs, were not possible. The patients were dependent on PEG for nutrition and/or medication, treated at the University Hospital Limerick or Children's Hospital Ireland – Crumlin, Ireland. Each were unsuitable for surgery. PEG tube fractures occurred in 4 children (2 female, 2 male; aged 6–15 years) with chronic complex medical conditions at 5-6 years dwell time. In each case novel sealing devices were created and customized to address fractured PEG tubes. The designs were 3D printed using biocompatible materials. The PEG tube fractures were effectively sealed with the 3D printed devices within 24 h, and tube potency was completely restored in one case for up to 205 days.

In recent years there has been a significant increase in the use of 3D technology in orthopaedic surgery. Consequently, innovative techniques in the use of 3D printed guides for different types of surgical interventions have been developed. However, the design and 3D printing of osteosynthesis implants customized to the patient's pathology is scarcer. This work presents the technical note and application in a clinical case on the design of a customised cutting guide as well as custom-made titanium osteosynthesis plate. Osteosynthesis cutting guides and plate were designed for a patient with functional ankle limitation and bone deformity due to a previous surgery in which he underwent intramedullary nailing. For this purpose, a virtual surgery was performed in which all the osteosynthesis material customized for the patient was designed. Subsequently, the 3D printing was performed, obtaining the cutting guides and the osteosynthesis plate that adapted and fixed precisely to the anatomy of the patient's bone. Currently, the patient is pain free and the bone deformity has been corrected. Custom designed and 3D printed cutting guides are a reliable method for bone deformity correction surgery, which can be complemented with a personalized osteosynthesis plate in clinical cases that require it.

A 78-year-old patient with a laryngectomy and a background of bronchiectasis experienced frequent hospital admissions due to pulmonary exacerbations. Standard care would be to trial a positive expiratory pressure (PEP) device to assist with secretion removal, however, no adaptor could be found to contour the patient's tracheostoma. A 3D printed patient-specific PEP adaptor was created, facilitating regular secretion clearance via PEP therapy. Frequency of hospital admissions and outcomes of disease-specific questionnaires (St. George's Respiratory Questionnaire (SGRQ) and Leicester Cough Questionnaire (LCQ)) were evaluated at three and six months. After six months of device use, the patient had not experienced a pulmonary exacerbation or required an admission, whilst demonstrating clinically significant improvements in both SGRQ (58.98 vs. 66.3/100) and LCQ (11.27 vs. 13.27/21) scores. Collaboration between consumers, clinicians and engineers can support the delivery of personalised healthcare and improve quality of life for patients with pulmonary conditions.

As anatomy lab hours have been decreased across medical school curricula, there is opportunity for Augmented Reality (AR) to emerge as an effective learning tool. In addition to live demonstrations such as those provided through the Peer Teaching Program (PTP), AR technology can provide 3-D realistic anatomic imaging that engages visuospatial skills and can be accessed remotely, The goal of this study is to provide an assessment of AR holograms as an educational intervention for anatomy learning. The study was quasi-experimental in design to determine the efficacy of AR compared to PTP. Two trials took place during regularly scheduled PTP sessions. For the AR intervention, students completed a pretest, interacted with AR holograms as either the 1st (AR1) or 2nd (AR2) educational intervention, then completed a posttest. A paired-t test was used on AR1 scores to determine AR efficacy. A one-sided MannWhitney-U test was used on post-intervention scores of AR1 vs PTP1. The AR1 group achieved a significant improvement in test scores. There was no significant difference in AR1 vs PTP1 post-intervention scores. CONCLUSION: In this pilot study, mobile-based AR was as effective as PTP in acquiring short-term learning and has the potential to be used for anatomy education to simulate hands-on laboratory time

The diabetic prevalent population is increasing day by day, which further increases the cases of diabetic ulceration, loss of sensation in the plantar region of the foot, and amputations in severe patients. These complications can be managed up to some extent by using modified shoes, offloading orthosis, etc. In recent advances, the use of additive manufacturing (i.e., 3D printing) to fabricate orthosis for diabetic patients is pioneering. The method of 3D printing of the foot orthosis for the diabetic foot management can be used along with the traditional methods. This review article will provide extensive literature on the pathophysiology of diabetes, the related complications and management techniques, and the use of additive manufacturing in the orthosis fabrication methods and its progress.

Nephron-sparing surgery (NSS) for Wilms Tumor patients has a positive surgical margin rate of 15.7–36.4%. Innovative approaches may reduce the occurrence of positive surgical margins in NSS and prevent these children from having additional radiotherapy and chemotherapy. The feasibility of performing mock surgery on patient-specific hydrogel phantoms of the kidney, tumor, and arterial vasculature for preoperative simulation of NSS was assessed in two patients. The development of patient-specific phantoms allowed the surgeon to practice surgery. Moreover, phantom specimens were assessed using MRI to understand the location and size of the smallest surgical margin. Surgeons reported that simulation surgery helped perform NSS safely and improved intraoperative tumor localization and resection planning. The technique is considered feasible and useful when preparing for NSS. In the future, this technique may further help to achieve negative surgical margins in NSS and may also allow the use of NSS in patients typically regarded as ineligible for this procedure.

Introduction: The objective of this investigation is to examine a wide array of commonly accessible 3D print filaments and assess their radiographic fidelity in vertebral models.

Material and methods: Solid cylinders were 3D printed on an Ultimaker S5 (Ultimaker B.V., Utrecht, Netherlands) in 12 commonly accessible filaments: ABS (Acrylonitrile butadiene styrene), PLA (Polylactic acid), Tough PLA, PP (Poly propylene), Carbon Fiber ABS, Wood fill, PETG (Polyethylene terephthalate glycol), Nylon, PC (Polycarbonate), Bronze fill, TPU 95A (Thermoplastic polyurethane), and CPE (Chlorinated polyethylene). Cylinders were imaged in a CT phantom with anatomic standards. Next, 11 identical L4 human vertebral models were 3D printed in the same materials (omission of TPU 95A). AP and lateral fluoroscopic images were taken of each of the vertebrae and sent to board-certified/board-eligible neurosurgeons, neuroradiologists, and orthopedic spine surgeons for evaluation.

Results: CT imaging of the materials yielded a range of Hounsfield values from –120.6 HU (PP) to 167.76 HU (PETG). The polled experts rated CF ABS as the highest fidelity model (mean 4.069) and Bronze fill as lowest (mean 2.000). All simulated vertebrae in this study ranked higher than Bronze fill (p<0.05). Notably, CF ABS (p=0.0029), ABS (p=0.0075), and CPE (p=0.0182) ranked significantly higher than Tough PLA.

Discussion: It was determined that CT values of examined filaments were not comparable to cortical bone standard but similar to other bone standards. Our results suggest that apart from Bronze fill, educators can create high fidelity fluoroscopic models with print materials such as ABS, CF ABS, and CPE.