RT info:eu-repo/semantics/doctoralThesis
T1 Impresión 3D en Cirugía Ortopédica y Traumatología. Revisión sistemática de su aplicabilidad y estudio de los métodos de esterilización más adecuados para la utilización en quirófanos de las impresiones realizadas en el hospital.
A1 Aguado Maestro, Ignacio
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Ortopedia y Traumatología
K1 3D printing
K1 Impresión 3D
K1 Surgical guide
K1 Guía quirúrgica
K1 Sterilization
K1 Esterilización
K1 3109.10 Cirugía
AB IntroductionIn-Hospital 3D printing has been broadly developed since the end of the addictive manufacturing patents. However, although there are many printing technologies, the most frequent in our field are Fused Deposition Modelling (FDM) and Stereolithography (SLA), which usually use hollow infill patterns in order to save time and material. It is common to use these models and surgical guides in the operating room, however, there were no publications warranting an adequate sterilization of the in-house prints. ObjectivesTo describe systematically all the current applications of in-hospital 3D printing up to date and to run an experimental study which demonstrates the sterilization of the inside of our anatomical models and surgical guides. Material and MethodsA systematic review was made on PubMed to obtain all the published articles regarding this topic up to December 2021. Those publications in other language (not in English or Spanish) or describing industrial applications, cell therapies, pharma therapies or involving human specimens were rejected. A record card was made for each application to make further search easier. For the experimental study, a total of 24 cylinders were designed and printed with a 3D printer in Polylactic Acid (PLA) with an infill density of 12%. Manufacturing was paused when 60% of the print was reached and 20 of the cylinders were inoculated with 0.4 mL of a suspension of S epidermidis ATTCC 1228 in saline solution at turbidity 1 McFarland. Printing was resumed, being all the pieces completely sealed with the inoculum inside. Posteriorly, 4 groups were made according to the chosen sterilization method: Ethylene Oxide (EtO), Gas Plasma, Steam Heat or non-sterilized (positive control). Each group included 5 contaminated cylinders and 1 non-contaminated cylinder as a negative control. After sterilization, the inside of the cylinders was cultured during 7 days. ResultsWe obtained a total of 1193 articles in the research, of which 298 articles met the inclusion criteria, finding a total of 143 applications which are summarized as record cards. In the sterility study, we observed bacterial growth of just a few Forming Colony Units (FCU) in 4 out of 5 positive controls and in 2 out of 5 contaminated cylinders sterilized with Gas Plasma. We could not assess any bacterial growth in any of the EtO or Steam Heat samples or in any of the negative controls. Pieces sterilized under Steam Heat resulted completely deformed. ConclusionsThere are multiple applications for in-house 3D printing in the field of orthopaedics. High temperatures reached during the procedure of additive manufacturing can decrease the bacterial load of the biomodels. However, there is a potential risk of contamination during the proce- dure. We recommend sterilization with EtO for in-hospital 3D-printed PLA hollow biomodels or guides. Otherwise, in case of using Gas Plasma, an infill of 100% should be applied.
YR 2023
FD 2023
LK https://uvadoc.uva.es/handle/10324/61887
UL https://uvadoc.uva.es/handle/10324/61887
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 17-jul-2024