The utility of three-dimensional models in complex microsurgical reconstruction

Area of Science:

• Plastic Surgery
• Surgical Technology
• Medical Imaging

Background:

• Three-dimensional (3D) model printing offers superior spatial visualization of anatomical structures compared to 2D data.
• 3D models provide an exact replica of the surgical site for intraoperative reference.
• Evidence on the impact of 3D models in microsurgical reconstruction on clinical outcomes is limited.

Purpose of the Study:

• To evaluate the effect of 3D model printing on preoperative planning and clinical outcomes in reconstructive breast microsurgery.
• To compare the accuracy of surgical decisions and flap harvest times between conventional imaging and 3D models.

Main Methods:

• Retrospective review of 116 patients undergoing reconstructive breast microsurgery (2017-2019).
• Comparison of patients who received computed tomography angiography (CTA) scans alone versus those with CTA plus 3D models for preoperative planning.
• Tracking of preoperative flap decision-making (DIEP vs. MS-TRAM), changes in decision during surgery, and postoperative complications.

Main Results:

• No flap loss occurred in either the conventional CTA group (58 flaps) or the 3D model group (58 flaps).
• Flap harvest time was significantly reduced with 3D model use (109.8±11.6 min) compared to conventional CTA (117.7±14.2 min; P=0.001).
• Preoperative decisions on flap type remained unchanged in 100% of cases using 3D models, versus 75.9% with conventional CTA.

Conclusions:

• Three-dimensional model printing enhances the accuracy of preoperative planning in complex microsurgical reconstruction.
• The use of 3D models significantly reduces flap harvest time.
• 3D model printing leads to similar postoperative complication rates compared to conventional imaging techniques.