3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study

Autor: Rathi Ratha Krishnan, Tegan K. Plunkett, Suan Gek Ng, Jun Cong Looi, Catherine M. Chia, Jia Min Yen, Chien Joo Lim, Karen Sui Geok Chua, Yan Ming Soh, Jai Rao
Rok vydání: 2021
Předmět:
Male
Critical Care and Emergency Medicine
Traumatic Brain Injury
medicine.medical_treatment
Electronics engineering
Pilot Projects
Engineering and technology
Vascular Medicine
Diagnostic Radiology
Cohort Studies
Cognition
Outcome Assessment
Health Care
Medicine and Health Sciences
Tomography
Musculoskeletal System
Trauma Medicine
Multidisciplinary
Rehabilitation
Radiology and Imaging
3D printing
Middle Aged
Tolerability
Printing
Three-Dimensional
Medicine
Female
Head Protective Devices
Decompressive craniectomy
Anatomy
Traumatic Injury
Research Article
Cohort study
Adult
Decompressive Craniectomy
3d printed
medicine.medical_specialty
Imaging Techniques
Science
Pain
Neuroimaging
Hemorrhage
Motor Activity
Dehiscence
Research and Analysis Methods
Signs and Symptoms
Diagnostic Medicine
medicine
Prototypes
Humans
Vulnerable population
Skeleton
Aged
business.industry
Skull
Biology and Life Sciences
Cosmesis
Computed Axial Tomography
Surgery
Technology Development
Brain Injuries
Feasibility Studies
Cranium
Clinical Medicine
business
Neurotrauma
Head
Neuroscience
Zdroj: PLoS ONE, Vol 16, Iss 10, p e0258296 (2021)
PLoS ONE
PLoS ONE, Vol 16, Iss 10 (2021)
ISSN: 1932-6203
Popis: Objectives 3D-printed (3DP) customized temporary cranial protection solutions following decompressive craniectomy (DC) are currently not widely practiced. A pilot trial of a 3DP customized head protection prototype device (HPPD) on 10 subjects was conducted during the subacute rehabilitation phase. Materials and methods Subjects > 30 days post-DC with stable cranial flaps and healed wounds were enrolled. HPPD were uniquely designed based on individuals’ CT scan, where the base conformed to the surface of the individual’s skin covering the cranial defect, and the lateral surface three-dimensionally mirrored, the contralateral healthy head. Each HPPD was fabricated using the fused deposition modeling method. These HPPD were then fitted on subjects using a progressive wearing schedule and monitored over 1, 2, 4, 6 and 8 follow-up (FU) weeks. Outcomes during FU included; reported wearing time/day (hours), subjective pain, discomfort, pruritus, dislodgment, cosmesis ratings; and observed wound changes. The primary outcome was safety and tolerability without pain or wound changes within 30 minutes of HPPD fitting. Results In all, 10 enrolled subjects received 12 HPPDs [5/10 male, mean (SD) age 46 (14) years, mean (SD) duration post-DC 110 days (76)] and all subjects tolerated 30 minutes of initial HPPD fitting without wound changes. The mean (SD) HPPD mass was 61.2 g (SD 19.88). During 8 weeks of FU, no HPPD-related skin dehiscence was observed, while 20% (2/10) had transient skin imprints, and 80% (8/10) reported self-limiting pressure and pruritis. Discussion Findings from this exploratory study demonstrated preliminary feasibility and safety for a customized 3DP HPPD for temporary post-DC head protection over 8 weeks of follow-up. Monitoring and regular rest breaks during HPPD wear were important to prevent skin complications. Conclusion This study suggests the potential for wider 3DP technology applications to provide cranial protection for this vulnerable population.
Databáze: OpenAIRE
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