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Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique

SIMPLE SUMMARY: Current planning techniques, including computer-aided design/computer-aided manufacturing (CAD/CAM), offer ways to plan reconstructive surgery that optimize aesthetic outcomes and functional rehabilitation. In addition, the use of these techniques promotes safety and reduces the dura...

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Autores principales: Rodríguez-Arias, Juan Pablo, Tapia, Blanca, Pampín, Marta María, Morán, Maria José, Gonzalez, Javier, Barajas, Maria, Del Castillo, Jose Luis, Navarro Cuéllar, Carlos, Cebrian, Jose Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224908/
https://www.ncbi.nlm.nih.gov/pubmed/35743715
http://dx.doi.org/10.3390/jpm12060930
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author Rodríguez-Arias, Juan Pablo
Tapia, Blanca
Pampín, Marta María
Morán, Maria José
Gonzalez, Javier
Barajas, Maria
Del Castillo, Jose Luis
Navarro Cuéllar, Carlos
Cebrian, Jose Luis
author_facet Rodríguez-Arias, Juan Pablo
Tapia, Blanca
Pampín, Marta María
Morán, Maria José
Gonzalez, Javier
Barajas, Maria
Del Castillo, Jose Luis
Navarro Cuéllar, Carlos
Cebrian, Jose Luis
author_sort Rodríguez-Arias, Juan Pablo
collection PubMed
description SIMPLE SUMMARY: Current planning techniques, including computer-aided design/computer-aided manufacturing (CAD/CAM), offer ways to plan reconstructive surgery that optimize aesthetic outcomes and functional rehabilitation. In addition, the use of these techniques promotes safety and reduces the duration of operations. This study compares both the cost of CAD/CAM technology and the clinical results with those of the conventional technique in remodeling the fibula for mandibular reconstruction. ABSTRACT: (1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperative virtual planning of mandibular reconstruction using a free fibula flap compared with freehand plate bending and osteotomies. (2) Methods: A retrospective comparative study was carried out in the Oral and Maxillofacial Department of La Paz University Hospital, Madrid, Spain. The study compared 18 patients in the CAD/CAM group with 19 patients in the conventional freehand group. A comparison was made between the total surgical time, the comorbidities, and the hospital stay. The resource consumption was estimated using a cost analysis. (3) Results: Although CAD/CAM was a statistically more expensive procedure in the perioperative phase, no significant differences were observed in total health care costs between the two groups. There was a non-significant trend towards an increase in complications with conventional reconstruction plates compared to patient-specific plates (PSI). (4) Conclusions: CAD/CAM technology and a 3D printed cutting guide offer a significantly shorter surgical time, which is associated with a reduction in hospital days, PACU days, and complications. The cost of CAD/CAM technology is comparable to that of the conventional freehand technique.
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spelling pubmed-92249082022-06-24 Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique Rodríguez-Arias, Juan Pablo Tapia, Blanca Pampín, Marta María Morán, Maria José Gonzalez, Javier Barajas, Maria Del Castillo, Jose Luis Navarro Cuéllar, Carlos Cebrian, Jose Luis J Pers Med Article SIMPLE SUMMARY: Current planning techniques, including computer-aided design/computer-aided manufacturing (CAD/CAM), offer ways to plan reconstructive surgery that optimize aesthetic outcomes and functional rehabilitation. In addition, the use of these techniques promotes safety and reduces the duration of operations. This study compares both the cost of CAD/CAM technology and the clinical results with those of the conventional technique in remodeling the fibula for mandibular reconstruction. ABSTRACT: (1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperative virtual planning of mandibular reconstruction using a free fibula flap compared with freehand plate bending and osteotomies. (2) Methods: A retrospective comparative study was carried out in the Oral and Maxillofacial Department of La Paz University Hospital, Madrid, Spain. The study compared 18 patients in the CAD/CAM group with 19 patients in the conventional freehand group. A comparison was made between the total surgical time, the comorbidities, and the hospital stay. The resource consumption was estimated using a cost analysis. (3) Results: Although CAD/CAM was a statistically more expensive procedure in the perioperative phase, no significant differences were observed in total health care costs between the two groups. There was a non-significant trend towards an increase in complications with conventional reconstruction plates compared to patient-specific plates (PSI). (4) Conclusions: CAD/CAM technology and a 3D printed cutting guide offer a significantly shorter surgical time, which is associated with a reduction in hospital days, PACU days, and complications. The cost of CAD/CAM technology is comparable to that of the conventional freehand technique. MDPI 2022-06-07 /pmc/articles/PMC9224908/ /pubmed/35743715 http://dx.doi.org/10.3390/jpm12060930 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rodríguez-Arias, Juan Pablo
Tapia, Blanca
Pampín, Marta María
Morán, Maria José
Gonzalez, Javier
Barajas, Maria
Del Castillo, Jose Luis
Navarro Cuéllar, Carlos
Cebrian, Jose Luis
Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title_full Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title_fullStr Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title_full_unstemmed Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title_short Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique
title_sort clinical outcomes and cost analysis of fibula free flaps: a retrospective comparison of cad/cam versus conventional technique
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224908/
https://www.ncbi.nlm.nih.gov/pubmed/35743715
http://dx.doi.org/10.3390/jpm12060930
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