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Burhamah W, Alshawaf SM, Alwazzan S, AlYouha S, Al-Sabah S. The Utilization of Three-Dimensional Printing in Creating a Surgical Instrument: An Areola Cookie Cutter. Aesthet Surg J Open Forum 2022; 4:ojac055. [PMID: 35903516 PMCID: PMC9317162 DOI: 10.1093/asjof/ojac055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Three-dimensional (3D) printing is a rapidly evolving technology with many applications in the medical field. It involves printing solid objects from a digital file. In this paper, we describe our experience with the use of 3D printing in creating an areola cookie cutter that is compatible with sterilization. The objective of this study is to explore accurate and cost-effective methods of producing patient-specific areola cookie cutters. Auto computer-aided design (CAD) 3D software was used to design a digital model that was subsequently converted to a standard tessellation language (STL) file. The models were printed with the Formlabs Form 3+ SLA printer (Somerville, MA) using a resin material. Washing and curing were then performed followed by autoclave sterilization of the models. A total of 3 areola cookie cutters were created, each with different sizes (33, 38, and 42 mm) using resin material (Formlabs BioMed Clear Resin; Somerville, MA). All 3 models were able to withstand autoclave sterilization. The use of 3D printing has proven to be a valuable tool in Plastic surgery. We describe our experience of designing and producing an areola cookie cutter using a 3D printer; our model is compatible with the process of sterilization. We emphasize the advantages of a quick production time and accuracy in design.
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Affiliation(s)
- Waleed Burhamah
- Division of Plastic & Reconstructive Surgery, Jaber Al Ahmad Al Sabah Hospital, Kuwait City, Kuwait
| | - Solaiman M Alshawaf
- Division of Plastic & Reconstructive Surgery, Jaber Al Ahmad Al Sabah Hospital, Kuwait City, Kuwait
| | - Sabika Alwazzan
- Department of General Surgery, Jaber Al Ahmad Al Sabah Hospital, Kuwait City, Kuwait
| | - Sarah AlYouha
- Corresponding Author: Dr Sarah AlYouha, Health Sciences Centre, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait. E-mail: ; Instagram: @drSarahalyouha
| | - Salman Al-Sabah
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Popescu D, Baciu F, Amza CG, Cotrut CM, Marinescu R. The Effect of Disinfectants Absorption and Medical Decontamination on the Mechanical Performance of 3D-Printed ABS Parts. Polymers (Basel) 2021; 13:4249. [PMID: 34883752 PMCID: PMC8659898 DOI: 10.3390/polym13234249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022] Open
Abstract
Producing parts by 3D printing based on the material extrusion process determines the formation of air gaps within layers even at full infill density, while external pores can appear between adjacent layers making prints permeable. For the 3D-printed medical devices, this open porosity leads to the infiltration of disinfectant solutions and body fluids, which might pose safety issues. In this context, this research purpose is threefold. It investigates which 3D printing parameter settings are able to block or reduce permeation, and it experimentally analyzes if the disinfectants and the medical decontamination procedure degrade the mechanical properties of 3D-printed parts. Then, it studies acetone surface treatment as a solution to avoid disinfectants infiltration. The absorption tests results indicate the necessity of applying post-processing operations for the reusable 3D-printed medical devices as no manufacturing settings can ensure enough protection against fluid intake. However, some parameter settings were proven to enhance the sealing, in this sense the layer thickness being the most important factor. The experimental outcomes also show a decrease in the mechanical performance of 3D-printed ABS (acrylonitrile butadiene styrene) instruments treated by acetone cold vapors and then medical decontaminated (disinfected, cleaned, and sterilized by hydrogen peroxide gas plasma sterilization) in comparison to the control prints. These results should be acknowledged when designing and 3D printing medical instruments.
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Affiliation(s)
- Diana Popescu
- Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, 060042 Bucharest, Romania; (D.P.); (C.G.A.)
| | - Florin Baciu
- Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, 060042 Bucharest, Romania; (D.P.); (C.G.A.)
| | - Catalin Gheorghe Amza
- Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, 060042 Bucharest, Romania; (D.P.); (C.G.A.)
| | - Cosmin Mihai Cotrut
- Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Rodica Marinescu
- Department of Orthopedics, University of Medicine and Pharmacology Carol Davila, 020021 Bucharest, Romania;
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Zaidi S, Naik P, Ahmed S. Three-Dimensional printed instruments used in a Septoplasty: A new paradigm in Surgery. Laryngoscope Investig Otolaryngol 2021; 6:613-618. [PMID: 34401479 PMCID: PMC8356858 DOI: 10.1002/lio2.579] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Three-dimensional (3D) printing has been rapidly adopted by different surgical disciplines. It has shown itself to have improved outcomes in education, pre-operative planning, and reconstruction. However, using 3D printing to create surgical instruments is a niche within the literature that has not yet been fully explored. The authors present a study in which it is hypothesized that 3D printing surgical instruments can be utilized successfully within ENT surgery. METHODS As one of the most common ENT operations worldwide, a septoplasty was chosen as the procedure to provide proof of concept. For the septoplasty, five instruments were printed: a scalpel handle, needle holders, toothed forceps, a Cottle/Freer elevator, and a Killian's speculum. The entire set took 224 minutes on average to print, weighed 36 g, and only used approximately 86 pence ($1.20 USD) worth of polylactic acid plastic to create. RESULTS All steps in performing a septoplasty on a human cadaver with the 3D printed tools were possible and were undertaken successfully. This yielded a similar outcome to using stainless steel with the added benefit of there being a large reduction in cost and the ability for rapid customization according to the surgeon's preferences. CONCLUSION As technology and mainstream interest in 3D printing develops, the availability of more precise Computer-Aided Design software will allow for more complex designs of tools to be created. Currently, 3D printing has been shown to be a promising method from which future surgical tools can be fashioned to meet the complex, dynamic demands of surgery. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Syed Zaidi
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
| | - Paresh Naik
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
| | - Shahzada Ahmed
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
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PolliRS: A 3D-printed Pollicization Retractor System that Improves Access and Autonomy during the Surgical Procedure. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3632. [PMID: 34123690 PMCID: PMC8191700 DOI: 10.1097/gox.0000000000003632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
We demonstrate the design, manufacture, and deployment of the first custom-made 3-dimensional (3D)-printed hand retractor for the pollicization procedure. Radiological images of the patient’s hand were taken preoperatively to measure anatomical dimensions and guide the design of the device in a patient-precise manner. The 3D-printed, sterilizable, device was autoclaved and successfully used on a patient that underwent a pollicization procedure in our unit. The radiolucency of the device and the fluency enabled by the ability to exchange between different positions demonstrated the potential of this device in increasing the overall autonomy afforded to the lead-surgeon during the operation and demonstrated the potential of rapid-prototyping techniques such as 3D printing for producing patient-precise tools on-the-fly that taken account the specific needs of the patient.
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Chen JV, Dang ABC, Dang A. Comparing cost and print time estimates for six commercially-available 3D printers obtained through slicing software for clinically relevant anatomical models. 3D Print Med 2021; 7:1. [PMID: 33404847 PMCID: PMC7786189 DOI: 10.1186/s41205-020-00091-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/10/2020] [Indexed: 02/11/2023] Open
Abstract
Background 3D printed patient-specific anatomical models have been applied clinically to orthopaedic care for surgical planning and patient education. The estimated cost and print time per model for 3D printers have not yet been compared with clinically representative models across multiple printing technologies. This study investigates six commercially-available 3D printers: Prusa i3 MK3S, Formlabs Form 2, Formlabs Form 3, LulzBot TAZ 6, Stratasys F370, and Stratasys J750 Digital Anatomy. Methods Seven representative orthopaedic standard tessellation models derived from CT scans were imported into the respective slicing software for each 3D printer. For each printer and corresponding print setting, the slicing software provides a print time and material use estimate. Material quantity was used to calculate estimated model cost. Print settings investigated were infill percentage, layer height, and model orientation on the print bed. The slicing software investigated are Cura LulzBot Edition 3.6.20, GrabCAD Print 1.43, PreForm 3.4.6, and PrusaSlicer 2.2.0. Results The effect of changing infill between 15% and 20% on estimated print time and material use was negligible. Orientation of the model has considerable impact on time and cost with worst-case differences being as much as 39.30% added print time and 34.56% added costs. Averaged across all investigated settings, horizontal model orientation on the print bed minimizes estimated print time for all 3D printers, while vertical model orientation minimizes cost with the exception of Stratasys J750 Digital Anatomy, in which horizontal orientation also minimized cost. Decreasing layer height for all investigated printers increased estimated print time and decreased estimated cost with the exception of Stratasys F370, in which cost increased. The difference in material cost was two orders of magnitude between the least and most-expensive printers. The difference in build rate (cm3/min) was one order of magnitude between the fastest and slowest printers. Conclusions All investigated 3D printers in this study have the potential for clinical utility. Print time and print cost are dependent on orientation of anatomy and the printers and settings selected. Cost-effective clinical 3D printing of anatomic models should consider an appropriate printer for the complexity of the anatomy and the experience of the printer technicians. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-020-00091-4.
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Affiliation(s)
- Joshua V Chen
- Department of Orthopaedic Surgery, University of California, San Francisco, USA.
| | - Alan B C Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, USA.,CA Department of Surgery, San Francisco VA Health Center, Orthopaedic Section, San Francisco, USA
| | - Alexis Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, USA.,CA Department of Surgery, San Francisco VA Health Center, Orthopaedic Section, San Francisco, USA
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Petsiuk A, Tanikella NG, Dertinger S, Pringle A, Oberloier S, Pearce JM. Partially RepRapable automated open source bag valve mask-based ventilator. HARDWAREX 2020. [PMID: 32835141 DOI: 10.20944/preprints202006.0318.v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study describes the development of a simple and easy-to-build portable automated bag valve mask (BVM) compression system, which, during acute shortages and supply chain disruptions can serve as a temporary emergency ventilator. The resuscitation system is based on the Arduino controller with a real-time operating system installed on a largely RepRap 3-D printable parametric component-based structure. The cost of the materials for the system is under $170, which makes it affordable for replication by makers around the world. The device provides a controlled breathing mode with tidal volumes from 100 to 800 mL, breathing rates from 5 to 40 breaths/minute, and inspiratory-to-expiratory ratio from 1:1 to 1:4. The system is designed for reliability and scalability of measurement circuits through the use of the serial peripheral interface and has the ability to connect additional hardware due to the object-oriented algorithmic approach. Experimental results after testing on an artificial lung for peak inspiratory pressure (PIP), respiratory rate (RR), positive end-expiratory pressure (PEEP), tidal volume, proximal pressure, and lung pressure demonstrate repeatability and accuracy exceeding human capabilities in BVM-based manual ventilation. Future work is necessary to further develop and test the system to make it acceptable for deployment outside of emergencies such as with COVID-19 pandemic in clinical environments, however, the nature of the design is such that desired features are relatively easy to add using protocols and parametric design files provided.
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Affiliation(s)
- Aliaksei Petsiuk
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
| | - Nagendra G Tanikella
- Department of Materials Science & Engineering, Michigan Technological University, USA
| | | | - Adam Pringle
- Department of Materials Science & Engineering, Michigan Technological University, USA
| | - Shane Oberloier
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
| | - Joshua M Pearce
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
- Department of Materials Science & Engineering, Michigan Technological University, USA
- Équipe de Recherche sur les Processus Innovatifs (ERPI) , Université de Lorraine, France
- School of Electrical Engineering, Aalto University, Finland
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7
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Petsiuk A, Tanikella NG, Dertinger S, Pringle A, Oberloier S, Pearce JM. Partially RepRapable automated open source bag valve mask-based ventilator. HARDWAREX 2020; 8:e00131. [PMID: 32835141 PMCID: PMC7417990 DOI: 10.1016/j.ohx.2020.e00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/23/2020] [Accepted: 07/30/2020] [Indexed: 05/18/2023]
Abstract
This study describes the development of a simple and easy-to-build portable automated bag valve mask (BVM) compression system, which, during acute shortages and supply chain disruptions can serve as a temporary emergency ventilator. The resuscitation system is based on the Arduino controller with a real-time operating system installed on a largely RepRap 3-D printable parametric component-based structure. The cost of the materials for the system is under $170, which makes it affordable for replication by makers around the world. The device provides a controlled breathing mode with tidal volumes from 100 to 800 mL, breathing rates from 5 to 40 breaths/minute, and inspiratory-to-expiratory ratio from 1:1 to 1:4. The system is designed for reliability and scalability of measurement circuits through the use of the serial peripheral interface and has the ability to connect additional hardware due to the object-oriented algorithmic approach. Experimental results after testing on an artificial lung for peak inspiratory pressure (PIP), respiratory rate (RR), positive end-expiratory pressure (PEEP), tidal volume, proximal pressure, and lung pressure demonstrate repeatability and accuracy exceeding human capabilities in BVM-based manual ventilation. Future work is necessary to further develop and test the system to make it acceptable for deployment outside of emergencies such as with COVID-19 pandemic in clinical environments, however, the nature of the design is such that desired features are relatively easy to add using protocols and parametric design files provided.
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Affiliation(s)
- Aliaksei Petsiuk
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
| | - Nagendra G. Tanikella
- Department of Materials Science & Engineering, Michigan Technological University, USA
| | | | - Adam Pringle
- Department of Materials Science & Engineering, Michigan Technological University, USA
| | - Shane Oberloier
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
| | - Joshua M. Pearce
- Department of Electrical & Computer Engineering, Michigan Technological University, USA
- Department of Materials Science & Engineering, Michigan Technological University, USA
- Équipe de Recherche sur les Processus Innovatifs (ERPI) , Université de Lorraine, France
- School of Electrical Engineering, Aalto University, Finland
- Corresponding author.
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Vidakis N, Petousis M, Velidakis E, Liebscher M, Tzounis L. Three-Dimensional Printed Antimicrobial Objects of Polylactic Acid (PLA)-Silver Nanoparticle Nanocomposite Filaments Produced by an In-Situ Reduction Reactive Melt Mixing Process. Biomimetics (Basel) 2020; 5:biomimetics5030042. [PMID: 32887263 PMCID: PMC7559372 DOI: 10.3390/biomimetics5030042] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/18/2022] Open
Abstract
In this study, an industrially scalable method is reported for the fabrication of polylactic acid (PLA)/silver nanoparticle (AgNP) nanocomposite filaments by an in-situ reduction reactive melt mixing method. The PLA/AgNP nanocomposite filaments have been produced initially reducing silver ions (Ag+) arising from silver nitrate (AgNO3) precursor mixed in the polymer melt to elemental silver (Ag0) nanoparticles, utilizing polyethylene glycol (PEG) or polyvinyl pyrrolidone (PVP), respectively, as macromolecular blend compound reducing agents. PEG and PVP were added at various concentrations, to the PLA matrix. The PLA/AgNP filaments have been used to manufacture 3D printed antimicrobial (AM) parts by Fused Filament Fabrication (FFF). The 3D printed PLA/AgNP parts exhibited significant AM properties examined by the reduction in Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) bacteria viability (%) experiments at 30, 60, and 120 min duration of contact (p < 0.05; p-value (p): probability). It could be envisaged that the 3D printed parts manufactured and tested herein mimic nature’s mechanism against bacteria and in terms of antimicrobial properties, contact angle for their anti-adhesive behavior and mechanical properties could create new avenues for the next generation of low-cost and on-demand additive manufacturing produced personal protective equipment (PPE) as well as healthcare and nosocomial antimicrobial equipment.
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Affiliation(s)
- Nectarios Vidakis
- Mechanical Engineering Department, Hellenic Mediterranean University, Estavromenos, 71004 Heraklion, Crete, Greece; (N.V.); (E.V.)
| | - Markos Petousis
- Mechanical Engineering Department, Hellenic Mediterranean University, Estavromenos, 71004 Heraklion, Crete, Greece; (N.V.); (E.V.)
- Correspondence: ; Tel.: +30-2810-37-9227
| | - Emmanouel Velidakis
- Mechanical Engineering Department, Hellenic Mediterranean University, Estavromenos, 71004 Heraklion, Crete, Greece; (N.V.); (E.V.)
| | - Marco Liebscher
- Institute of Construction Materials, Technische Universität Dresden, DE-01062 Dresden, Germany;
| | - Lazaros Tzounis
- Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
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Tzounis L, Bangeas PI, Exadaktylos A, Petousis M, Vidakis N. Three-Dimensional Printed Polylactic Acid (PLA) Surgical Retractors with Sonochemically Immobilized Silver Nanoparticles: The Next Generation of Low-Cost Antimicrobial Surgery Equipment. NANOMATERIALS 2020; 10:nano10050985. [PMID: 32455641 PMCID: PMC7279541 DOI: 10.3390/nano10050985] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/09/2020] [Accepted: 05/17/2020] [Indexed: 01/17/2023]
Abstract
A versatile method is reported for the manufacturing of antimicrobial (AM) surgery equipment utilising fused deposition modelling (FDM), three-dimensional (3D) printing and sonochemistry thin-film deposition technology. A surgical retractor was replicated from a commercial polylactic acid (PLA) thermoplastic filament, while a thin layer of silver (Ag) nanoparticles (NPs) was developed via a simple and scalable sonochemical deposition method. The PLA retractor covered with Ag NPs (PLA@Ag) exhibited vigorous AM properties examined by a reduction in Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Escherichia coli (E. coli) bacteria viability (%) experiments at 30, 60 and 120 min duration of contact (p < 0.05). Scanning electron microscopy (SEM) showed the surface morphology of bare PLA and PLA@Ag retractor, revealing a homogeneous and full surface coverage of Ag NPs. X-Ray diffraction (XRD) analysis indicated the crystallinity of Ag nanocoating. Ultraviolent-visible (UV-vis) spectroscopy and transmission electron microscopy (TEM) highlighted the AgNP plasmonic optical responses and average particle size of 31.08 ± 6.68 nm. TEM images of the PLA@Ag crossection demonstrated the thickness of the deposited Ag nanolayer, as well as an observed tendency of AgNPs to penetrate though the outer surface of PLA. The combination of 3D printing and sonochemistry technology could open new avenues in the manufacturing of low-cost and on-demand antimicrobial surgery equipment.
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Affiliation(s)
- Lazaros Tzounis
- Composite and Smart Materials Laboratory (CSML), Department of Materials Science & Engineering, University of Ioannina, GR-45110 Ioannina, Greece
- Correspondence: (L.T.); (N.V.); Tel.: +30-26510-09024 (L.T.); +30-2810-379833 (N.V.)
| | - Petros I. Bangeas
- Department of emergency medicine, INSELSPITAL, Universitätsspital Bern, 18, 3010 Bern, Switzerland; (P.I.B.); (A.E.)
| | - Aristomenis Exadaktylos
- Department of emergency medicine, INSELSPITAL, Universitätsspital Bern, 18, 3010 Bern, Switzerland; (P.I.B.); (A.E.)
| | - Markos Petousis
- Mechanical Engineering Department, Hellenic Mediterranean University, Estavromenos, 71004 Heraklion, Crete, Greece;
| | - Nectarios Vidakis
- Mechanical Engineering Department, Hellenic Mediterranean University, Estavromenos, 71004 Heraklion, Crete, Greece;
- Correspondence: (L.T.); (N.V.); Tel.: +30-26510-09024 (L.T.); +30-2810-379833 (N.V.)
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10
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Chen JV, Tanaka KS, Dang ABC, Dang A. Identifying a commercially-available 3D printing process that minimizes model distortion after annealing and autoclaving and the effect of steam sterilization on mechanical strength. 3D Print Med 2020; 6:9. [PMID: 32297041 PMCID: PMC7161250 DOI: 10.1186/s41205-020-00062-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fused deposition modeling 3D printing is used in medicine for diverse purposes such as creating patient-specific anatomical models and surgical instruments. For use in the sterile surgical field, it is necessary to understand the mechanical behavior of these prints across 3D printing materials and after autoclaving. It has been previously understood that steam sterilization weakens polylactic acid, however, annealing heat treatment of polylactic acid increases its crystallinity and mechanical strength. We aim to identify an optimal and commercially available 3D printing process that minimizes distortion after annealing and autoclaving and to quantify mechanical strength after these interventions. METHODS Thirty millimeters cubes with four different infill geometries were 3D printed and subjected to hot water-bath annealing then immediate autoclaving. Seven commercially available 3D printing materials were tested to understand their mechanical behavior after intervention. The dimensions in the X, Y, and Z axes were measured before and after annealing, and again after subsequent autoclaving. Standard and strength-optimized Army-Navy retractor designs were printed using the 3D printing material and infill geometry that deformed the least. These retractors were subjected to annealing and autoclaving interventions and tested for differences in mechanical strength. RESULTS For both the annealing and subsequent autoclaving intervention, the material and infill geometry that deformed the least, respectively, was Essentium PLA Gray and "grid". Standard retractors without intervention failed at 95 N +/- 2.4 N. Annealed retractors failed at 127.3 N +/- 10 N. Autoclave only retractors failed at 15.7 N +/- 1.4 N. Annealed then autoclaved retractors failed at 19.8 N +/- 3.1 N. Strength-optimized retractors, after the annealing then autoclaving intervention, failed at 164.8 N +/- 12.5 N. CONCLUSION For 30 mm cubes, the 3D printing material and infill geometry that deformed the least, respectively, was Essentium PLA and "grid". Hot water-bath annealing results in increased 3D printed model strength, however autoclaving 3D prints markedly diminishes strength. Strength-optimized 3D printed PLA Army-Navy retractors overcome the strength limitation due to autoclaving.
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Affiliation(s)
- Joshua V. Chen
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
| | - Kara S. Tanaka
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
| | - Alan B. C. Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
- Department of Surgery, Orthopaedic Section, San Francisco VA Health Care System, San Francisco, CA USA
| | - Alexis Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
- Department of Surgery, Orthopaedic Section, San Francisco VA Health Care System, San Francisco, CA USA
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Abstract
Coronavirus Disease 2019 (COVID-19) threatens to overwhelm our medical infrastructure at the regional level causing spikes in mortality rates because of shortages of critical equipment, like ventilators. Fortunately, with the recent development and widespread deployment of small-scale manufacturing technologies like RepRap-class 3-D printers and open source microcontrollers, mass distributed manufacturing of ventilators has the potential to overcome medical supply shortages. In this study, after providing a background on ventilators, the academic literature is reviewed to find the existing and already openly-published, vetted designs for ventilators systems. These articles are analyzed to determine if the designs are open source both in spirit (license) as well as practical details (e.g. possessing accessible design source files, bill of materials, assembly instructions, wiring diagrams, firmware and software as well as operation and calibration instructions). Next, the existing Internet and gray literature are reviewed for open source ventilator projects and designs. The results of this review found that the tested and peer-reviewed systems lacked complete documentation and the open systems that were documented were either at the very early stages of design (sometimes without even a prototype) and were essentially only basically tested (if at all). With the considerably larger motivation of an ongoing pandemic, it is assumed these projects will garner greater attention and resources to make significant progress to reach a functional and easily-replicated system. There is a large amount of future work needed to move open source ventilators up to the level considered scientific-grade equipment, and even further work needed to reach medical-grade hardware. Future work is needed to achieve the potential of this approach by developing policies, updating regulations, and securing funding mechanisms for the development and testing of open source ventilators for both the current COVID19 pandemic as well as for future pandemics and for everyday use in low-resource settings.
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Affiliation(s)
- Joshua M. Pearce
- Department of Materials Science & Engineering and Department of Electrical & Computer Engineering, Michigan Technological University, Houghton, MI, 49931, USA
- Équipe de Recherche sur les Processus Innovatifs (ERPI), Université de Lorraine, Nancy, France
- School of Electrical Engineering, Aalto University, Helsinki, Finland
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12
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Abstract
Coronavirus Disease 2019 (COVID-19) threatens to overwhelm our medical infrastructure at the regional level causing spikes in mortality rates because of shortages of critical equipment, like ventilators. Fortunately, with the recent development and widespread deployment of small-scale manufacturing technologies like RepRap-class 3-D printers and open source microcontrollers, mass distributed manufacturing of ventilators has the potential to overcome medical supply shortages. In this study, after providing a background on ventilators, the academic literature is reviewed to find the existing and already openly-published, vetted designs for ventilators systems. These articles are analyzed to determine if the designs are open source both in spirit (license) as well as practical details (e.g. possessing accessible design source files, bill of materials, assembly instructions, wiring diagrams, firmware and software as well as operation and calibration instructions). Next, the existing Internet and gray literature are reviewed for open source ventilator projects and designs. The results of this review found that the tested and peer-reviewed systems lacked complete documentation and the open systems that were documented were either at the very early stages of design (sometimes without even a prototype) and were essentially only basically tested (if at all). With the considerably larger motivation of an ongoing pandemic, it is assumed these projects will garner greater attention and resources to make significant progress to reach a functional and easily-replicated system. There is a large amount of future work needed to move open source ventilators up to the level considered scientific-grade equipment, and even further work needed to reach medical-grade hardware. Future work is needed to achieve the potential of this approach by developing policies, updating regulations, and securing funding mechanisms for the development and testing of open source ventilators for both the current COVID19 pandemic as well as for future pandemics and for everyday use in low-resource settings.
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Affiliation(s)
- Joshua M. Pearce
- Department of Materials Science & Engineering and Department of Electrical & Computer Engineering, Michigan Technological University, Houghton, MI, 49931, USA
- Équipe de Recherche sur les Processus Innovatifs (ERPI), Université de Lorraine, Nancy, France
- School of Electrical Engineering, Aalto University, Helsinki, Finland
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