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J Reconstr Microsurg 2025; 41(05): 432-442
DOI: 10.1055/a-2404-7819
Original Article

Computer-Aided Design and Manufacturing to Facilitate Microvascular Free Tissue Transfer in Extremity, Pelvic, and Spinal Reconstructions

Alec D. Simoni
1   The University of Arizona College of Medicine, Phoenix, Arizona
,
Justin E. Bird
2   Department of Orthopedic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
,
Patrick P. Lin
2   Department of Orthopedic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
,
Laurence D. Rhines
3   Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
,
Alexander F. Mericli
4   Department of Plastic Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
› Author Affiliations Funding Alexander F. Mericli, MD:
1. Mentor Worldwide, LLC: Scientific Advisory Board Member and Consultant.
2. Allergan, Inc: Consultant.
3. Destiny Pharma, PLC: Consultant.
Laurence Rhines, MD:
1. Stryker: Consultant.
2. Icotec Medical, Inc: Consultant.
Patrick P. Lin, MD:
1. MTF: Medical Board of Trustees.
› Further Information
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Abstract

Background Numerous surgical fields have embraced computer-aided design and computer-aided manufacturing (CAD/CAM), including plastic and reconstructive surgery. However, most of the literature and clinical use pertains to reconstruction of the head and neck. Herein, we provide a case series and systematic review of the literature, documenting the use of CAD/CAM in facilitating complex microvascular free tissue transfer for reconstructions involving the extremities, pelvis, and spine (EPS).

Methods This study consisted of two components: a case series and a systematic review of the literature. For the case series, the senior author's cases that included CAD/CAM to assist microvascular free tissue transfer reconstructions of the EPS were included. For the systematic review, all PubMed-, Scopus-, and Google Scholar–indexed studies describing the use of CAD/CAM to facilitate free tissue transfer in the EPS were identified and included using PRSMA guidelines.

Results The case series identified 10 patients who received CAD/CAM-assisted microvascular reconstruction. Our systematic review identified 15 articles, representing 124 patients and 133 CAD/CAM-assisted free tissue transfers. Most authors believed that CAD/CAM facilitated a more efficient operation by shifting much of the intraoperative planning to the preoperative phase, ultimately translating to a shorter and more accurate surgery with improved function and cosmesis.

Conclusion CAD/CAM can be used to facilitate microvascular reconstruction of the EPS. Our cases series and systematic review suggest that CAD/CAM for EPS surgery may improve outcomes.

Keywords

CAD/CAM - virtual surgical planning - free flap - microsurgery - extremity - pelvis - spine

Supplementary Material



Publication History

Received: 22 May 2024

Accepted: 12 August 2024

Accepted Manuscript online:
27 August 2024

Article published online:
27 September 2024

© 2024. Thieme. All rights reserved.

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