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

<h4>Objectives</h4> 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 r...

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Autores principales:	Karen Sui Geok Chua, Rathi Ratha Krishnan, Jia Min Yen, Tegan Kate Plunkett, Yan Ming Soh, Chien Joo Lim, Catherine M. Chia, Jun Cong Looi, Suan Gek Ng, Jai Rao
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/eab32cc898734b079b7e4d7fbcd22277
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spelling	oai:doaj.org-article:eab32cc898734b079b7e4d7fbcd222772021-11-04T06:49:32Z3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study1932-6203https://doaj.org/article/eab32cc898734b079b7e4d7fbcd222772021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553164/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4> 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. <h4>Materials and methods</h4> 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. <h4>Results</h4> 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. <h4>Discussion</h4> 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. <h4>Conclusion</h4> This study suggests the potential for wider 3DP technology applications to provide cranial protection for this vulnerable population.Karen Sui Geok ChuaRathi Ratha KrishnanJia Min YenTegan Kate PlunkettYan Ming SohChien Joo LimCatherine M. ChiaJun Cong LooiSuan Gek NgJai RaoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karen Sui Geok Chua Rathi Ratha Krishnan Jia Min Yen Tegan Kate Plunkett Yan Ming Soh Chien Joo Lim Catherine M. Chia Jun Cong Looi Suan Gek Ng Jai Rao 3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
description	<h4>Objectives</h4> 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. <h4>Materials and methods</h4> 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. <h4>Results</h4> 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. <h4>Discussion</h4> 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. <h4>Conclusion</h4> This study suggests the potential for wider 3DP technology applications to provide cranial protection for this vulnerable population.
format	article
author	Karen Sui Geok Chua Rathi Ratha Krishnan Jia Min Yen Tegan Kate Plunkett Yan Ming Soh Chien Joo Lim Catherine M. Chia Jun Cong Looi Suan Gek Ng Jai Rao
author_facet	Karen Sui Geok Chua Rathi Ratha Krishnan Jia Min Yen Tegan Kate Plunkett Yan Ming Soh Chien Joo Lim Catherine M. Chia Jun Cong Looi Suan Gek Ng Jai Rao
author_sort	Karen Sui Geok Chua
title	3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
title_short	3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
title_full	3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
title_fullStr	3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
title_full_unstemmed	3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study
title_sort	3d-printed external cranial protection following decompressive craniectomy after brain injury: a pilot feasibility cohort study
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/eab32cc898734b079b7e4d7fbcd22277
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3D-printed external cranial protection following decompressive craniectomy after brain injury: A pilot feasibility cohort study

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