Pulumati Anika, Algarin Yanci A, Kim Sarah, Latta Steven, Li Jeffrey N, Nouri Keyvan
University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA.
Arch Dermatol Res. 2024 May 2;316(5):147. doi: 10.1007/s00403-024-02893-6.
Mohs Micrographic Surgery (MMS) is effective for treating common cutaneous malignancies, but complex repairs may often present challenges for reconstruction. This paper explores the potential of three-dimensional (3D) bioprinting in MMS, offering superior outcomes compared to traditional methods. 3D printing technologies show promise in advancing skin regeneration and refining surgical techniques in dermatologic surgery. A PubMed search was conducted using the following keywords: "Three-dimensional bioprinting" OR "3-D printing" AND "Mohs" OR "Mohs surgery" OR "Surgery." Peer-reviewed English articles discussing medical applications of 3D bioprinting were included, while non-peer-reviewed and non-English articles were excluded. Patients using 3D MMS models had lower anxiety scores (3.00 to 1.7, p < 0.0001) and higher knowledge assessment scores (5.59 or 93.25% correct responses), indicating better understanding of their procedure. Surgical residents using 3D models demonstrated improved proficiency in flap reconstructions (p = 0.002) and knowledge assessment (p = 0.001). Additionally, 3D printing offers personalized patient care through tailored surgical guides and anatomical models, reducing intraoperative time while enhancing surgical. Concurrently, efforts in tissue engineering and regenerative medicine are being explored as potential alternatives to address organ donor shortages, eliminating autografting needs. However, challenges like limited training and technological constraints persist. Integrating optical coherence tomography with 3D bioprinting may expedite grafting, but challenges remain in pre-printing grafts for complex cases. Regulatory and ethical considerations are paramount for patient safety, and further research is needed to understand long-term effects and cost-effectiveness. While promising, significant advancements are necessary for full utilization in MMS.
莫氏显微外科手术（MMS）在治疗常见皮肤恶性肿瘤方面有效，但复杂修复通常会给重建带来挑战。本文探讨了三维（3D）生物打印在MMS中的潜力，与传统方法相比，其效果更佳。3D打印技术在推进皮肤再生和完善皮肤科手术技术方面显示出前景。使用以下关键词在PubMed上进行了搜索：“三维生物打印”或“3D打印”以及“莫氏”或“莫氏手术”或“手术”。纳入了讨论3D生物打印医学应用的同行评审英文文章，排除了非同行评审和非英文文章。使用3D MMS模型的患者焦虑评分较低（从3.00降至1.7，p < 0.0001），知识评估得分较高（5.59或93.25%正确回答），表明对手术过程有更好的理解。使用3D模型的外科住院医师在皮瓣重建（p = 0.002）和知识评估（p = 0.001）方面表现出更高的熟练度。此外，3D打印通过定制手术导板和解剖模型提供个性化患者护理，减少术中时间同时提高手术效果。同时，正在探索组织工程和再生医学方面的努力，作为解决器官供体短缺的潜在替代方案，消除自体移植需求。然而，诸如培训有限和技术限制等挑战仍然存在。将光学相干断层扫描与3D生物打印相结合可能会加快移植速度，但在为复杂病例预打印移植物方面仍存在挑战。监管和伦理考量对患者安全至关重要，需要进一步研究以了解长期影响和成本效益。虽然前景广阔，但要在MMS中充分利用仍需重大进展。
