Hussein Sara M, Kuruoglu Doga, Morris Jonathan M, Sears Victoria A, Shehab Abdallah A, Gibreel Waleed, Sharaf Basel A
Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Neural Engineering and Precision Surgery Laboratories, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Med. 2025 Apr 17;14(8):2788. doi: 10.3390/jcm14082788.
: Despite increased adoption of virtual surgical planning (VSP) in various craniofacial indications, the incorporation of VSP/3DP into facial trauma care remains limited. Therefore, Expedited Preoperative Point of Care for Fracture Reduction to Normalized Anatomy and 3DP to Improve Surgical Outcomes (EPPOCRATIS) was introduced in 2021. This study evaluates our experience with EPPORATIS in craniomaxillofacial trauma over 10 years. : A retrospective review of patients who underwent facial trauma repair between September 2014 and September 2024 was conducted. For each VSP/3DP case, a patient with similar facial trauma patterns, who was treated without VSP, was selected. Evaluation metrics included operative time, blood loss, length of stay, complication rates, and fracture reduction accuracy through 3D heatmap analyses. Operative metrics were normalized by implant (i.e., fracture plates and screws) count to account for fracture complexity. A value of < 0.05 was deemed statistically significant. : The VSP group presented with more complex injuries and higher involvement of various surgical specialties ( < 0.5) and demonstrated longer operative times ( < 0.03). Although the difference was not statistically significant ( = 0.4), when adjusted for implant count, the VSP group had shorter operative times (median: 15.4 vs. 19.3 min/implant) and reduced blood loss compared to non-VSP cases (median: 3.4 mL/implant vs. 4.2 mL/implant). Complications, revision rates, and length of stay showed no significant differences. The use of VSP/3DP (EPPOCRATIS) in craniomaxillofacial trauma reconstruction demonstrated operative efficiency and accurate fracture reduction in complex cases. Further studies are needed to examine the feasibility and cost-effectiveness of point-of-care VSP/3DP in trauma centers.
尽管虚拟手术规划(VSP)在各种颅面适应症中的应用有所增加,但将VSP/3DP纳入面部创伤治疗的情况仍然有限。因此,2021年引入了骨折复位至正常解剖结构的快速术前即时护理和3DP以改善手术结果(EPPOCRATIS)。本研究评估了我们在10年期间使用EPPORATIS治疗颅颌面创伤的经验。:对2014年9月至2024年9月期间接受面部创伤修复的患者进行了回顾性研究。对于每例VSP/3DP病例,选择一名面部创伤模式相似但未接受VSP治疗的患者。评估指标包括手术时间、失血量、住院时间、并发症发生率以及通过3D热图分析得出的骨折复位准确性。手术指标通过植入物(即骨折板和螺钉)数量进行标准化,以考虑骨折的复杂性。P值<0.05被认为具有统计学意义。:VSP组的损伤更复杂,涉及的外科专科更多(P<0.5),手术时间更长(P<0.03)。尽管差异无统计学意义(P = 0.4),但在调整植入物数量后,与非VSP病例相比,VSP组的手术时间更短(中位数:15.4分钟/植入物对19.3分钟/植入物),失血量减少(中位数:3.4毫升/植入物对4.2毫升/植入物)。并发症、翻修率和住院时间无显著差异。在颅颌面创伤重建中使用VSP/3DP(EPPOCRATIS)在复杂病例中显示出手术效率和准确的骨折复位。需要进一步研究以检验创伤中心即时护理VSP/3DP的可行性和成本效益。