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
