From Academia: Four-axis 3D printing, Efficacy of 3D printed model for breast cancer reconstruction, and Cultured Meat

Category: Blog,From Academia
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From Academia” features recent, relevant, close to commercialization academic publications in the space of healthcare 3D printing, 3D bioprinting, and related emerging technologies. In this issue, we selected a recent paper on using four-axis extrusion-based 3D printing method to create a tubular scaffold, a paper from Stanford demonstrating clinical efficacy using 3D printed model for preoperative planning in breast cancer reconstruction surgeries, and a paper focusing on the science and potential of 3D printing in cultured meat.

Email: Rance Tino (tino.rance@gmail.com) if you want to pen an Expert Corner blog for us or want to share relevant academic publications with us.

Controllable four axis extrusion-based additive manufacturing system for the fabrication of tubular scaffolds with tailorable mechanical properties

– Authored by Kenny A. van Kampen, Elena Olaret, Izabela-Cristina Stancu, Lorenzo Moroni, Carlos Mota. Materials Science and Engineering: C, 30 August 2020 

Fourth axis extrusion-based system. (A) Schematic overview of the fabrication process. (B) Examples of possible designs that can be manufactured with the fourth axis FDM system. (C) Rectangular pore design with rings and struts that can be introduced. (D) Diamond pore design with the amount of helices and rotations that can be varied in the design. Copyright. Materials Science and Engineering: C
Fourth axis extrusion-based system. (A) Schematic overview of the fabrication process. (B) Examples of possible designs that can be manufactured with the fourth axis FDM system. (C) Rectangular pore design with rings and struts that can be introduced. (D) Diamond pore design with the number of helices and rotations that can be varied in the design. Copyright. Materials Science and Engineering:
Three-point bending at 40% deformation on the 5R9S design. (A) Three-point bending at 40% deformation on the 5R9S design when the probe is centred on top of the ring. (B) Three-point bending at 40% deformation on the 5R9S design when the probe is centred between two rings. (C) Difference in luminal diameter at 40% deformation during three-point bending on the 5R9S design. Copyright. Materials Science and Engineering: C
Three-point bending at 40% deformation on the 5R9S design. (A) Three-point bending at 40% deformation on the 5R9S design when the probe is centred on top of the ring. (B) Three-point bending at 40% deformation on the 5R9S design when the probe is centred between two rings. (C) Difference in luminal diameter at 40% deformation during three-point bending on the 5R9S design. Copyright. Materials Science and Engineering: C

Abstract: 

Many tubular tissues such as blood vessels and trachea can suffer long-segmental defects through trauma and disease. With current limitations in the use of autologous grafts, the need for a synthetic substitute is of continuous interest as possible alternatives. Fabrication of these tubular organs is commonly done with techniques such as electrospinning and melt electrowriting using a rotational collector. Current additive manufacturing (AM) systems do not commonly implement the use of a rotational axis, which limits their application for the fabrication of tubular scaffolds. In this study, a four-axis extrusion-based AM system similar to fused deposition modeling (FDM) has been developed to create tubular hollow scaffolds. A rectangular and a diamond pore design were further investigated for mechanical characterization, as a standard and a biomimicry pore geometry respectively. We demonstrated that in the radial compression mode the diamond pore design had a higher Young’s modulus (19,8 ± 0,7 MPa compared to 2,8 ± 0,5 MPa), while in the longitudinal tensile mode the rectangular pore design had a higher Young’s modulus (5,8 ± 0,2 MPa compared to 0,1 ± 0,01 MPa). Three-point bending analyses revealed that the diamond pore design is more resistant to luminal collapse compared to the rectangular design. This data showed that by changing the scaffold pore design, a wide range of mechanical properties could be obtained. Furthermore, full control over scaffold design and geometry can be achieved with the developed 4-axis extrusion-based system, which has not been reported with other techniques. This flexibility allows the manufacturing of scaffolds for diverse tubular tissue regeneration applications by designing suitable deposition patterns to match their mechanical pre-requisites.

The utility of three-dimensional models in complex microsurgical reconstruction

– Authored by Adeyemi A. Ogunleye, Peter L. Deptula, Suzie M. Inchauste, Justin T. Zelones, Shannon Walters, Kyle Gifford, Chris Le Castillo, Sandy Napel, Dominik Fleischmann, Dung H. Nguyen. Archives of Plastic Surgery. 15 September 2020

3D model for vascularized lymph node transfer. Preoperative computed tomography angiography (CTA) (A) and three-dimensional (3D) printed model (B) demonstrate the availability of the medial circumflex femoral recipient vessels for vascularized lymph node transfer (C). The preoperative images and model accurately predict the anatomy seen intraoperatively. The white arrows indicate the medial circumflex femoral artery. Preoperative CTA (D) and 3D printed model (E) demonstrate a patent lateral sural artery recipient site for vascularized lymph node transfer. The preoperative models accurately guide the intraoperative dissection (F). The white and black arrows demonstrate the lateral sural artery. 3D printed model (H) based on preoperative CTA (G) accurately predicts the availability of anterior tibial artery recipient site for vascularized lymph node transfer. The models accurately reflect the vascular anatomy encountered intraoperatively (I). The white and black arrows indicated the anterior tibial artery. Copyright. Archives of Plastic Surgery
3D model for vascularized lymph node transfer. Preoperative computed tomography angiography (CTA) (A) and three-dimensional (3D) printed model (B) demonstrate the availability of the medial circumflex femoral recipient vessels for vascularized lymph node transfer (C). The preoperative images and model accurately predict the anatomy seen intraoperatively. The white arrows indicate the medial circumflex femoral artery. Preoperative CTA (D) and 3D printed model (E) demonstrate a patent lateral sural artery recipient site for vascularized lymph node transfer. The preoperative models accurately guide the intraoperative dissection (F). The white and black arrows demonstrate the lateral sural artery. 3D printed model (H) based on preoperative CTA (G) accurately predicts the availability of anterior tibial artery recipient site for vascularized lymph node transfer. The models accurately reflect the vascular anatomy encountered intraoperatively (I). The white and black arrows indicated the anterior tibial artery. Copyright. Archives of Plastic Surgery

Abstract: 

Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes. A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction. Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with the use of the 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in the preoperative decision on the type of flap harvested in all cases in the 3D print group (0%), compared with a 24.1% change in the conventional CTA group. The use of 3D print model improves the accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.

3D Printing of cultured meat products

– Authored by Harish K. Handral, Shi Hua Tay, Weng Wan Chan & Deepak Choudhury. Critical Reviews in Food Science and Nutrition. 21 September 2020

Schematic diagram of the cultured meat production process. Stem cells are obtained from the animal and seeded onto scaffolds before inserting them into the bioreactor filled with growth media to culture meat. Copyright. Critical Reviews in Food Science and Nutrition
Schematic diagram of the cultured meat production process. Stem cells are obtained from the animal and seeded onto scaffolds before inserting them into the bioreactor filled with growth media to culture meat. Copyright. Critical Reviews in Food Science and Nutrition

Abstract: 

Three-dimensional (3D) printing is a fast-developing digital technology with colossal market scope in food and nutrition technology, providing a platform for establishing unique food products with enhanced sensory and nutritional value for a particular end-user. Cultured meat is the concept of producing meat sustainably in laboratory conditions without the sacrifice of animal life and the excessive use of antibiotics. 3D printing could offer unique solutions for the vital issues of cultured meat production; particularly on regulating the protein, fat, and other nutritional content, along with providing realistic texture. This review highlights the immense benefits of 3D printing technology for the scalable and reproducible production of cultured meat products.

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