Cost Analysis for In-house versus Industry-printed Skull Models for Acute Midfacial Fractures

Abstract

Background: Industry-printed (IP) 3-dimensional (3D) models are commonly used for secondary midfacial reconstructive cases but not for acute cases due to their high cost and long turnaround time. We have begun using in-house (IH) printed models for complex unilateral midface trauma. We hypothesized that IH models would decrease cost and turnaround time, compared with IP models. Methods: We retrospectively examined cost and turnaround time data from midface trauma cases performed in 2017–2019 using 3D models (total, n = 15; IH, n = 10; IP, n = 5). Data for IH models were obtained through itemized cost reports from our Biomedical Engineering Department, where the models were printed. Data associated with IP models were obtained through itemized cost reports from our industry vendor. Perioperative data were collected from electronic medical records. Results: The average cost for IH models ($236.38 ± 26.17) was significantly less ( P < 0.001) than that for IP models ($1677.82 ± 488.43). Minimal possible time from planning to model delivery was determined. IH models could be produced in as little as 4.65 hours, whereas the IP models required a minimum of 5 days (120 hours) from order placement. There were no significant differences in average operating room time ( P = 0.34), surgical complications, or subjective outcomes, but there was a significant difference in estimated blood loss ( P = 0.04). Conclusion: Utilization of IH 3D skull models is a creative and practical adjunct to complex unilateral midfacial trauma that also reduces cost and turnaround time compared with IP 3D models.

Patient-Specific Implant Customization for Treatment of Internal Orbital Fractures Using Office-Based Three-Dimensional Printing

“…It has previously been shown that an office-based 3D printing workflow demonstrated improvements in operating room efficiency and cost-effectiveness, with satisfactory patient safety and outcomes in mandibular fractures. 2,5 In this study, we report a similar workflow in successfully repairing orbital fractures.…”

“…Disadvantages of in-house 3D printing have been the material costs associated with obtaining and using a 3D printer, the lack of experience and/or guidance in utilizing the software required to print the 3D models, and regulations for clinical application 4 . Consequently, patient-specific implant (PSI) models often rely on outsourcing to various vendors, which can add cost and delay fracture repair 5 …”

Advanced Preoperative Planning Techniques in the Management of Complex Proximal Humerus Fractures

“…Centres utilising 3D printing must take into account not only the cost of the physical printer but also the printing materials themselves [31]. A 2020 study evaluated the cost of in-house printing of mandibular models in facial trauma to be $1677.82/patient [32].…”

Virtual Planning and 3D Printing in the Management of Acute Orbital Fractures and Post-Traumatic Deformities

“…The cost breakdown of printing in-house came out to be $34.50 for software and disposable fees, $43.80 for segmentation, $11 for materials, $65.60 for print time fees, and $20.50 for production. 40 Thus, printing at the point-of-care can further decrease the cost of PSIs and increase their availability to patients.…”