How to Sterilize 3D Printed Objects for Surgical Use? An Evaluation of the Volumetric Deformation of 3D-Printed Genioplasty Guide in PLA and PETG after Sterilization by Low-Temperature Hydrogen Peroxide Gas Plasma

Abstract

Introduction: In the present time, there is rapid development in the application of 3D printing technology in surgery. One of the challenges encountered by the surgeon is the sterilization of these 3D-printed objects for use in the operating room. Materials and Methods: Forty-two identical cutting guides used for genioplasty were 3D-printed: twenty-one in Polylactic acid (PLA) and twenty-one in Polyethylene terephthalate glycol (PETG). The guides were CT scanned after printing. They were then sterilized with the low-temperature hydrogen peroxide gas plasma technique (Sterrad®). A CT scan of the guides was also performed at T1 (after printing) and T2 (after sterilization). A software (Cloudcompare ®) was then used to accurately compare the volume of each guide at T0 (the initial computer-aided designed guide) vs T1 and T1 vs T2. Statistical analysis was then performed. Results: Although there are differences that are statistically significant for each series between T0 and T2 and T1 and T2 for both PLA and PETG, this had no impact on the clinical use of sterilized objects using hydrogen peroxide sterilization technique because these morphological differences were minimal at less than 0.2mm. Conclusion: Morphological deformations induced by the hydrogen peroxide sterilization are sub-millimeter and acceptable for surgical use. The hydrogen peroxide sterilization is, therefore, an alternative to avoid the deformation of 3D-printed objects made from PLA and PETG during conventional steam sterilization (autoclave). To the best of our knowledge, this is the first study regarding the morphologic deformation of 3D-printed objects in PLA and PETG after sterilization for medical use.

Geometric accuracy of an acrylonitrile butadiene styrene canine tibia model fabricated using fused deposition modelling and the effects of hydrogen peroxide gas plasma sterilisation

“…In order to use optimal parameter settings for segmentation procedure from CT scanning to virtual model reconstruction, in the present study, we used certi ed commercial software a that speci es accuracy is below scanning resolution and clinical relevance [29]. This means the bone models can be used for presurgical rehearsal and further clinically relevant applications in bone surgery [3,30].…”

Does Low-Temperature Sterilization Affect the Geometrical Properties of 3D Printed Models and Surgical Guides from a Reconstruction of CT Images using the Mimics Innovation Suite?

“…The sterilization methods adequate for different 3D-printing materials have been tested in terms of infection rate, mechanical performance, and dimensional stability, or, on the contrary, geometrical deformation (7,9,15,(19)(20)(21). Low-temperature hydrogen peroxide gas plasma has been an optimal sterilization procedure for printouts produced by FDP in ABS.…”

3-D Printed Protective Equipment during COVID-19 Pandemic

“…Visors can be manufactured from several types of materials that include polycarbonate, propionate, acetate, poly(vinylchloride), and PETG [9]. Since PLA and PETG are known to show volume change during sterilization processes [21], one-time use of the visor is recommended, whereas a study showed that sterilized 3-D printed surgical splints using filaments based on lignin (Green-TEC Pro) remained dimensionally stable [22]. The sterilization of the frame might be possible, but was not tested in this study.…”