Clinical Outcomes and Cost Analysis of Fibula Free Flaps: A Retrospective Comparison of CAD/CAM versus Conventional Technique

(1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperativ...

Descripción completa

Detalles Bibliográficos
Autores: Rodríguez Arias, Juan Pablo, Tapia, Blanca, Pampín Martínez, Marta María, Morán, María José, Gonzalez, Javier, Barajas, Maria, Castillo, Jose Luis del, Navarro Cuéllar, Carlos, Cebrián, José Luis
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/72159
Acceso en línea:https://hdl.handle.net/20.500.14352/72159
Access Level:acceso abierto
Palabra clave:617.52
Oral cancer
Head and neck tumor
Fibula free flap
Virtual surgical planning
CAD/CAM
Cost analysis
Medicina
Cirugía
Diagnóstico por imagen y medicina nuclear
Oncología
32 Ciencias Médicas
3213 Cirugía
3204.01 Medicina Nuclear
3201.01 Oncología
Descripción
Sumario:(1) Background: A decrease in operative time can not only improve patient outcomes through a reduction in the risk of developing complications but can also result in cost savings. The aim of this study is to determine whether there an intraoperative time gain can be achieved by using the preoperative virtual planning of mandibular reconstruction using a free fibula flap compared with freehand plate bending and osteotomies. (2) Methods: A retrospective comparative study was carried out in the Oral and Maxillofacial Department of La Paz University Hospital, Madrid, Spain. The study compared 18 patients in the CAD/CAM group with 19 patients in the conventional freehand group. A comparison was made between the total surgical time, the comorbidities, and the hospital stay. The resource consumption was estimated using a cost analysis. (3) Results: Although CAD/CAM was a statistically more expensive procedure in the perioperative phase, no significant differences were observed in total health care costs between the two groups. There was a non-significant trend towards an increase in complications with conventional reconstruction plates compared to patient-specific plates (PSI). (4) Conclusions: CAD/CAM technology and a 3D printed cutting guide offer a significantly shorter surgical time, which is associated with a reduction in hospital days, PACU days, and complications. The cost of CAD/CAM technology is comparable to that of the conventional freehand technique.