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...

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Published inJournal of personalized medicine Vol. 12; no. 6; p. 930
Main Authors Rodríguez-Arias, Juan Pablo, Tapia, Blanca, Pampín, Marta María, Morán, Maria José, Gonzalez, Javier, Barajas, Maria, Del Castillo, Jose Luis, Navarro Cuéllar, Carlos, Cebrian, Jose Luis
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 07.06.2022
MDPI
Subjects
Aesthetics
CAS
Clinical outcomes
Comorbidity
Computer assisted surgery
Cost analysis
Cost control
Fibula
Health care
Hospitalization
Hospitals
Mandible
Maxillofacial
Ostomy
Patients
Planning
Postoperative period
Precision medicine
Reconstructive surgery
Rehabilitation
Tomography
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Summary:(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.
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ISSN:2075-4426
2075-4426
DOI:10.3390/jpm12060930