A Novel Customized 3D Printed Arm Stand Improving Skin Preparation Efficiency in Hand Surgery

Abstract

Patient preparation for hand surgery often necessitates skin preparation via the use of an assistant to hold the arm to be operated on in mid-air while disinfectant is applied. This study introduces a three-dimensional printed arm stand that decreases dead time during skin preparation, while also enabling the more efficient use of an assistant. The arm stand devices were customized on the anatomy of the patients and then successfully used on patients having general or regional anesthesia. A practical, reusable, and effective three-dimensional printed arm stand has been developed and applied on both adult and pediatric patients. We have found the bespoke device to be beneficial in terms of reducing theater dead time and overall costs, while increasing the efficiency of an upper limb operating theater list. The rapid prototyping cycle afforded by 3D printing renders this technology a valuable tool for developing medical devices with patient-precise dimensions.

Fig. 1.

Photographs illustrating the development of the device. A, First prototype with an olecranon dip at the centre. B, Second prototype with a central curve. C, Final prototype with an elastic cap.

Fig. 2.

Photograph displaying an adult and a pediatric device for comparison. Pediatric device is provided with an elastic cap.

Fig. 3.

A, A 1-year-old patient under GA on the pediatric arm stand having the elastic cap. Adequate lift of the hand to facilitate skin preparation is demonstrated. B, An adult patient (aged 37 years) under LA on the arm stand device without the elastic cap. The red arrow shows the positioning of the device. The yellow arrow shows the level of the elbow. The green arrow shows the position of the arm tourniquet. The position of the device is superior to the olecranon. In both views, adequate lifting of the hand for skin preparation is demonstrated.