Dr Tasciana Gordon1
1Greenslopes Hospital, , Australia
Deep burns can lead to hypertrophic scarring as well as contractures. Current management of facial burns includes burn masks created by alginate application, followed by a liquid mask and then creation of a Transparent Face Orthosis(TFO’s) created using heat. This process is time-consuming, uncomfortable for patients and may result in poor compliance. This process often requires general anaesthesia and the anaesthetised face geometry may not be the same as the awake patient. Three-Dimensional printing allows for a more detailed, accurate and reliable process. This is because the 3D scanning process involves a “no-touch” technique which eliminates pain. The resultant orthosis is more accurately printed to apply compression pressure to the face to reduce hypertrophic scarring.
A literature search was conducted using search engines Medline, TripDatabase and Pubmed. Exclusion criteria were articles published prior to 2010, as well as non-facial burn management and the inability to obtain the full text. Key words included ‘three-dimensional’, ‘burn management’ and ‘contracture’.
Five studies were identified. These were: a retrospective study, a case-control study and three case series studies. The studies reviewed showed improved patient satisfaction for the manufacture, application and results of the masks. There was an overall objective decrease in scar thickness and hypertrophic scarring measured by subsequent imaging. Padding was added to some of the TFO’s and new moulds were easily made as burn resolution progressed resulting in improved outcomes.
Further studies are recommended however, the literature reviewed show promising results for the development of 3D-printed TFO’s in the management of facial burns. There was reduced hypertrophic scarring, contracture and patient satisfaction was improved. Accessibility and expenditure on 3D scanners and printers is recognised but as technology and further experience with this process is refined it is likely to contribute to the future management of facial burn scarring.
Dr. Tasciana Gordon is currently working as a Plastic and Reconstructive Principal House Officer at Greenslope’s Hospital in Queensland