One area the CoMeddi project is focussing on is facial burns. Project partners, the Maxillofacial Lab at Morriston Hospital, have pioneered treatment of facial burns for over a decade. Efficient and long-term treatment of facial burns is crucial to reduce scaring and improve functional outcomes for patients.
The team at Morriston Hospital have developed the use of 3d design engineering technologies. These methods reduce the use of invasive impression taking methods and allow accurate, custom-fitting facial splints to be produced. These splints compress the scar tissue and reduce the prominence of scarring over time. This is faster and more effective that conventional methods.
In a recent report, Peter Evans, Maxillofacial Laboratory Services Manager at Morriston Hospital said "We are one of the few maxillofacial laboratory units UK-wide to employ this technology for burns masks, which is recognised by the Katie Piper Foundation as setting the standard for the way burns patients should receive their splints. There is great disparity in the services provided throughout the UK, but hopefully digital technology can help to reduce this by providing services remotely and at less cost. The current system is static, but we are looking at portable cameras that can be posted to local clinical staff to use, so that patients wouldn't need to attend hospital to access this service.” One of the most affordable 3d scanning solutions is being trialed as part of the CoMeddi project. This system uses an iPad and Structure Sensor, which makes it highly portable and therefore potentially more suitable for remote, rural applications.
3d scanning is used to capture the scarred facial anatomy. This data is then smoothed and processes in computer aided design software (Morriston Hospital and PDR use 3D-Systems, Geomagic FreeForm Plus). The replica smoothed anatomy is then 3d printed and reinforced with plaster to make a vacuum forming tool. PET material heated and sucked down over the tool to make the final splint.
These 3d design-led methods are possible through various collaborative projects undertaken between the Maxillofacial Unit, PDR and other CARTIS collaborators. At Morriston Hospital, projects supported by the Welsh Government have enabled the purchase of mobile 3d cameras, which allow the methods to become mobile, reducing the need for patients to attend hospital appointments in a potentially fragile state. The approaches being developed through CoMeddi should make a further step change. One ambition is to fabricate end use splints directly.
The methods are also applied to creating highly realistic facial prostheses. CARTIS has published and presented widely on the use of advanced 3d design engineering methods applied to burns splints and facial prosthetics. This research has direct impact on improving patient care.
Further details of the Morriston services are covered in the recent Advances Wales publication.