Use of surface scanning for creation of transparent facial orthoses. A report of two cases.
OBJECTIVE: To introduce the advantages of surface scanning over conventional burn mask construction to produce better fitting transparent facial orthoses (TFO). DESIGN: Two case reports. SETTING: Regional burn center. PARTICIPANTS: Two burn survivors who sustained 25% and 82% total body surface area second and third degree flame burns, respectively. DESCRIPTION: A 50-year-old male who sustained 4.5% second and third degree facial burns and a 41-year-old female who sustained 6% second and third degree facial burns during the World Trade Center were fitted with a digitally produced TFO approximately 4 months after injury. After the patients were scanned, the images were edited to smooth existing scars and replicated as a mold through which the healing process was observed. RESULTS/DISCUSSION: Facial burns represent many psychological and rehabilitation challenges. We recommend the use of a digitally produced device in patients with severe facial burns who require constant pressure to minimize hypertrophic scarring and to improve cosmesis. Scar management studies have shown that surface scanning results in a better fitting mask than conventional fabrication, without the labor-intensive, time-consuming, and imprecise process, which may delay treatment effects. The conventional process is slow and anxiety-provoking, especially for children, who often require anesthesia. In contrast, the head scanner rotates 360 degrees around the pateint's head, painlessly and accurately capturing the profile and contour of the face in 7s. Since the procurement of this scanner, our two patients, as well as many other burn victims, have greatly benefited from the creation of face masks utilizing this equipment. We believe that all rehabilitation professionals caring for burn patients should be aware of this new technology.