Customized Fabrication Approach for Hypertrophic Scar Treatment: 3D Printed Fabric Silicone Composite

³ Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hong Kong

⁴ Department of Advanced Fibro Science, Kyoto Institute of Technology, Japan

IJB 2020, 6(2), 262 https://doi.org/10.18063/ijb.v6i2.262

© Invalid date by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Download PDF

Cite

XML

Abstract

Hypertrophic scars (HS) are considered to be the greatest unmet challenge in wound and burn rehabilitation. The most common treatment for HS is pressure therapy, but pressure garments may not be able to exert adequate pressure onto HS due to the complexity of the human body. However, the development of three-dimensional (3D) scanning and direct digital manufacturing technologies has facilitated the customized placement of additively manufactured silicone gel onto fabric as a component of the pressure therapy garment. This study provides an introduction on a novel and customized fabrication approach to treat HS and discusses the mechanical properties of 3D printed fabric reinforced with a silicone composite. For further demonstration of the suggested HS therapy with customized silicone insert, silicone inserts for the finger webs and HS were additively manufactured onto the fabric. Through the pressure evaluation by Pliance X system, it proved that silicone insert increases the pressure exerted to the HS. Moreover, the mechanical properties of the additively manufactured fabric silicone composites were characterized. The findings suggest that as compared with single viscosity print materials, the adhesive force of the additively manufactured silicone and fabric showed a remarkable improvement of 600% when print materials with different viscosities were applied onto elevated fabric.

Keywords

Three-dimensional printing

Soft material

Textile fabric

Pressure therapy

Hypertrophic scars

References

1. Zhou L, Gao Q, Fu J, et al., 2019, Multi-Material 3D Printing of Highly Stretchable Silicone Elastomer. ACS Appl Mater Interfaces, 11(26):23573–83. DOI: 10.1021/acsami.9b04873.

2. Fozi MA, Salleh MN, Ismail KA, 2019, Development of 3D-printed Customized Facial Padding for Burn Patients. Rapid Prototyp J, 25(1):55–61. DOI: 10.1108/rpj-09-2017-0179.

3. Unkovskiy A, Spintzyk S, Brom J, et al., 2018, Direct 3D Printing of Silicone Facial Prostheses: A Preliminary Experience in Digital Workflow. J Prosthet Dent, 120(2):303–8. DOI: 10.1016/j.prosdent.2017.11.007.

4. Gibson I, 2015, In: Rosen DW, Stucker B, editors. Additive Manufacturing Technologies: 3D Printing, Rapid Prototyping, and Direct Digital Manufacturing. 2nd ed. Springer, New York. DOI: 10.1007/978-1-4939-2113-3_16.

5. Bibb R, 2015, In: Dand E, Paterson A, editors. Medical Modelling: The Application of Advanced Design and Rapid Prototyping Techniques in Medicine. 2nd ed. Woodhead Publishing, Cambridge.

6. Li-Tsang CW, Feng B, Huang L, et al., 2015, A Histological Study on the Effect of Pressure Therapy on the Activities of Myofibroblasts and Keratinocytes in Hypertrophic Scar Tissues After Burn. Burns, 41(5):1008–16. DOI: 10.1016/j.burns.2014.11.017.

7. Yu A, Yick KL, 2018, Compression and stretch fit garments. In: Engineering of High-Performance Textiles. Woodhead Publishing, Sawston, United Kingdom. pp. 279-303. DOI:10.1016/b978-0-08-101273-4.00011-1.

8. Cho YS, Jeon JH, Hong A, et al., 2014, The Effect of Burn Rehabilitation Massage Therapy on Hypertrophic Scar after Burn: A Randomized Controlled Trial. Burns, 40(8):1513–20. DOI: 10.1016/j.burns.2014.02.005.

9. Dewey WS, Richard RL, Parry IS, 2011, Positioning, Splinting, and Contracture Management. Phys Med Rehabil Clin, 22(2):229–47.

10. Kwan P, Hori K, Ding J, et al., 2009, Scar and Contracture: Biological Principles. Hand Clin, 25(4):511–28. DOI: 10.1016/j.hcl.2009.06.007.

11. Carney BC, Liu Z, Alkhalil A, et al., 2017, Elastin is Differentially Regulated by Pressure Therapy in a Porcine Model of Hypertrophic Scar. J Burn Care Res, 38(1):28–35. DOI: 10.1097/bcr.0000000000000413.

12. Wei Y, Wang Y, Zhang M, et al., 2018, The Application of 3D-printed Transparent Facemask for Facial Scar Management and its Biomechanical Rationale. Burns, 44(2):453–61. DOI: 10.1016/j.burns.2017.08.006.

13. Liravi Fand Toyserkani E, 2018, Additive manufacturing of silicone structures: A review and prospective. Addit Manufact, 24:232–42. DOI: 10.1016/j.addma.2018.10.002.

14. Perkins K, Davey R, Wallis K, 1983, Silicone Gel: A New Treatment for Burn Scars and Contractures. Burns, 9(3):201– 4. DOI: 10.1016/0305-4179(83)90039-6.

15. Mercer NGS, 1989, Silicone Gel in the Treatment of Keloid Scars. Plast Surg Nurs, 9(4):162.

16. Quinn K, Evans J, Courtney J, et al., 1985, Non-pressure Treatment of Hypertrophic Scars. Burns, 12(2):102–8. DOI:10.1016/0305-4179(85)90035-x.

17. Van den Kerckhove E, Stappaerts K, Boeckx W, et al., 2001, Silicones in the Rehabilitation of Burns: A Review and Overview. Burns, 27(3):205–14. DOI: 10.1016/s0305-4179(00)00102-9.

18. Gilman TH, 2003, Silicone Sheet for Treatment and Prevention of Hypertrophic Scar: A New Proposal for the Mechanism of Efficacy. Wound Repair Regen, 11(3):235–6. DOI: 10.1046/j.1524-475x.2003.11313.x.

19. Ko WJ, Na YC, Suh BS, et al., 2013, The Effects of Topical Agent (Kelo-cote or contractubex) Massage on the Thickness of Post-burn Scar Tissue Formed in Rats. Arch Plast Surg, 40(6):697–704. DOI: 10.5999/aps.2013.40.6.697.

20. Di Rocco G, Gentile A, Antonini A, et al., 2011, Enhanced Healing of Diabetic Wounds by Topical Administration of Adipose Tissue-Derived Stromal Cells Overexpressing Stromal-Derived Factor-1: Biodistribution and Engraftment Analysis by Bioluminescent Imaging. Stem Cells Int, 2011:304562. DOI: 10.4061/2011/304562.

21. Berman B, Perez OA, Konda S, et al., 2007, A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and Management. Malden, USA. pp. 1291–303. DOI: 10.1111/j.1524-4725.2007.33280.x.

22. Bosworth C, 2002, Burn Trauma: Management and Nursing Care. 2nd ed. Whurr, London.

23. Macintyre L, Gilmartin S, Rae M, 2007, The Impact of Design Variables and Aftercare Regime on the Long term Performance of Pressure Garments. J Burn Care Res, 28(5):725–33. DOI: 10.1097/bcr.0b013e318148c999.

24. Leung P, Ng M, 1980, Pressure Treatment for Hypertrophic Scars Resulting from Burns. Burns, 6(4):244–50. DOI:10.1016/s0305-4179(80)80007-6.

25. Rivers E, Strate R, Solem L, 1979, The Transparent Face Mask. Am J Occup Ther, 33(2):108–13.

26. Staley MJ, Richard RL, 1997, Use of Pressure to Treat Hypertrophic Burn Scars. Adv Wound Care, 10(3):44-6.

27. Yu A, Yick KL, Ng SP, et al., 2016, Orthopaedic Textile Inserts for Pressure Treatment of Hypertrophic Scars. Textile Res J, 86(14):1549–62. DOI: 10.1177/0040517515573409.

28. Pendleton H, Schultz-Krohn W, 2018, Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction. 8th ed. Elsevier Health Sciences, Amsterdam, Netherlands.

29. Uslu AA, Sürücü AA, Korkmaz AM, et al., 2019, Acquired Localized Hypertrichosis Following Pressure Garment and/or Silicone Therapy in Burn Patients. Ann Plast Surg, 82(2):158–61. DOI: 10.1097/sap.0000000000001686.

30. Yu A, Yick KL, Ng SP, et al., 2013, Prediction of Fabric Tension and Pressure Decay for the Development of Pressure Therapy Gloves. Textile Res J, 83(3):269–87. DOI: 10.1177/0040517512456757.

31. Juckett G, Hartman-Adams H, 2009, Management of Keloids and Hypertrophic Scars. Am Fam Phys, 80(3):253–60.

32. Li-Tsang CW, Zheng YP, Lau JC, 2010, A Randomized Clinical Trial to Study the Effect of Silicone Gel Dressing and Pressure Therapy on Posttraumatic Hypertrophic Scars. J Burn Care Res, 31(3):448–57. DOI: 10.1097/bcr.0b013e3181db52a7.

33. Kamal RM, Khalaf MM, Elshazely A, et al., 2016, Dynamic Splint Versus Static Splint and Active Range of Motion in Treatment of Post Burn Hand Contracture. Int J PharmTech Res, 9(6):75–83.

34. Narula A, Pastore CM, Schmelzeisen D, et al., 2018, Effect of Knit and Print Parameters on Peel Strength of Hybrid 3-D Printed Textiles. J Textiles Fibrous Mater, 1:1–5. DOI: 10.1177/2515221117749251.

35. Hearle JW, 2008, In: Morton WE, editor. Physical Properties of Textile Fibres. 4th ed. Elsevier Science, Burlington.

36. Lai CH, Li-Tsang CW, 2009, Validation of the Pliance X System in Measuring Interface Pressure Generated by Pressure Garment. Burns, 35(6):845–51. DOI: 10.1016/j. burns.2008.09.013.

37. Wiseman J, Simons M, Kimble R, et al., 2018, Reliability and Clinical Utility of the Pliance X for Measuring Pressure at the Interface of Pressure Garments and Burn Scars in Children. Burns, 44(7):1820–8. DOI: 10.1016/j.burns.2018.05.002.

Previous article in this issue

Next article in this issue

International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing