3D-printed noses for accident victims
"within a year"

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3D-printed prostheses by Fripp Design and Research

News: 3D-printed nose and ear replacements for accident victims and people with facial disfigurements could be just a year away, according to a design firm working on a new generation of prosthetics (+ interview).

Patients could get a customised nose or ear printed within 48 hours, rather than the ten weeks it takes to make a hand-made prosthesis, Fripp Design & Research believes.

"It's time saving and cost saving," the company's founder Tom Fripp told Dezeen. "Particularly, the time-saving is great for the patient. Traditionally to have one made you're waiting for about ten weeks for a hand-made prosthesis. From start to finish we would scan, design and print within 48 hours."

Fripp said that the technology could be ready this time next year, although getting the health services to embrace it was the biggest challenge. "I think to actually get anywhere from now to [having an] available service you're talking about a year," he said. "It requires some sort of acceptance into the health services. That's the biggest barrier to it."

The project is being exhibited as part of the 3D Printshow Hospital at the 3D Printshow in London. The exhibition, which explores how 3D printing is transforming healthcare, also features a bio-printer that could print human cells that could eliminate the need for animal testing of new drugs.

Fripp is also working on 3D-printed eyes, which could be produced for less than £100, compared to the current price of up to £4,000 for existing ocular prosthetics.

UK-based Fripp uses colour 3D printing to create soft-tissue prostheses that can be used by patients who are missing sections of their face. Each custom prosthesis printed with bio-compatible starch and silicone will match the wearer's skin colour, and take less than two days to produce.

"We reproduce the colour, which is an exact match for the skin tone," Fripp told Dezeen. "Following that, we have to colour code it for the printer because if you send any colour to any standard printer, you get a totally different colour."

The current process is lengthy and costly and involves taking an impression of the area to create a mould for the prosthesis, which then has to be hand painted and modified during fitting.

To speed this up, Fripp Design & Research are collaborating with researchers at the University of Sheffield to map the shape of the patient's trauma area and capture skin colour data in an instant using a setup of multiple digital cameras.

The prosthetics are then designed using previous scans of the patients, if available, by mapping features from the patients' relatives or simply taking stock files of parts like noses or ears.

"[We use] a graphic clay that we can carve away and morph to the trauma area," said Fripp, "so we make sure we have a dead accurate fit."

The shape is then printed with the precise colour profile using a Z Corp Z510 colour 3D printer. This will cost around the same as a handmade prosthetic, but once created the file can be used to generate multiple copies for replacements at a significantly lower cost.

3D-printed prostheses by Fripp Design and Research

Fripp admits his products are less realistic than the current models: "They're not as high quality as a hand-made one which really are beautiful, but a patient can have this as an interim until their handmade one is actually produced."

He says they have tested and fitted a prosthetic for a patient but that the project is awaiting medical accreditation. He believes that the people who are going to benefit the most from this process will be "individuals currently in the developing world who go without because they don't have the money to pay for a skilled technician to build one."

Fripp's company is also working with Manchester Metropolitan University to produce stock batches of prosthetic eyes that patients could buy for just £30, which they also hope to be selling in a year's time.

He also claims that his company has developed the first machine to 3D-print entirely in silicon, which will help remove the white lines that form around the edge of the protheses due to the silicon reacting with the starch.

For our one-off 3D-printing magazine Print Shift, we reported that the technology is making strides towards medical applications such as printing organs. Scientists have also printed a bionic ear that can hear radio frequencies beyond a human's normal range.

Here's the full interview we conducted with Tom Fripp:


Dan Howarth: How you go about printing a nose or an ear?

Tom Fripp: It starts off with a data capture, half of it, because we deal with patients who are sometimes very nervous, sometimes very agitated, we have to use a structured light system, it's an instant capture. People who are nervous tend to move around and fidget, lasers take too long to produce them because they don't stay still. So we use a colour photogrammetry system. It's an array of cameras mounted in pads that are calibrated to know where each pod is sat. They all take a picture at the same time then they can work out the physical geometry and at the same time capture the colour.

That gives us a mesh of the area of the trauma. What that doesn't include obviously is what you've got to produce to replace any trauma area which might be due to surgery or through disease. The next thing to do is to create that geometry, we can use either stock prosthetics that we have as CAD files or we can image a friend or family member and we will adjust it all to fit in 3D CAD. Or we could use CCRMI data if thats available.

There's quite a lot of ways that we could reproduce, lets say for example a nose to make sure that it fits. We use a voxel modelling system for modelling so it's pixels rather than surfaces or solid modelling, it uses a graphic clay that we can carve away and morph to the trauma area. So we make sure we have a dead accurate fit. Then we have to make sure we get the colour right and we do this by taking a special photometer reading from the patient, all captured at the same time. Then we reproduce the colour which is an exact match for the skin tone. Following that, we have to colour code it for the printer because if you send any colour to any standard printer, you get a totally different colour. Then the final stage is that we produce it, we actually 3D print the full colour part in starch because it's a stable, lightweight and porous material. The processing involves forcing medical grade silicon into the starch, that brings out its final qualities and then the prothesis is ready to go to the fitter to be adjusted and fitted to the patient.

Dan Howarth: What are the benefits compared to the current methods of creating protheses?

Tom Fripp: It's time saving and cost saving. Particularly, the time saving is great for the patient. Traditionally to have one made you're waiting for about ten weeks for a hand made prosthesis. From start to finish we would scan, design and print within 48 hours. They're not as high quality as a hand-made one which really are beautiful, but a patient can have this as an interim until their handmade one is actually produced.

The other benefit is that it is much more cost effective. Although the first one would cost about the same amount which is between £1500 and £3000 depending on where you are in the country. Our first one would cost about the same because of the design side. For a repeat handmade one you're talking up to a thousand pounds. For our one it comes down to about £130 because we've just got a CAD file, we just press print again.

Dan Howarth: Has this been tested and used on patients yet?

Tom Fripp: No, we have fitted it to a patient to see what their response is to it but its not actually been provided out there as prosthesis yet. The main reason is that it's difficult for products to get into the medical profession. We are an industrial design company, we're finding an awful lot of resistance to it because traditionally, things come from surgeons and clinicians having an idea and developing it rather than an external design company doing the same.

Dan Howarth: How long do you think it will be until it's taken up?

Tom Fripp: I think to actually get anywhere from now to available service, you're talking about a year. It requires some sort of acceptance into the health services. That's the biggest barrier to it.

Dan Howarth: What sort of printers do you use to print out the files?

Tom Fripp: We use Z Corp Z510s deliberately because its a much more of an open system and we can play about with the materials before, the more recent ones are more cartridge based.

Dan Howarth: How does the prothesis then attach to the face?

Tom Fripp: There's a variety of ways. A lot of patients will already have an implant placed on the good tissue. So any bone underneath the trauma area that can be used, they all have a steel implant drilled into the bone then we can capture the orientation and location in our scanning process. Then we would produce the prosthesis with magnets actually inside the prosthesis which would just clip onto the implants. But the prosthesis is also made with a fine fitted edge which means that you can place a medical grade adhesive around this edge that reactivates when you clean it. So you can actually take the prosthesis off overnight and allow air to get to any scar tissue, clean it and then clip it back onto the implant with the medical adhesive, with a little bit of make-up round the edge, it hides it.

Dan Howarth: Who is going to benefit the most from this?

Tom Fripp: The people who are going to benefit the most from this are the individuals currently in the developing world who go without because they don't have the money to pay for a skilled technician to build one. There are areas where technicians aren't actually available and they would have to wait for up to a year or so to visit a more developed country where you get academics going over and starting up small clinics. It happens very regularly but you still have to wait a long time, and in most cases some still can't afford it.

Dan Howarth: What's next after it gains medical accreditation? Could you then develop it to create other body parts?

Tom Fripp: Yes, we are currently constrained on the physical parts that we can produce so for example limbs are a bit troublesome because of their physical size. The starch material is very delicate when it comes out of the printer so a large limb might collapse when you actually try to process it. We have looked at other parts, things like replacing breasts, they are particularly difficult to produce because of the physical size of the moulds required to make them, make them incredibly heavy to process. The process is straightforward but there's quite a lot of work to do on the material side before we can produce something that large.

Dan Howarth: Have you got anything else in the pipeline?

Tom Fripp: For the last year and a half to two years, we've also been developing ocular prosthetics, replacing eyes for people. You have a similar situation with the handmade prosthetics, we've developed a way of full colour 3D printing them without them costing about £3000-4000, we can produce them for less than £100.

Dan Howarth: That works in the same way as the noses?

Tom Fripp: Kind of. With the ocular prosthetics, we're actually producing them as stock parts so they're a standardised set of 3D printed parts. At the moment, all of the ocular prosthetics are handmade and very expensive to produce whereas ours are far quicker and far cheaper. So ours will be about £30 and we can make approximately 150 in three hours on our system.

Dan Howarth: Is this project in the same stage as the noses?

Tom Fripp: The product is more refined actually and the process is pretty much complete. The materials are standard, there's no issue with the materials. We're currently working with Manchester Metropolitan University on that project. We starting to scale up the process for production. There's an awful lot of interest in the product particularly from India.

Dan Howarth: How long do you think until that might be put into mass production?

Tom Fripp: I would imagine within 12 months, we should be producing this product and its should be going out to India.

I should mention, one of the problems with the soft tissue prosthetics is that starch and silicon don't get on too well. So when you over-stress the prosthesis, you get a small white grazing line on it, which isn't too much of a problem if you've got a temporary prosthesis. The only way to get around that is to eliminate the starch from the process, so for the last six months or so, Fripp Design as a company has developed its own new type of 3D printer which actually prints directly in silicone, which is a complete game changer because nobody is actually able to print in silicone and we've discovered a way. We have a test rig up and running at the moment and we're producing samples and filed the patent about two weeks ago.