by Amanda GallagherA little girl sits propped on a phonebook as a laser washes over her face. Within seconds, every contour, every millimeter of her skin, is drawn to 3-D perfection on a computer screen. The girl hops off the phonebook and says she is ready for pancakes at McDonalds. She is completely unaffected by the sci-fi image suspended on the computer screen. Yet this very image is a phenomenal step
in her recovery.
The little girl is Selena Gallegos. At the age of 7, she has survived a horrifying car accident: a collision with an 18-wheeler. The impact caused an explosion that burned 37 percent of Selenaís body. "She was really hurting a lot those first three or four months," said her mother, Martha Munoz. But after the face scan, Selena feels fine. "That didnít hurt at all," she said. And that is exactly how a face scan is supposed to work.
The technology combines a laser imaging device with FaceScan© software. It takes precise and painless measurements of a burn victimís face. Technicians use the dimensions to create transparent facemasks. The plastic masks prevent raised scars from forming while smoothing existing scar tissue. They are standard treatment for burn victims. But the FaceScan© is not.
"We are the only place in Texas that has this laser imaging technology," said Bill Rogers, an instructor in the department of rehabilitation medicine and the mastermind of the FaceScan©. "Only three or four other places in the country use laser imaging to develop masks."
In most burn centers, clinicians make a "cast" of the patientís face by pouring a substance called alginate over the patientís damaged skin. The patient must remain motionless until it hardens. "It took two or three hours and I was horribly uncomfortable," said Leticia Avila, a burn victim and a veteran of the casting process. "I had to breathe through straws they put in my nose. I felt claustrophobic."
Because patients have difficulty breathing during the casting process, the facemasks often come out distorted. Technicians have to recast about 86 percent of the them. "Mine was too round. It didnít fit my face properly so my skin wasnít healing," Avila said.
That is exactly why Rogers decided to create the imaging technology. "We knew the imaging system would be easier on the patient and produce more accurate contours of the face," Rogers said. "We already used laser imaging devices on wounds. It only cost a couple thousand dollars to convert the device for measuring facial patterns."
After Rogers created a prototype, he called the U.S. Army Institute of Surgical Research at Brooke Army Medical Center (BAMC) - the regionís only burn center. BAMC typically uses the casting process to develop the plastic masks, but therapists were excited about the new technology.
"We initially referred two patients to the Health Science Center and the results were excellent. The patients had no anxiety, no discomfort and the masks fit better," said Capt. Ted Chapman, an occupational therapist at the U.S. Army Institute of Surgical Research Burn Center at BAMC.
The better fit is the result of the precise measurements from the scan and the custom work therapists can do in the computer. "If a patient has a certain area you want to focus on, you can build it up on the computer image. You can target certain areas more aggressively," said Don Dilworth, M.D., Capt., U.S.A.F., a Wilford Hall surgeon who is collaborating on the project. "And, if the mask doesnít fit, itís easy to change. You can rebuild it on the computer." This spares patients the agony of sitting through another casting process.
Itís also quicker. It takes about six to 11 hours to make a mask from a cast, and only three to four hours to develop one from a computer. And if youíre still not sold, consider the price. A mid-west company creates a similar system that costs about $150,000. "We can build a prototype for about one-tenth of that," Rogers said. "The only difference is the other imagingsystems have color. But the optical quality is still the same."
Creating an inexpensive and portable system was a priority for Rogers, who wants the technology available to every burn victim in the country. Therapists agree.
"Due to the low cost, improved quality and ease of use of the system, we envision therapists at all burn care facilities will use this technology to fabricate masks," Capt. Chapman said. "Itís cost effective and you get optimal conformity." And itís a relief. "This is giving me so much hope for my daughter," Munoz said.
Rogers began using the system in November. He is working with the BAMC Burn Center to fine-tune the design, and he is looking for a commercial developer to market the product. Until then, heís slowly changing the face of South Texas.
UT Health Science Center
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