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A voluntary organization based in the UK, REMAP provides bespoke solutions for people with disabilities whose needs cannot be met using off-the-shelf devices, or via primary avenues of help available to them, such as the UK’s National Health Service (NHS). One of REMAP’s long-term volunteers, Bill Fraser, a 75-year-old retired engineer, lives in the Scottish Highlands, near Inverness.
Bill was working on ways of helping a young woman named Karis, who had problems with her respiratory system. The need to continuously wear a mask for much of her life had caused her natural facial profile to change, so that a standard mask eventually leaked unacceptably.
In another case, a woman in the Outer Hebrides had struggled for years to perform everyday chores because of her acute skin sensitivity. Born without several of her fingers, Helen was unable to use regular protective gloves.
The nature of these problems changed over time, and Bill’s involvement in both cases stretches back across several years. Bill concluded that providing the optimum solution in either of these cases would be difficult unless the exact shape of the changed facial profile, or of the fingerless hands, could be accurately established. In March 2019 his research into 3D scanning options led him to contact Patrick Thorn of Artec 3D Gold Certified partner Patrick Thorn & Co. Together, they quickly concluded that an Artec Eva Lite would best suit the task.
“Everything REMAP does is entirely dependent on charitable donations and the voluntary input of time and materials by its members,” says Patrick. “REMAP doesn’t have much in its bank account, and so the cost of the scanner represented a significant obstacle to further progress the acquisition of a 3D scanner.” Working together, Patrick and Bill devised a custom solution involving concessionary discounts and pension funds to make it possible for REMAP to purchase an Eva Lite scanner.
The budget version of the bestselling scanner Artec Eva, the Artec Eva Lite offers the same accuracy yet with reduced functionality, allowing it to focus on creating high-quality textureless scans when working with objects rich in geometry, such as human body parts. As a relatively inexpensive option, the Eva Lite is ideal for anyone seeking a professional 3D scanner without a large budget to draw from.
Patrick traveled to Edinburgh in Scotland with the Eva Lite, where he was met by Bill and one of his REMAP colleagues. They spent a day of tutoring with Patrick as he demonstrated how to conduct 3D scanning, explained the ins and outs of the Eva Lite, and shared some ideas on how they may achieve their goal utilizing the scans in other 3D packages. Within days of Patrick’s visit, Bill had successfully scanned Karis’ facial profile, and had also completed a trip out to the Hebrides, returning with the long-awaited scans of Helen’s hands. Prior to all this, Bill had had no scanning experience.
This case revolves around Karis, a young woman with congenital muscular dystrophy. This restricts her physically to a wheelchair and leaves her completely dependent on her carers for support. For many years, she has needed a ventilator and full face mask to effectively assist her breathing. Karis is bright and intelligent, and – despite all the complications she has to contend with – maintains an impressively positive and communicative outlook on life. Her wide range of outside interests includes the classics, art, film, the theater, and football, to name just a few! In all of these, she participates to the fullest extent possible. Recently she completed her honors degree in Creative Writing & Classical Studies at the Open University, and was honored to be specially invited to London to participate in celebrations of the Open University’s 50th Anniversary.
Unfortunately, the need to constantly wear a face mask for many years caused a gradual change to her natural facial profile. This ultimately led to the situation where a standard face mask would no longer seal properly against her face. The consequence was increasingly inadequate respiratory function, which in turn was starting to seriously affect Karis’ health and quality of life. Any effective solution would need to find some way of improving the seal between her mask and her altered facial profile.
“The standard mask comprises a rigid plastic shell fitted with a sophisticated, pliable silicone lip seal,” Bill explains. “This seals very effectively against a range of normal facial profiles to contain the positive pressure within the mask as it inflates the lungs. As the profile of Karis’ face changed, her carers had been obliged to increasingly tighten the mask head-straps in their efforts to maintain an effective seal between the standard mask and her face.” This, however, aggravated the damage the mask was doing to Karis’ face, and compounded the problem.
Bill had already devised a mask seal modification that had worked well for Karis from 2015 until 2019. However, due to ongoing changes to her face, leakage was now beginning to develop again beyond this modification. Resolving this would require a bespoke mask designed specifically to suit Karis. This could not be done unless her face could be scanned to obtain the exact geometry of her facial profile. Any scanning process would have to be quick; without her mask on, Karis can’t breathe.
Using the Artec Eva Lite, in less than 30 seconds, Bill was able to acquire the detailed scan of Karis’ facial profile that he needed. Work on creating the custom mask could then begin.
The original standard mask shell, the bespoke extension, and the lip seal
To avoid the need to repeatedly remove her mask and interrupt her breathing to carry out progress checks, a 3D print-out was made from the new scan data for Karis’ face. The original silicone lip seal was carefully dis-bonded from the shell of a standard mask. A detailed scan was then made of the exposed edge of the rigid mask shell. Utilizing 3D design software, the shape of an extension piece was calculated by digitally lofting the edge of the original shell to meet the scanned image of Karis’ facial profile. The required extension piece was then physically created by 3D-printing the calculated shape from PLA. Finally, the inner edge of the extension piece was bonded to the original mask shell, and the original silicon lip seal was re-bonded onto the outer edge of the extension piece.
Comparison of the original mask (left) and the mask customized for Karis (right)
These modifications enabled the lip seal to function as intended, and to seal the mask against Karis’ face with significantly reduced tension in the mask head-straps. Satisfactory respiratory function was restored, and the mask is now more comfortable to wear. Work continues to refine the shape of the extension piece and further improve the performance of the custom mask.
“Karis is a truly remarkable young lady, who doesn’t allow the significant difficulties she has to contend with to in any way diminish her bright and enthusiastic outlook on life,” says Bill. “I’m truly grateful to Artec for facilitating procurement of the scanner that enabled us to help her.”
Karis with David Attenborough at The Open University’s 50th Anniversary Dinner in London. (Photo courtesy of The Open University)
A second REMAP application for the Eva Lite was helping Helen, who lives in the remote Outer Hebrides (or Western Isles) in the UK. Born without several of her fingers, Helen suffers from an extreme form of dermatological sensitivity. This makes the skin on her hands liable to react and flare up following even slight exposure to a wide range of substances, including household cleaning products, toiletries, food juices, and even sunlight. Following such a flare up, Helen – who lives on her own – finds it difficult to wash, clean, or cook until the skin on her hands has healed. It may take several weeks of scrupulously avoiding even the slightest contact with any of the many potential irritants to get the reaction to subside and allow her skin to recover.
Helen’s hands (Photo courtesy of Helen)
Problems like these are normally resolved by using disposable protective gloves, or a suitable barrier cream. Helen has tried many of these, but her acute skin sensitivity has resulted in an adverse reaction to every product tried. For years she has also been trying to adapt and use a wide range of different off-the-shelf regular gloves to protect her hands. “Numerous trials were carried out, including manually modifying cotton gloves, cutting fingers off standard disposable gloves and re-sealing them, inverting fingers and anchoring the inverted fingers inside the glove,” says Bill. “None of these provided a workable solution. We even investigated whether prosthetic fingers might give Helen a way of getting regular gloves to stay on”.
REMAP also spent time researching the availability of bespoke gloves globally, but no affordable solution was found. For years, Helen has been personally researching possible solutions. Eventually, she came up with a breakthrough in October 2018, when she established that her skin seemed to be compatible with a silicone rubber product called Dragon Skin, used in the film and theatre industries to create special effects. The challenge for Bill now became the relatively simple one of finding a way to make Dragon Skin gloves that would fit Helen’s hands and stay on!
Initially, the two of them explored the idea of obtaining the shape of each of Helen’s hands by pouring molding gel around it. Once the molding gel had set, her hand would be extracted from the mold and the mold used to cast a replica model of that hand. Helen was up for this, but REMAP didn’t want to risk a skin flare up from bringing her hands into contact with the molding gel. It soon became apparent that getting a 3D scan of Helen’s hands would be the only safe way of enabling the project to proceed. Because of Helen’s remote location – even a brief visit there from the mainland requires three full days and costs several hundred pounds – attempts were made to have this scan conducted for REMAP by some other agency more local to Helen. No such agency could be found. Moving the project forward became contingent on REMAP itself acquiring the necessary 3D scans of Helen’s hands.
Once the Eva Lite had been delivered to REMAP by Patrick, little further time was lost. In June 2019 Bill traveled to the Outer Isles – meeting Helen face-to-face for the first time – and 3D-scanned her hands. He digitally modified these scans, adding cuffs, and adjusting dimensions to ensure that the gloves formed using them would have adequate clearance to enable Helen to put them on and take them off again without too much trouble. The next stage involved obtaining 3D print-outs of these glove models.
“REMAP frequently has to depend on engaging the goodwill and generosity of others to realize its objectives,” says Bill. “Obtaining 3D print-outs on which to make the gloves was a case in point, as 3D printing can be quite expensive. The limited size of any of the available 3D printers meant that each glove mold would have to be printed in two parts that subsequently would have to be joined.”
The 3D print-outs of Helen’s hands
“Dragon Skin is a two-part silicone rubber. Until it cures, the mix is fairly fluid and it tends to gradually slump down to the lowest point,” Bill explains. “A rotating device therefore had to be designed and constructed to ensure that successive films of Dragon Skin applied to the molds would remain evenly distributed and so produce gloves of reasonably uniform thickness.”
Numerous grades of Dragon Skin are available, each offering a different combination of strength and flexibility when cured. Helen had obtained several samples to verify their compatibility with her skin. She also used the samples to assess the probable suitability of that grade as a protective glove material, and suggested three grades to Bill that she thought might work. He then produced several pairs of gloves, varying the grade and the number of layers of it, so that Helen could try these and assess which offered the best solution.
The initial batch of bespoke gloves, alongside the molds mounted on the rotating device
Helen has now received this initial batch, and is in the process of trialing them. While the team is still working on improvements to the final product, she has already seen a difference. “I can’t even begin to explain how much easier it is not having stray bits of glove finger sticking out, or the weird weight of tucked-in fingers dragging the gloves off,” Helen says.
Development of further improvements to both face mask and gloves is ongoing. However, one fact is clearly evident: Neither the shape of Karis’ face, nor the shape of Helen’s hands, could have been adequately defined without the application of 3D scanning technology. “The Artec Eva Lite scanner provided us with that technology,” Bill says. “Without it and the continued support from Patrick, neither project could have progressed with the accuracy and creativity required to produce an effective solution.”
Moving forward, REMAP continues its work to provide custom solutions for those to whom disability presents problems in everyday living, and who have to face up to and overcome unique challenges. Regrettably, in these times of severely constrained resources, it often seems that those affected feel they have been failed by the organizations that the rest of us might have expected to provide the assistance they need.
“It’s quite a privilege to be able work for an organization like REMAP,” says Bill, “and to have the opportunity to help where nothing else is available.”
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