Improving Lives in Three Dimensions: The Feasibility of 3D Printing for Creating Personalized Medical Aids in a Rural Area of Sierra Leone

Abstract

The aim of this feasibility study was to investigate how a 3D printer could be put to its best use in a resourcelimited healthcare setting. We have examined whether a 3D printer can contribute to making prostheses, braces, or splints for patients who underwent major limb amputation because of complex wounds, for example, due to burns and subsequent scarring, accidents, conflicts, or congenital abnormalities. During a 3-month period, we investigated the benefits of customized, 3D-printed arm prostheses, splints, and braces in Sierra Leone. Using a handheld 3D scanner and a 3D printer, patient-specific medical aids were designed, manufactured, and tested. Questionnaires regarding patient satisfaction and the functionality of the prostheses were used for a short-term follow-up. Four esthetic prostheses were designed: two prostheses of the hand, one of the forearm, and one of the entire arm. Follow-ups were conducted after 3 to 4 weeks to investigate the quality of the prostheses and to complete a patient questionnaire. Even though the prostheses primarily fulfill esthetic needs, they also exhibit some degree of functionality. In addition, four splints for hands and arms were made to prevent scar contractures after skin transplantation. Finally, a brace for a young boy with kyphoscoliosis was manufactured. The boy has accepted the brace and will be followed up in the months to come. Long-term follow-up is required to prove the sustainability of the 3D-printed brace and prosthetic arms. Further research into how to sustain and refine this project is underway.

Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural population in Sierra Leone – an observational cohort study

“…At the start of the 3D printing Sierra Leone project, we quickly realised that the demands of Sierra Leonean amputees are different from those in Europe. In our earlier work focusing on arm prostheses, it became clear that aesthetics plays an important role [23]. All participants indicated that aesthetics was just as important as functionality.…”

“…In collaboration with the 3D laboratory at the Radboud University Medical Centre, a 3D lab was set up in the Masanga Hospital in Sierra Leone [21,22]. In 2018 and 2019, a feasibility study was performed to investigate the use of a 3D printer in a resource-limited healthcare setting [23]. With this relatively simple technology, low-cost 3Dprinted arm prostheses and other medical aids were produced within a short time.…”

Quality of life of patients with 3D-printed arm prostheses in a rural area of Sierra Leone

“…Although patients were involved in the design process, designs were kept simple to enable reproducibility. The design and manufacturing of the prosthesis have been described in detail before by Van der Stelt et al, 2020 andby Van Gaalen et al (2021). The designs were made in close collaboration with a Dutch prosthetic specialist and a 3D specialist who were not on site but available by email and WhatsApp Messenger (WhatsApp Inc., Menlo Park, California, USA).…”

“…The latter since it provides us inside in the experience of the patient concerning for example the use, sustainability and comfort of the prosthesis. This questionnaire was created earlier by Gaber et al, in 2001 to assess perceived benefits of using a certain socket for upper limb prostheses and can be found in supplement file A (Gaber et al, 2001;Van der Stelt et al, 2020). The second questionnaire was completed at the same intervals as the EQ-5D-5L questionnaire but without a null measurement.…”

“…Based on earlier feasibility research carried out within the framework of this project by Van der Stelt et al 2020, it was concluded that aesthetics play an equally important role as functionality for Sierra Leonean amputees. Furthermore, results showed that patients missing a limb can feel insecure due to feeling incomplete.…”