Is additive manufacturing a magic bullet to resupply lacking PPE? Producing respirators and face shields during COVID-19 pandemic: A systematic review

Abstract

Coronavirus Disease 2019 (COVID-19) pandemic caused an increase in the demand for personal protective equipment (PPE) and disruptions in production chains, resulting in an acute shortage of PPE. A possible solution to this problem was additive manufacturing (AM) technology -allowing for a quick start of the production of PPE and potentially able to meet the demand until the production is restored. In addition, AM allows for the production of PPE prototypes with potentially greater comfort of use or degree of protection. In order to assess the production of PPE in AM during the COVID-19 pandemic, previously published articles in this field were analyzed. After analyzing abstracts and full texts, 30 original works were selected from the initially collected 487 articles. Based on the analyzed literature, it was found that there are not enough studies comparing traditional and AM PPE as well as not enough comparisons of the different types of AM PPE with each other. In many cases, researchers focused only on the subjective assessment of the comfort of using PPE, without assessing their effectiveness in preventing infections. Despite that, AM has a great potential to quickly produce lacking PPE. Respirators and shields made by AM were rated by the vast majority of users as comfortable to wear. Some of the respirators could be adapted to a specific user, by designing on the basis of a face scan or after warming up the finished print and modeling the shape.

A Meta-Review about Medical 3D Printing

“…The materials can be divided into polymers, ceramics and metals [145]. The most mentioned materials are ABS, titanium, and PCL [27, 149]. For 3DP technology, SLA and FFF seem to be the most used [146, 149].…”

“…Non-invasive devices are external applications, like 3DP models. The medical fields included are anesthesia [1], cardiology [2][3][4][5][6][7][8][9][10][11][12][13], coloproctology [14], dentistry [15][16][17][18], general surgery [19][20][21][22][23][24][25], health care engineering [26,27], hepatology [28], interventional radiology [29], medical education [30][31][32][33][34], neurosurgery [35][36][37][38][39], oncology [40][41][42][43] and radiation oncology [44][45][46]. Further medical fields included are oral and maxillofacial surgery [47][48][49]<...…”

“…Materials can be categorised into 5 classes: polymers, metals, ceramics, organic materials and composite materials. In the class of polymers the following materials were found: ABS [1, 8, 37, 38, 45, 48, 61, 64, 79, 88, 90, 105], clear resin [103, 106], HIPS [79, 80, 84], latex resin [12], nylon [24, 28, 77, 105], PA [11, 28, 81, 92], PS [92], PET-G [25, 27, 77, 106], PCL [83, 84], PEEK [77, 92],PHA [25], photopolymer [5, 6, 12, 16, 25, 38, 79, 80, 103–106], PLA [4, 17, 25, 40, 55, 77, 80, 104, 105], PMMA [18, 49, 90, 94], PVS [15, 91], PU [4, 38, 92], PUR [105] and silicone [11, 13, 19, 38, 47, 49, 78, 80, 84]. Organic materials include biocompatible photopolymer [25, 94, 103, 106], gelatin [12, 49], high-acyl gellan gum [38], starch and cellulose powder [104] and wax [94].…”

“…The pathologies in this section include cancer [25, 42, 44, 83], Covid-19 [26, 27], cranio-maxillofacial defects [25, 48, 50, 118], foot abnormalities such as flat feet [120, 121], limb loss [122, 123], neurological disorders [124], tooth loss [18, 115–117], various fracture types such as forearm fractures or tibial plateau fractures [63, 74, 119, 125] and different types of ear disorders [78].…”

“…Procedures include dental procedures such as implantation and production of dental crowns or prostheses [18, 116, 117], production of personal protective equipment (PPE) such as face shields [26, 27] and surgical procedures such as total mesorectal excision, craniofacial surgery, upper extremity surgery, amputation, otologic and auricular management, cardiovascular surgery, neurosurgery, transplantation surgery, urological and gastrointestinal procedures, orthopedic surgery [25, 42, 44, 48, 50, 63, 78, 83, 89, 93, 118, 122–124].…”