Point-of-care digital manufacturing workflow for patient-specific 3D-printed burn orthoses in a low-resource setting: A retrospective study.

Abstract

Burn injuries cause substantial long-term disability in low- and middle-income countries (LMICs), where access to specialized rehabilitation and patient-specific orthoses is limited. Hospital-based point-of-care (POC) digital manufacturing may enable local production of customized burn orthoses in resource-constrained healthcare settings. This retrospective study evaluated a hospital-based workflow integrating optical three-dimensional (3D) scanning, computer-aided design (CAD), and in-house fused filament fabrication (FFF) 3D printing. Four patients aged 3-16 years represented acute-phase, preoperative, postoperative, and hybrid perioperative orthotic pathways. Feasibility outcomes included workflow completion, technical failures, design iterations, fabrication time, clinical fitting, and delivery time. The workflow was completed successfully in all four cases without technical abandonment, repeat scanning due to technical failure, conversion to conventional fabrication, or print failure. Scanning required 20-25 min, CAD customization 5-8 h, and cumulative printer operation 29-78 h. All orthoses were clinically fitted and delivered within 2-3 days of the clinical request. Three cases were completed after a single design iteration, whereas Case 4 required three iterations because of evolving postoperative anatomy and functional requirements. Hospital-based POC digital manufacturing of patient-specific burn orthoses was technically and operationally feasible in this low-resource clinical setting. The workflow supported orthotic management across multiple stages of burn care and provides a practical implementation framework for resource-constrained healthcare systems. Larger prospective studies are needed to evaluate clinical outcomes, cost-effectiveness, and long-term sustainability.