Harnessing the Transparent Face Orthosis for facial scar management: a comparison of methods

The Transparent Face Orthosis (TFO) is widely used in the treatment of facial burns to minimize hypertrophic scarring and maintain the contours of the face against deforming scars. Compression of the TFO is achieved with forces provided by the harness system (straps and anchors) used to secure the TFO on the face. A variety of harness system designs are used clinically yet none have been described or compared in the literature. The purpose of this study was to compare seven common methods of TFO harnessing including cost, time, and ease of fabrication. Results showed that harness systems vary in cost from $0.22 to 96.45 and take 2-49 min to fabricate. The 4-point harness was the least expensive and the easiest harness to fabricate. The Beanie Cap harness was the most complex system to make, while the Open Mask Stabilizer was the most expensive. The systems resulted in varying distributions of compression when depicted with three-dimensional laser scanned images. This description and comparison of fabrication materials and methods for TFO harnessing can guide clinicians within the burn community worldwide who have varying skills and resources for facial scar management.