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Face masks

Regions Hospital - Burn Center - Burn mask

Snug-fitting compression garments can reduce scarring from burns by keeping the tissue flat and smooth during the healing process. These garments include masks, shirts, pants, leotards and gloves. Compression garments are made to fit any injured areas and are often colored light brown to mimic natural skin tones so they are less noticeable. Fabric masks for facial burns, however, are very noticeable, difficult to conceal and do not maintain adequate pressure on the natural curves of a face (facial contours).

Regions Hospital - Burn Center - Burn mask 2

Responding to these needs, Elizabeth Rivers, an occupational therapist working at the Regions Hospital Burn Center, invented a clear plastic mask in 1975. The new mask, which is sometimes called a TFO or “transparent facial orthosis”, was not as visible as a fabric mask. Because it was transparent (clear), therapists could see how well the mask compresses the scars. As a result, the plastic mask was significantly more effective in reducing the scarring following a burn injury.

A transparent face mask is a see-through mask that is worn after a face burn. The mask helps the face skin heal with the least amount of scarring. The transparent face mask is worn 18–20 hours every day for 18–24 months after the face or neck graft or until the skin graft is mature and done healing.

New Face Graft - Cool the Burn

This is a new face graft right after the graft was done.

 
Regions Hospital - Burn Center - Mature Face Graft

This is a person with a face graft that is mature, about two years after the injury. The skin graft is done healing. The skin is mature when it is soft, flat and light in color.

 
Regions Hospital - Burn Center - Fabric Face Mask

Some burn centers recommend using a fabric face mask. The fabric masks are made from the same tight elastic fabric as compression garments.

 

How to make a transparent face mask or TFO

To make a transparent face mask, a model or impression needs to be made of the patient’s face. It does not hurt to take an impression, but some young children are put to sleep during the process because it might frighten them.

Regions Hospital - Burn Center - Coating face with petroleum jelly

The first step in making the mask is to put a thin coat of petroleum jelly over the patient’s face and ears. Next, the face is covered with a gooey, oatmeal-like substance called Jeltrate. To let the patient breathe, however, Jeltrate is never put over the nostrils or the mouth.

When the Jeltrate dries, it become very rubbery.

The Jeltrate impression of the face is then reinforced with strips of plaster which harden in about ten minutes.

Regions Hospital - Burn Center - Cover face with Jeltrate

After the plaster has dried, the mask is removed from the patient’s face. The inside of the mask duplicates the curves of the person’s face and is called a “face impression”.

Next, the face impression is filled with liquid plaster. When the plaster dries, it forms a solid head.

Regions Hospital - Burn Center - Face impression filled with liquid plaster

After the plaster has thoroughly dried, the layered plaster strips are cut and carefully removed from the impression. Then the rubbery Jeltrate is peeled away as well.

Regions Hospital - Burn Center - Dried plaster Jeltrate pulled away

Next, the therapist cleans the plaster head and sands it smooth.

Meanwhile, a sheet of transparent plastic is heated in an oven until the plastic is soft and pliable.

Regions Hospital - Burn Center - Transparent plastic sheet heated

This warm plastic sheet is then draped and completely pressed over the plaster head. This step is called “pulling a mask”.

Regions Hospital - Burn Center - Warm plastic sheet pressed over plaster head

After the plastic cools, the therapist cuts openings in the mask for eyes, nose, mouth and ears, and attaches elastic straps to the sides.

Regions Hospital - Burn Center - Plastic is cut for eyes, mouth, nose, ears

The therapist alters or revises the mask daily with spot heating to increase pressure on the patient’s scars. As the skin tissue matures, fewer revisions to the mask are needed.

Regions Hospital - Burn Center - Daily alterations to mask Usually, most patients wear their masks for a year-and-a-half or more to achieve the best results possible.

Transparent face orthosis (TFO) mask

Purpose:

A see-through mask that is worn after a face burn; the mask helps the face skin heal with the least scarring.

Wearing:

18–24 hours each day for 18–24 months; off for eating, care and face exercises only.

Discomfort:

Not after you get used to it; painful if only worn during occasional return visits for revisions.

It won’t fit if you only wear it when you come to visit the doctor and therapist.

Transparent neck orthosis (TNO)


Purpose:

A see-through mask that is worn after a neck burn; the splint helps the neck skin heal with the least scarring.

Wearing:

18–24 hours a day; removed for eating, care and face exercises.

Discomfort:

Not after you get used to it; painful if only worn during occasional return visits for revisions.

It won’t fit if you only wear it when you come to visit the doctor and therapist.