1 s2.0 S2666964122000467 Main

Annals of 3D Printed Medicine 9 (2023) 100092
Contents lists available at ScienceDirect
Annals of 3D Printed Medicine

journal homepage: www.elsevier.com
Review
A systematic review on materials, design, and manufacturing of swabs

Vedant Vashista,b,1, Neil Banthiaa,b,1, Swapnil Kumara,c, Prajwal Agrawala,*
a
AMM Engineering Laboratory, NewEra Hospital and Research Institute, Nagpur, Maharashtra 440008, India
b
School of Mechanical Engineering, Department of Manufacturing, VIT Vellore, Vellore, Tamil Nadu 632014, India
c
Department of Aeronautics, Imperial College London, London, SW7 2AZ, United Kingdom
A R T I C L E I N F O A B S T R A C T
Article History: From simple cleaning to metagenomic studies and now the detection of the SARS-2 virus, swabs are absor-
Received 5 February 2022 bent pads with handles that hold significant promise in several applications and properties. Furthermore, the
Revised 13 November 2022 swab is now used for a wide range of medical purposes, such as the collection of bacteria and other patho-
Accepted 25 November 2022
gens such as influenza and H1N1. Various designs and materials used for the tip have led to a wide range of
Available online 26 November 2022
applications. In this review, we discuss the characteristics of essential tip materials such as rayon, polyester,
nylon, and polyurethane in the context of specimen collection from various substrates. Further, this article
Keywords:
reviews swab manufacturing techniques, including injection molding and calendar roll pressing, among
Additive manufacturing
COVID-19 swabs
others. In recent years, advances in additive manufacturing technology have made it possible to produce
Swabs materials swabs in a fast and efficient manner. Furthermore, the design for additive manufacturing (DfAM) is given for
Swabs manufacturing the production of swabs. We also examine how 3-D printing of bio-resin swabs has revolutionized the
Medical devices manufacturing process, making it autonomous, quicker, more efficient, and environmentally friendly. Addi-
3D-Printing tionally, a shortage of medical devices for testing the SARS-2 virus has zealously motivated the medical
industry to revolutionize through additive manufacturing of swabs, thus revolutionizing the medical indus-
try. In conclusion, the limitations of the current techniques and future directions for swabs are discussed.
© 2022 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/)
1. Introduction sweeping the deck with a cloth, they attached fabric at the end of a
stick to reduce the effort and maximize cleaning results. These deck-
Among the 5 primary senses, hearing is the most beneficial for cleaning sailors were called ’Swabbers,’ and hence through time, we
communication. Our ears, however, have weaknesses, like earwax adapted these absorbent pads for cleaning and sampling to be known
build-up and tinnitus, to name a couple. Because of earwax build-up, as swabs [4].
the ear is prone to infections and damage [1,2]. The ear cleaning Subsequently, since the first patent for swabs in 1874 was made
problem has been a massive issue throughout history. This is mainly by Moritz Leiner; the designs, manufacturing, materials, and applica-
due to the damage to the eardrum while cleaning the canal for ear- tions have developed greatly. Swabs were initially made by twining
wax. In the early centuries, ’Ear pickers’ made of metal were used wires and attaching a thread akin to a spoon at the end [5]. Soon, dif-
which was dangerous [3]. This practice continued until people real- ferent materials like sponges, cotton, polyester, and rayon were
ized that adding small fibers of cloth not only made them safer to use attached at the ends of the wires, enhancing present-day applica-
but also helped remove earwax more efficiently [5]. Cotton, a generic tions. No longer for ear cleaning alone, swabs have been used to
fabric used since prehistoric times, was the pre-dominant answer to study the human genome. In the recent COVID-19 pandemic, naso-
put at the tips of the so-called ear pickers. This idea was derived from pharyngeal swabs played an important role in testing in humans
the mops that medieval sailors used for cleaning decks: Instead of through the extraction of epithelial cells and membranes [6−8].
According to Verdon, Mitchell, and van Oorschot [9], present-day
technology divides swabs into 3 significant designs: wound swabs,
List of abbreviations: AM, Additive Manufacturing; CAD, Computer-aided designing;
PET, Polyethylene terephthalate; SEM, Scanning Electron Microscopy; DNA, Deoxyribo-
flocked swabs, and pad swabs. Each dominant design has specific
nucleic acid; CFU, Colony-forming unit; IRB, Institutional Review Board; DiY, Do it applications. Their research describes each design in a detailed man-
yourself; FFF, Fused Filament Fabrication; SLA, Stereolithography Apparatus; MJF, ner, summarized in the next few lines. A wound swab, as shown in
Multi Jet Fusion; NP, Nasopharyngeal swabs; PETG, Polyethylene terephthalate glycol Fig. 1a, consists of pure long fibers being wound up to the shaft,
* Corresponding author at: AMM Engineering Laboratory, NewEra Hospital and
which is the antiquated design, [10]. Verdon described it to be
Research Institute, Nagpur, Maharashtra 440008, India.
E-mail address: [email protected] (P. Agrawal). extremely efficient under difficult situations of specimen collection
1
These authors contributed equally to this work when paired with the intended material. Fiber density and
https://doi.org/10.1016/j.stlm.2022.100092
2666-9641/© 2022 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
V. Vashist, N. Banthia, S. Kumar et al. Annals of 3D Printed Medicine 9 (2023) 100092
Fig. 1. Overview of differing types of swabs and their manufacturing. a. Absorbent pad with a cavity for attaching the handle. b. Swab with a non-circular cross-section. c. The
sectional view of the absorbed pad with barbed handle inserted.d. Side view of the common cotton swabs with elongated tips. e. Edge view of the design of nematodic swab (during
the removal of the lower layer from the other two layers for trapping microorganisms). f. A working demonstration of the cotton swab that cannot clean trapped ear wax in the ear
canal. g. Side view of a newly designed cotton swab with a disc inserted at the terminal. h. Prototyped swab computer-aided design for 3D-printed fabrication. (I−VIII) FAMES Lab
designs. (IX−X) Abiogenic designs. (XI−XIII) Fathom designs. (XIV) USF Health design. (XV−XIX) Wyss designs. (XX) Copan ESwab 481C swab. i. The heads of the swab designs are
shown in 1h. h, i: Reprinted with permission from [93].
absorption also play a vital role in sample extraction. The next inno- to spines on porcupines, which allow a plethora of contact points and
vation was the advent of pad swabs, inspired by foams and other hence enhance the surface area for specimen collection [9]. Originally
sponge-like porous materials, such as those in Fig. 1b. These can derived from the shape of hydrophilic plants, flocked swabs revolu-
extract samples from porous surfaces like wood due to their high tionized the industry [11]. While wound swabs were originally pro-
absorptivity and ranges in porosity. The foam, being produced in duced by hand, now all three dominant designs can be produced by
sheets, allows different pore sizes, tip shapes, and sizes for specific machines, mostly 3D printed, in much higher quantities.
applications in various environments. Lastly, flocked swabs consist of The manufacturing technology of swabs has progressed from orig-
fibers attached perpendicularly at the end of the swab stem similar inal hand-made products to automated manufacturing [12]. For the
2
production of elongated swabs, specific parameters were set for the procedure for testing swab samples in labs, which has now become
sheet material of the tip to be cut out from, which were then roll- rudimentary for research in all fields. Here is one example [22]:
pressed onto the shaft. In 1999, fully automated systems were devel- Firstly, the swab is sterilized and then prepared for sample extraction
oped for the fabrication of foam swabs. The process involved molding from the given region. After extraction, it is stored in vials with
and then cutting pads, which were later attached to the stems enrichment media and transported under freezing conditions with-
through hot electrodes. The automated machines were subdivided out antibiotics. Samples are then re-extracted from the swab into a
into five stations for the processes discussed above. Lastly, oval- prepared culture where it is incubated for the pathogen to grow as it
shaped swab tips were formed by calendar roll presses, which were will be easy to detect further. All of these processes are done carefully
set at a high temperature for molding of thermoplastic material, by and the swabs are isolated in small medical storage chambers. A vor-
deformation [13]. This economical process is currently used for mak- tex mixer or a centrifuge is used, depending on what is needed, are
ing cotton earbuds. The motorized system for manufacturing involves used to take out the pathogen, and check under microscopic condi-
five stations. However, current manufacturing systems are much tions [23].
more efficient and safer, thanks to many technological advancements After observing all the data given above, a perceptible analysis for
in automated production techniques. For example, additively manu- each series of materials, manufacture, and design is required. Since
factured swabs are much safer to manufacture and are more durable swabs are of paramount importance for testing patients during the
than hand-made produce [14]. Covid-19 pandemic, it would be valuable to be well-informed about
Since the beginning of the 21st century, the pace of technological existing swabs types and the designs of swabs available. This includes
development has surged [15]. One such impact has been through the fact that most swabs would be fabricated through additive
‘Additive Manufacturing (AM). Other equivalent names for this pro- manufacturing techniques due to avoid health risks posed by a coro-
cess are 3D Printing, Solid Freeform Fabrication, Layered Manufactur- navirus and also for faster results. This review paper discusses the
ing, and Rapid Prototyping. It is a procedure through which virtual 3- various designs, their drawbacks, and how additive manufacturing
D models on software, based on computer-aided designing (CAD) has aided in a new solution. Additionally, various material tips and
data are constructed. Currently, it encompasses major industries manufacturing techniques for swabs are discussed with their applica-
such as aerospace, defense, medicine, sports, automobiles, and many tion in various fields. Furthermore, due to the rise of additive
more. The name additive manufacturing’’ comes from the way it con- manufacturing technologies, the current scenarios and the future of
structs the 3-D model, layer by layer. This makes the fabrication of swabs are also discussed.
products easier and faster even when complex shapes are designed. The main objectives of this review paper are to understand the
Furthermore, dimensional accuracy is high, and custom user-based various improvements made in designs and materials for swab
models of complex geometries are also possible. This technological manufacturing and to report on the functioning of suitable materials
feat has been exploited for several purposes, but perhaps the most among cotton, rayon, polyester, nylon, and polyurethane by examin-
important is the advancement of healthcare. A good example would ing their clinical performance. Because of the Covid-19 pandemic, we
be medical equipment production. 2022’s COVID-19 pandemic has have seen a shift in the paradigm towards 3D printed/ Additive Man-
taught us well that the production of medical equipment can be ufactured swabs due to their rapid manufacturability. In this manu-
much faster, more efficient, accurate, and safer for all users when script, the spectrum of opportunities and challenges for the future of
compared to current manufacturing techniques. Within additive additive-manufactured swabs and their application is discussed.
manufacturing, there are not one but several processes through
which objects can be fabricated [16,17]. Inventions of different mate- 2. Materials and Methods
rials used in 3D printing have allowed us to expand our horizons
[18]. 3D printed swabs used for nasopharyngeal testing for COVID-19 Since swabs have so many applications in the medical industry,
are made from autoclavable biocompatible resins, which are non- the effectiveness of materials in the tips has always played a signifi-
toxic and very safe to use. Here, not only did swabs become safe, but cant role in specimen sampling. Scientists and researchers require
also their mechanical properties were enhanced. For example, naso- achieving accurate results during experimentation through swab
pharyngeal testing swabs 3D printed by Abiogenix displayed excel- sampling. Knowing that the proximity of location for specimen
lent torsional properties and were flexible enough to sustain the extraction and data inspection is distant, swabs have to go through
pressure put by the nasalis muscle in the upper parts of the nose [19]. the storage and transportation phase where specimens extracted
Also, the usage of additive manufacturing makes things simple in the from the workplace have to be isolated. So, it would be no use to
supply chain as all the required parts and designs can be manufac- select swabs that degrade, lose, or lose inspection samples during
tured using a single machine, and printing the products in bulk or storage, transportation, and experimentation. The evolution from
single will cost the same thus also reducing the risk of huge logistics. ear-cleaning tools to DNA and pathogen detectors constitutes a major
Among many additive manufacturing techniques, the occurrence leap, as shown in the materials used. Swab materials have augmented
of biological materials has become a growing trend due to the their properties over time. Beginning with naturally-found products
immense amount of resources spent to gain knowledge in this area. like cotton, researchers have shifted the paradigm to a more syn-
Like this, an emerging field in the medical expertise for surgical thetic, human-made material usage. Most of these materials now can
equipment and internal body structures, the predictions, results, and be 3D printed and are eco-friendly. Thus, the absorption capacity and
products need to be very safe and usable as ethical and moral issues sample collection properties of swabs in various environments have
in studies come into the picture. The arena of additive manufacturing become more efficient, depending on the material used [24]. The sci-
has recently been able to achieve the use of biocompatible polymers ence behind water absorption of swabs depends on factors like chem-
and metals in coronary angioplasty and organ-on-chip designs [20]. ical composition, microstructure, and surface polarity. The chemical
Given these advancements in medical technology, this paper is nature of the tips of swabs exerts polar forces that attract the hydro-
intended to invigorate the role of additive manufacturing in the philic or any other groups that are present in samples [25]. Further-
once-primitive tool known as the ‘swab’ [21]. more, 3D printing allows swabs to easily be designed to include more
As the importance of the swabs grew throughout history, many surface area to augment properties.
standard procedures were established to investigate and detect Furthermore, capillary action also influences this property [26].
microbial samples through extractions performed on them. Process- Hence, pre-moistening with water or a binder allows the hydrophilic
ing sampled swabs, and testing for pathogens is a long and painstak- groups to latch onto the tips as the attraction forces increase [27].
ing process. After a plethora of research, scientists formed a standard With many advancements taking place in materials, the development
3
of diverse materials continued and even enhanced these properties suitable yarn. By 1913, Camille Dreyfus used acetate to make a seam-
depending on the uses, as the difference in chemical properties of less sample of a continuous yarn, which revolutionized the fabric
fibers influences the efficiency of sample recovery (Different materi- industry. Electron micrograph images of rayon (given in Fig. 2b),
als used for swab manufacturing are shown in Table 1. Even though reveal it, as a long, thin, and less dense fiber, which explains the high
there may be many swab products of the same material in the mar- liquid absorption and retention capacity. The difference between
ket, each swab type is generally backed by specific scientific evidence using cotton and rayon swabs is that cotton contains growth inhibi-
or literature. All the primary materials used for making the tips of tors for a few bacteria due to the diffusion of fatty acids in liquid pres-
swabs are discussed as follows: ence, and also because they leave cotton fibers on the extraction site
due to being tightly wound. Whereas, rayon, on the other hand, is
2.1. Cotton softer, more economical, and doesn’t leave fibers on the substrate
giving it an added benefit [34]. Having cellulose in its chemical matrix
It is one of the oldest materials cultivated since ancient civiliza- allows a higher rate of water absorption and surfactant, although it
tions. It has been used throughout history for several medical and doesn’t make it better than cotton but is just widespread in use. In an
commercial purposes [27]. It consists of repeating units of cellulose experiment conducted by Kathryn Harry et al. [25] in 2013, where
that contain hydroxyl groups, giving excellent absorption through water and protein absorption by swabs were compared, the mean
hydrogen bonding [28]. The scanning electron microscope image absorption of rayon-flocked swabs was 17.1% for water and 16.1% for
from Fig. 2a depicts thin, long, and tightly wound fibers, which protein. In all tests (including culture studies of test organisms), the
enhance absorption. During cellular testing in body parts, like naso- rayon swab was not a paragon swab material, but it was conventional
pharyngeal tests, the hydroxyl groups between cotton and carbohy- enough to give legitimate results [25]. However, according to Comte
drates in cell membranes form bonds [28]. The forensics industry has et al. [35], in a comparison between flocked nylon swabs and rayon
done significant testing with cotton and also compared it to several swabs, they both show no significant difference in the recovery of
other materials. Cotton swabs have excelled in DNA testing, and common respiratory bacteria [36]. On the development side, the Cell
major swab manufacturing industries have always started with cot- swab, a new type of rayon swab, was examined by Esposito et al.
ton due to its inexpensive and efficient nature. Bacillus anthracis [34], which showed absorption and release of the sample liquid up to
spore recovery from steel surfaces for cotton was the highest with a 1.3 and 3.5 times more than dacron swabs. There are many rayon
mean of 93.9% [29]. Furthermore, bacterium like Escherichia coli and swab kits available with different designs, which include desiccants
Staphylococcus aureus found in the environment have shown high or ventilation holes to dry the swab promptly, hence evaporating the
amounts of DNA, and colony-forming units (ability to multiply under extra water/liquid collected by the rayon swabs [37].
controlled conditions), which have been easily sampled by cotton
swabs with accurate results obtained [30]. For other sample recover-
ies, scientists/researchers have found that pre-moistening the swab 2.3. Polyester
with water or chemicals, depending on the use, will aid [29]. The
overall efficiency of pre-moistened cotton swabs was better than It is a synthetic fiber made through non-renewable sources like
standard cotton swabs. Nonetheless, employing cotton swabs to this petroleum, which comes from a chemical type called polyethylene
date has been scarce due to environmental issues involved; however, terephthalate (PET) and contains esters (functional group). It comes
newer materials and designs that clients quickly manufactured while in different grades, which are used to make products including rela-
providing similar or even better results are now dominating this tively inexpensive clothes and bottles [38]. Polyester swabs were
industry [31]. tested for biological material samples from different substrates by
the forensic crime department, and it is quite efficient in collecting
and releasing specimens. Also, the scanning electron microscopy
2.2. Rayon (SEM) images (Fig. 2c and d) depict polyester with long and irregu-
larly-formed fibers that leave fewer open spaces than cotton and
It is made from cellulose (wood pulp) and heavily processed and rayon. Therefore, it is less efficient for extraction [29]. Additionally,
hence classified as a manufactured fiber [32]. It can imitate the tactile pre-moistened polyester swabs show no difference from the same
nature of cotton, silk, wool, and linen [33]. Many researchers from dry swabs in Bacillus anthracis spore recovery from non-porous sur-
the early 1800s tried to find the perfect way to fabricate a safe, faces. However, Mulligan et al. [28] noted that cotton and polyester
Table 1
Different materials used for swabs and their properties.
TIP MATERIAL PROPERTIES PURPOSE Feasibility of Materials in ‘AM’
Cotton Absorptive, No quick-drying, Leaves fiber residue on most surfaces, B, C Has to be wound externally
Poor chemical resistance, and compatibility, Contains growth inhib-
itors for bacteria due to fatty acid presence, Inefficient in specimen
release, Inexpensive
Rayon Highly absorptive, No quick-drying, No abrasion of fibers, Excellent B, C, F Difficult to use in machines, typically wound externally
chemical resistance and compatibility (except strong acids and
bases), Mediocre in specimen release, Cost-efficient
Polyester Reasonably absorptive, quickly dries, No abrasion of fibers, Excellent B, F Can be incorporated into machines
chemical resistance, and compatibility (except strong bases), Good
efficiency in specimen release, Cost-efficient
Nylon Reasonably absorptive, quickly dries, No abrasion of fibers (used as B, F Can be incorporated into machines
flocked) but leaves a residue on rough surfaces, Excellent chemical
resistance, and compatibility (except acids and bases), Very efficient
in specimen release, Expensive
Polyurethane Highly absorptive, quickly dries, No abrasion (foam-based), Excellent B, C, F Difficult to use as foam structure in machines, typically foam is
chemical resistance and compatibility, Efficient in specimen release, attached externally
Expensive
[B − Biological, C − Cleaning, and F − Forensic]
4
Fig. 2. SEM images of different swab material tip portions. a. SEM Analysis for cotton swab tip at 50 £ 10KV and 500mm, b. SEM Analysis for rayon swab tip at 50 £ 10KV and
500mm, c and d. SEM Analysis for polyester swab tip at 50 £ 10KV and 500mm, e. SEM Analysis for nylon flocked swab tip at 50 £ 10KV and 500mm, f. SEM Analysis for polyure-
thane foam swab tip at 50 £ 10KV and 500mm. Reprinted with permission [38]. Copyright 2018, the Authors.
showed no significant difference in data collection for membranes. the high sensitivity factor for flocked nylon swabs proves them to be
However, other studies from the same group suggest bonds formed an excellent prospect as oral swabs for detecting pathogens and anti-
in cotton and rayon are more robust than in polyester and acrylic, bodies and storing them for further testing [15,39,41]. However, the
due to chemical compositions as seen with a 23% difference in range main drawback of these tips is that swab material is left on the sub-
while Deoxyribonucleic acid (DNA) swabbing with water as a solvent strate of rough surfaces limiting its usability [9].
[28]. Hence, proving DNA profiling is slightly better with cotton than
polyester. Young et al. [9] found that the polyester swab was ranked
2nd in the collection and release for neat blood samples from surfaces 2.5. Polyurethane
like glass, pitted, brick, and wood with a range of 110 to 140 nano-
grams. Furthermore, biological specimen collection from rough, non- It is an elastomer made by the condensation reaction of isocya-
porous surfaces and touch DNA from smooth, non-porous surfaces nates with polyols. It was invented by Otto Bayer and Dieter Dieterich
were recommended for polyester swabs [9]. in Germany during World War II [43]. Due to its frequent use in
foams and sponges, it was incorporated into swabs. As a natural
2.4. Nylon sponge, these foam swabs allow the accessible collection and release
of specimens. The SEM image (Fig. 2f) of polyurethane fibers displays
It is the world’s most commercially produced synthetic fiber. a uniform open structure with a light density that corroborates its
Being made from amide linkages, this thermoplastic has the most suitable absorption property. Spore recovery from the vortex and
extensive variety of products in the market [39]. Nylon swabs were sonication extraction method gave it the highest percentage of 22.5%
produced beginning in 2003 when the organization COPAN released [29]. Young et al. [9] found that the Puritan foam swabs ranked 2nd in
flocked nylon swabs. Its advancement is such that in scanning elec- the absorption and extraction efficiencies of biological fluids and
tron microscopy (SEM) imagery (Fig. 2e), short fibers of nylon have highest for the collection of 1.6 to 155 nanograms of biological mate-
split perpendicular ends, which provide improved surface area, sur- rials from wood/porous surfaces. Furthermore, recovery of S. epider-
face tension, and microchannels for increased absorption and extrac- midis bacteria and colony-forming unit (CFU)s were highest for foam
tion, and recovery efficiency up to 48.4% [40]. Flocked nylon swabs swabs under close-to-reality conditions’ [15,44]. Amongst different
absorb and release both cellular and cell-free material more effec- flocked swabs, polyurethane macrofoam again ranked 2nd giving 62%
tively than comparator swabs after analyzing the sample recovery of for protein, bacteria, and water absorption, whereas Puritan’s Hydraf-
infected cells [41]. For touch DNA, Hansson et al. [42] found flock lock was first [25]. However, the popularity of foam swabs was drasti-
nylon gave decent partial DNA profiles. CopanFLOQ swabs exhibited cally reduced due to an incident in Wales, where the tips of the swab
an active uptake and discharge of viruses and cells, which were addi- got detached from the stem and created significant safety issues for
tionally augmented in an Amies transport medium [15]. Furthermore, people [45].
5
3. Design Nasopharyngeal swab testing uses swabs that have a small minia-
ture tip with ultrafine flocked fibers and a thin long flexible handle,
Swab design has evolved through the centuries, starting from the breakable in the middle to make it easy to store/transport the col-
very basic stick-and-cotton type, all the way to a multi-layered syn- lected specimen. Whereas for the nasal test the swab is inserted up
thetic swab. Each design had a purpose and need, discussed below to the nasal membrane. In nasopharyngeal swab testing the sample
(Different designs for swabs are shown in Table 2). The new design of is collected from the upper part of the throat behind the nose, also
swabs consisted of only a stick or tube usually made of wood with called the nasopharynx [87]. The swab is inserted into the nostril par-
the absorbent covering at one of the ends or sometimes on both ends allel to the chin up to the point where resistance is felt. This testing
(As depicted in Fig. 1d). The handle part is called the stem of a swab. requires precision and is only done by professionals. Although both
The design was simple and very useful during the early days testing methods give similar accuracy, they differ in their applica-
because back then, swabs were only used for cleaning ears, nose, or tions. Patients that felt easier to collect their samples by themselves
other sensitive tissues of the body. However, this simple design had and then deposit them for testing used AN swab and the testing
its flaws. One such flaw was the potential damage to the eardrum, in method, as it was more comfortable and can be done without a pro-
response to counter this, some suggested installing flat discs under fessional [86].
the absorbent covering at the ends. The size of the disc prevented the Currently, the design of swabs could be complex and difficult to
swab from entering the ear canal and therefore protected the ear- fabricate. However, 3D printing has allowed swab design to be com-
drums [46]. Another problem was how to protect the tissue/inner ear plex, intricate, and specialized for suitable applications. Some of the
skin from the stem in case it protrudes through the soft covering, different possible designs can be depicted in Fig. 1h and i.
which was resolved when a cushion was placed in between the stem
end and soft covering to give some protection to the tissue [47,48]. 3.1. Swabs with elongated tips
But applying this solution proved to be difficult, because inserting a
flat disc (As depicted in Fig. 1g) and cushion made the swab harder to The next design introduced was called the cotton tip swab also
manufacture, difficult to use, and inefficient. known as the elongated tip swab (Depicted in Fig. 1d). In this design,
Design formation using software like Solidworks, AutoCAD, and eval- the swabs were made with an elongated stem with a conical, out-
uation using the finite element method are the key parameters for the wardly flared hollow end. These ends made the tips softer and
development of complex systems on a product level [94−98], and design reduced the amount of material used, thereby reducing manufactur-
for additive manufacturing serves as a foundation for developing light- ing costs. In this design, the stem is made of a flat cellulosic sheet
weight products. Design for additive manufacturing (DfAM) is mainly [47]. Another essential feature of this design is that it was manufac-
dependent on the speed of the material deposition, optimization for tured using die-cut paper, and hence less material was used for mak-
shape and manufacturing process, and minimization of volume faction, ing the swab. These types of swabs found their use in the cleaning of
and volume fraction is dependent on the voxel mesh optimization, and ears, nose, baby care, and also for cleaning wounds.
this produces optimized design and reduces the production time [96]. Another enhancement to the expanded tips swab was to use a
Nasal and nasopharyngeal swab testing are the two most widely non-circular external cross-section configuration for the swab ends.
used specimen-collecting methods for the SARS-2 virus. Swabs used The main reason for this improvement was that circular swabs could
for nasal testing are relatively smaller handles made of polystyrene push the wax further into the ear canal rather than pull it out (As
and medium-sized tip made of flocked fibers. The process of collect- shown in Fig. 1f).
ing the specimen involves the insertion of anterior nare swabs into Thermoplastic material is usually preferred for manufacturing the
the nostril at least a centimeter deep with the tip touching the side stem. For the absorbent covering materials like cotton, or any other
walls of the nostril, the swab is rotated for about 10−15 s [86]. The synthetic form material which can be made into the desired shape by
process is then repeated for the second nostril. pressurized heat treatment. To increase the rigidness of the wad
Table 2
Different designs used for swabs.
NAME OF THE DESIGN INVENTOR FUNCTIONAL FEATURES APPLICATIONS YEAR
Swabs with expanded tips Bennet Elongated ends, were outwardly flared and Very helpful in the cleaning of ears, nose, or 1998
conical in shape. other sensitive tissues.
Softer, with less material required
Swab with an inserted disc Schmerse, Jr. A disc was inserted under the absorbent cov- Was used mostly for cleaning the ears and 1992
erings to prevent the swab from damaging noses of children.
the ear canal.
Much more difficult to manufacture.
Tip with a non-circular external cross-sec- Can The shape of the tip was changed from a con- Used for cleaning ears and nose. 1987
tional configuration ventional round shape to a non-circular
shape.
This helped in removing the ear wax
properly.
Flocked design Absorbent material flocked rather than Used for collecting cells for specimens.
attached directly to the stem or could be
3D printed as a whole.
More absorbent than the default design.
Nematodic swabs V.P. Simmons Swabs with multiple layers. Used for collecting repeat specimens. 1961
NP and OP swabs NP swabs are used for taking samples from Used for detecting various viruses and
the nasopharyngeal cavity and OP swab is diseases.
used for taking the sample from the oro-
pharyngeal cavity.
Swab with an absorbent pad Melcher & Speichert Swab with a barbed removal stem attached Used for applying medication on wounds, 1999
to an absorbent pad or could be 3D printed cleaning wounds, or applying makeup.
as a whole.
6
(absorbent covering found at the end of the stem), a stiffener-like middle layer. The layers are glued together using an adhesive such as
starch is coated over the wad [13]. polyisobutylene or any other rubber-based adhesive [6].
Besides cleaning, swabs found an application in metagenomic
studies where they were mainly used for collecting biological and 3.4. Swabs with absorbent pads
environmental samples [30]. This design consists of a cylindrical rod
where one end is covered with a hydrophilic wad of fibers such as Absorbent pads in swabs served the purpose of applying makeup
rayon or cotton. A hydrophilic material is preferred to increase the and medication. This type of swab usually came with an absorbent
absorption of the specimens [49]. Adhesives were used to wrap pad that was inserted into the stem part or handles. One of the prom-
absorbent material around the ends of the swab, thus creating the inent advantages of these swabs is the ability to go through autoclav-
wad. ing (a process used for making swabs sterile for medical uses). They
In this design, the cylindrical rod is manufactured using injection are also cheaper to manufacture and more durable compared to other
molding or 3D printing, with mostly plastic as a material. Due to this swabs. It consists of a rigid stem partially inserted into a removable
method, a sharp truncating cut was formed at the ends of the stem, pad (As shown in Fig. 1a). The pad can be made up of any material for
which caused discomfort when inserting swabs into cavities [49]. To retaining substances on its surface.
counter this issue, more absorbent material is glued to the truncated The stem has two ends, one in the user’s hand, and the other
cut; this serves to reduce the discomfort for patients. For these rea- inserted into the pad, as shown above. The end meant for insertion
sons, the absorbent material is given a circular shape, which gradu- into the pad has barbed ends to stay (See Fig. 1c). These barbs can be
ally becomes thicker towards the end. This design, due to increased made while molding or by using a cutting die [55].
thickness, provides comfort to patients but has its limitations. One The tips or wads underwent various changes in design, starting
such limitation is the oversaturation of liquid in the hydrophilic with the basic spherical form. However, the design was improved to
material of the wad which may cause inefficiencies in data sampling. prevent damage to the eardrum: A disc was inserted under the absor-
After the sample is collected, it is released from the swab for anal- bent covering, changing the shape of the tip to resemble the letter D
ysis. This is done simply by placing a petri dish and then gently (See Fig. 1g).
spreading the swab over it. Even if this process is done carefully or A significant improvement in swabs tips came when one inventor
repeatedly, it is not possible to extract the sample completely [49]. suggested the use of a non-circular cross-section for tips. This solved
Additional problems regarding this design were the discomfort expe- the issue of wax being pushed deeper into the ear canal while clean-
rienced by patients when the sample was taken from urethral or ocu- ing. Swabs used for applying medicine or makeup tend to have a
lar cavities. more cuboidal shape for the tip, usually called an absorbent.
3.2. Flocked swabs 4. Traditional swab manufacturing
In response to the association with expanded swabs, flocked Manufacturing is a more significant challenge than designing a
swabs were introduced. The significant difference between these and product as it should be done cost-effectively and efficiently. In tradi-
previous swabs was the method of attaching the absorbent material tional swab manufacturing, the main parts consist of two processes:
to the truncated cut, a process known as flocking, hence the name. In The first one is the manufacturing of the stem, and the other one is
flocking, the fibers are placed perpendicular to the adhesive-coated placing the absorbent tip onto the stem. Over the years, scientists
surface of the tip in an electrostatic field [49]. The materials which and engineers have tried to make a fully automatic machine with dif-
can be used as an absorbent for flocked swabs are rayon, polyester, ferent workstations for manufacturing swabs rapidly and on a large
nylon, polyamide, carbon fiber, alginate, cotton, and silk. This design scale. The process of mass-producing swabs began in the late 1980s
proved beneficial in the case of collecting samples of respiratory epi- when an inventor suggested manufacturing swabs with a non-circu-
thelial cells. Studies showed a two to three-fold increase in the cell lar exterior configuration [13]. So, this swab is made with a non-cir-
yield during observation using the flocked design [41]. Furthermore, cular external configuration, which helps it to overcome problems
flocked designs can be easily 3D printed and are most commonly like pushing ear wax deeper into the ear canal rather than clearing it
used for the testing of the SARS-2 virus. out (Fig. 1f).
3.3. Nematodic swabs 4.1. First process: pressurized hot rolling
Another essential type of swab is a nematode swab. These swabs The basic idea behind manufacturing this type of swab is to give
consist of three-layer short-length tape with each layer possessing an oval shape to the cotton wad and then compress it under heat in a
slightly different physical characteristics (as depicted in Fig. 1e). As specific mold, to make it into the desired shape. The stem of the swab
the inventor Vaughan P. Simmons [50] described in his patent, this is usually made of thermoplastic material, and particular tempera-
swab worked well in samples taken for invasive parasites such as tures are set on these rolls for the softening of the thermoplastic
pinworms. These parasites tend to lay microscopic eggs around the material. Additionally, for applying the pressure to deform the stem
anus of their host. For the best treatment to occur, a medical profes- and wad assembly, calendaring rolls are used. After the application of
sional must take samples from that sensitive region daily. pressure under heated conditions, permanent deformation is
Before this swab’s invention, many unprofessional methods were observed in the shape of the stem-wad assembly. For making differ-
attempted for sampling, including using cellophane tape wrapped ent shapes, different calendaring rolls with different cavities or open-
around a caretaker’s finger. This method was poor for collecting sam- ings are used [13].
ples with integrity [50]. Thankfully, these days a multi-layered swab
can be used for taking samples; in this nematodes swab, each layer 4.2. Second process: die-cutting
uses different materials. The materials which can be used for making
the top layer are cloth, vinyl, or any pliant sheet material. The essen- In the year 1998, inventor Robert Bennet provided improvements
tial requirement for choosing the material is cleanliness and resis- in elongated cotton swabs, which were manufactured by only using a
tance to fingerprints. The second layer is made of transparent pliant single flat cellulosic sheet. Fig. 3a shows the process in which the die-
sheets; usually, cellulose acetate. The last layer is made of ethylene cut paper is used for the manufacturing of the stem and tapered ends
terephthalate, which serves to protect the adhesives applied to the of the swab. After preparing the sheet, as shown in Fig. 3a it is rolled
7
Fig 3. Hot rollers for swab manufacturing. a. For non-circular shape to the swab’s tip. b. An advanced version of the hot roller process where different shapes with cavities are made.
to give a stick shape to the swab. During this process, adhesives can was invented [55]. This swab consisted of a stem or rigid holder and
be used to maintain the shape. In the last step, a spinning mandrel is an absorbent pad with a hole in it so that the barbed end of the stem
used to provide the outward projection to the end [47]. can be fitted inside the pad. The barbs can be made by die-cutting or
molding, and the pad is usually made by molding. Tips are made
4.3. Third process: a fully automatic multi-station system from foam plastics like polyurethane. The manufacturer decides to
make a mold with or without slits in the pad that are used for attach-
With the increased use of swabs in the sampling of specimens and ing the stem. If done without the slits, then it can be formed later by
clinical studies, it became a necessity to sterilize swabs before usage. burning hot electrodes or by cutting using a knife. A fully automatic
To fulfill this need, a highly durable swab that can also be autoclaved method for making swabs is also shown in Fig. 3b.
Fig. 4. Manufacturing machines for Swabs. a The diagrammatic view of a high-speed system for manufacturing swabs. b. Schematic of Murray’s process for manufacturing swabs
by using a cotton dispenser and 2 shaping bars.
8
The depicted machine consists of 4 regions: a pad-forming station, provide better availability and versatility in the clinics but also use a
an opening-forming station, a handle-inserting station, and a cutting simpler manufacturing process for the masses.
station, all attached to a conveyor belt. During the first step at the
pad-forming station, a pad with the desired dimensions is used. How- 5. Clinical applications
ever, the length is decided according to the plurality of the number of
swabs being made. This is then passed onto the opening-forming sta- The usage of swabs has evolved within the past few decades [57]
tion through a conveyor belt, where the pad (formed in the previous from being used just for cleaning, they now have an abundance of
step) is automatically stopped and held in its place by using a flat applications, including DNA testing [9,37,58]. The rise of the additive
clamp powered by a hydraulic actuator. While being held at the manufacturing industry has increased the manufacture and applica-
clamp, hot electrodes are moved into the pad using a piston mecha- tion of swabs.
nism, and the slits are formed in the pad to make a pathway for the This development led to increased application for cleaning
handles. After this step, the pad is moved to the handle-inserting sta- wounds and applying medicine [55]. Additionally, researchers from
tion, which uses a similar mechanism as the previous station. Here, various disciplines began to notice the swab’s ability to collect sam-
the handles are inserted into the slits, and the pad is transferred to ples and specimens [50]. For example, they can be used to take sam-
the cutting station. At the last station, multiple knives are placed to ples of pinworm eggs for the study and monitoring of the parasite
cut the pad into individual swabs using pistons. The obtained swabs [50]. A study from McMaster University showed that swabs are very
are then packed and shipped as required. effective in taking specimens for acute respiratory infections, mostly
flocked and rayon swabs, which are used for this particular purpose,
but flocked swabs have been proven more effective when compared
4.4. Fourth process
with rayon swabs [41]. In the early 21st century, the use of swabs
increased for taking specimens that were used as a replacement for
In the year 2005, inventor Liam Anthony Murray [56] patented a
nasopharyngeal swab aspirates because, in regular day-to-day clini-
fully automatic machine used for mass manufacturing swabs. This
cal practice, it is a less harmful, more feasible, and inexpensive
machine consists of 5 stations and a conveyor belt [56]. At the first
method to take samples [59]. Swabs are now widely used for the
station, individual stems are placed on the conveyor belt and clipped
detection of viruses and bacteria [60]. The reason for using swabs is
into place. At the next station, an adhesive is applied to the ends of
that they are cost-effective, easy to use, and effective in adhesion
the stems. At the third station, buds of the desired material (typically
quality.
cotton) are applied to the stem. A coil of cotton is also obtained from
Mentioned below are some of the viruses, bacteria, and other tests
the bale and is looped adhesively onto the coated ends of the sticks.
in which sterilized swabs have been proven very useful:
At the next station, the cotton buds are given a proper shape using 2
shaping bars. The shaping bars travel faster than the conveyor belt, as For determining the presence of candida Albicans in vaginal
it helps in reducing the tailing associated with a drag of cotton
infection
strands from the buds. Lastly, at the fifth station, defective swabs are For identifying alpha and beta-hemolytic streptococci and
removed, and the rest is forwarded to the packing assembly [56].
staphylococci
For detecting bacterial growth in urine
4.5. Injection molding For identifying staphylococci [61]
For identifying proteus [62]
This pandemic has made it evident to the public, how fragile
global supply chains can be in these crises. A shortage of important For the following viruses, nasopharyngeal swabs (NP) are used.
clinical supplies used for the detection and treatment of covid like
nasopharyngeal swabs was observed [88]. A study by [89] put forth a Detection for influenza B [63]
new design manufactured using injection molding for nasopharyn- Detection for parainfluenza virus 2[51,52]
geal swabs. Detection for parainfluenza virus 3 [53,54]
The paper [89] describes the development of a single component
of the nasopharyngeal swabs also mentioned as Grooveswab, com- For the following viruses, oropharyngeal swabs (OP) are used
posed of medical grade polypropylene, mass manufactured using
injection molding techniques. These swabs consisted of a non-absor- Detection for influenza A [64]
bent stacked-ring structure which was inspired by cat tongue papil- Detection for 2009 H1N1 [65]
lae that allowed it for efficient and comfortable collection of viscous Detection for adenovirus [54]
mucus samples and faster release into the collection medium com-
pared to traditional swabs [89]. There are many more viruses that can be detected using swabs,
Along with the absorbent pad, the swab also has a handle and a but the viruses, as mentioned earlier, have shown better detection
flexible neck. These nasopharyngeal swabs can get difficult to design probability using specified swabs. Recent studies have shown the use
due to their specific design and geometry based on the mold design, of swabs for forensics studies and in detecting traces of explosives in
tolerances, and undercuts. The shortage led to various attempts to fingerprints. For this, the routine cotton swab is converted into a sur-
develop nasopharyngeal swabs solutions using 3D printing swabs [8 face-enhanced Raman scattering (SERS) substrate [66].
−11,90−92] as it doesn’t require complex multistep manufacturing In the COVID-19 pandemic, swabs made using additive
as compared to other methods. manufacturing are used for the detection of the SARS-2 virus [64].
This is a relatively recent way of production of swabs and is some- This application has helped the testing process for COVID-19, as it is
times preferred over 3D printing as it allows higher scalability for cost-effective, easy, and fast [67].
mass production purposes. In this process, the swab handles (shaft)
are injection molded vertically into a mold, and a simple and efficient 6. Present technologies: manufacturing swabs using additive
tip design is utilized. Injection molding has already been used for manufacturing
manufacturing medical devices; it offers the lowest cost per part for
mass production. And with most of the infrastructure already avail- In the last few months, additive manufacturing has emerged as an
able globally to produce low-cost nasopharyngeal swabs which will effective manufacturing technique in the current COVID-19
9
pandemic. As testing for the virus (Fig. 7) is conducted around the NP O1 Swabs with similar properties and quality as the Fiberflex
world, it resulted in a shortage of test swabs (Also different additive but a different design [69].
manufacturing techniques used for swabs are shown in Table 3) [68]. The principal reason for this paradigm shift to additive
So, the fabrication of swabs using additive manufacturing has proven manufacturing is based on the fact that this process is automatic and
beneficial, due to it requiring fewer laborers. Additive manufacturing doesn’t require much manpower, hence adhering to the government
processes like Stereolithography apparatus (SLA) printers are used restrictions/protocols and safety from the SARS-2 virus. When com-
widely for this purpose, and they are used to produce the stem part pared to mass production techniques, which require immense skilled
of the swab on which absorbent coverings are applied later. The labor, this process has provided an alternative to production directly
material used for the stem is usually an autoclavable biocompatible from design with brief delivery time and complex designs.
resin [69,99], as seen in Figs. 5 and 6. The advantage of using the addi-
tive manufacturing process rather than the other process is both
6. Experimental testing
quantitative and qualitative [70]. Additive manufacturing involves
the following process after the design is finalized, (a) conversion of
The mechanical test is designed for the clinical use of the naso-
the design file into an STL file (b) import of the STL file for
pharyngeal swabs and to evaluate the potential failure modes. The
manufacturing (c) Material selection (d) Setting of the AM parame-
mechanical analysis includes testing the swabs in tension, torsion,
ters for manufacturing.
and flexure to evaluate the following conditions respectively, pulling
The technologies that additive manufacturing hold for us, in the
out of the nasopharyngeal space; catching an obstruction when being
future, are purely dependent on the extent of our imagination. Even
rotated within the nasopharyngeal space, and bending when inserted
the way that swabs are manufactured during this pandemic has been
into a nasal cavity [92].
revolutionary. Many organizations like Form labs, Origin, Envision
Tech, HP, and others have helped ameliorate this technology and
have helped in developing different machinery [70,71]. Currently, 7. Future perspective
these are some of the largest producers of 3D-printed swabs that
were approved by the National Institutes of Health organization [72]. The inventions mentioned above provide extensive scope for the
Even more biocompatible materials are being made for non-toxic, future of swab usage. Swabs are being applied in new ways all the
durable, and flexible swabs, Fig. 6. One such example is surgical guide time, like the SERS Q-tip being used to detect traces of explosives on
resin, a biocompatible and autoclavable resin used to fabricate dental fingerprints. Traces of explosive materials on fingerprints up to a
guides and surgical implants. These swabs are now being made femtogram was detected by recently developed SERS Q-tip swabs.
through select carbon digital light synthesis printers, and HP’s multi- This application could prevent acts of terror and extremism [66].
jet fusion technology printers [73], Fig. 5. Additive manufactured swabs could acquire new built-in analogous
Additionally, a partnership between Mark Forged (manufacturers technology, like in pregnancy test kits, which immediately detect
of 3D printing systems) and Neurophotometrics (a fiber photometry viruses or other samples for which they are being tested. After
company) has produced a Fiberflex Rayon material and additively reviewing a variety of swabs, their designs, materials, and
manufactured a nasopharyngeal swab. This swab is beneficial for manufacturing, we have found that flocked designs manufactured
gathering viral particles and may diminish the number of incorrect using additive manufacturing among swabs have a significant influ-
swab tests [71]. The swab is fabricated using a nylon base with rayon ence on studies and in the market.
fibers wrapped around the tips for efficient absorption at the given The COVID era has brought a great progression in the evolution of
area for sampling. Validation of these swabs has been done by the technology, especially manufacturing. With more than a million cases
Institutional Review Board (IRB) at the University of California, San a day, swab testing requirements had been increasing rapidly. On top
Diego, and Rady’s Children hospitals. (The top portion of the shaft is of that, existing technologies for manufacturing swabs had become
exposed to rayon fibers which are flocked onto the thin stem of the less feasible to use due to safety concerns of individuals and the
swab shaft) [74]. spreading of Covid cases. This brought immense pressure on the
New technical innovations like HP’s multi-jet fusion printers medical professionals as swabs were getting scarcer and testing had
have allowed a revolutionary design for nasopharyngeal swabs become expensive. From the business perspective, this was a disaster
through companies like Fathom and Abiogenix. This design and as the supply chains had disrupted due to less manpower and a
specific material allow the swab to be extraordinarily flexible and shortage as working professionals were bound by government regu-
sustain torsion during testing [19], Fig. 6f−h. It also has a break- lations of safety issues of COVID protocols.
point area that allows easy storage in mediums for further testing. The additive manufacturing industry bridged the gap between
The design is nothing like flocked swabs but a twisted protruded researchers, designers, and industry workers as it allowed production
spiral that traps the epithelial cells between the crests and troughs to be safer, faster, and more qualitative. This allowed more and more
[19]. The same collaboration has been done with 3D printing com- on-time deliveries of swabs to hospitals, stores, and government test-
panies Origin and Stratasys, which have produced over a million ing sites.
Table 3
Additive manufacturing technologies used for COVID-19 swabs.
Additive Manufacturing type Manufacturer Swabs Material and Type Refs.
FFF AMIST and the University of Louisville NP swab made of Pliable resin material [68]
SLA Stratasys and Origin NP swab made of Biocompatible Photocurable Resin [69]
SLA Formlabs NP swab made of Surgical Guide Resin [73]
FFF Markforged and Neurophotometrics NP swab made of Fiberflex Rayon [71]
MJF Abiogenic and FATHOM NP swabs made of biocompatible, flexible plastic [74]
SLA Michigan Technical University NP swab made of PETG [75]
FFF Carbon NP swan made of a biocompatible material, KeySplint Soft Clear [76]
SLA EnvisionTEC NP swab made of E-Guide Soft C-29C resin Non-cytotoxic, not a sensitizer, non-irritating [43]
MJF or Inkjet Printing HP NP swabs made of nylon-based material [77]
FFF- Fused Filament Fabrication, SLA- Stereolithography Apparatus, MJF - Multi Jet Fusion, NP- Nasopharyngeal swabs, PETG- Polyethylene terephthalate glycol
10
Fig. 5. Five major Additive manufacturing techniques used for making 3D printed products during COVID-19: a. SLA: Stereolithography Apparatus, b. MultiJet (or PolyJet)
Printing, c. SLS: Selective Laser Sintering, d. MJF: Multi Jet Fusion, e. FDM/FFF: Fused Deposition Modelling/Fused Filament Fabrication. Reprinted with permission from [100].
Implementation of AM technology allows easy fabrication of pro- SEM images gave good detail to the fiber descriptions, which pro-
totypes and manufacturing models. This bridges the accuracy gap vided information about the absorption properties of materials. Swab
between prototypes and production models. This is an incredible materials like rayon and nylon have superior absorption and release
achievement for manufacturers and customers as they’ll be able to properties, which enables their usage in wide-ranged applications
experience the product as it was prototyped [78]. Furthermore, the Furthermore, these materials can be used in 3D printers which makes
cost of materials and production significantly decreases in the long them useful for fabrication by additive manufacturing. The flocked
term, even though the initial investment in machines would be high design invented in the 21st century has not only made sampling effi-
[69]. Recently, due to the development of the do-it-yourself (DIY) ciency better but also has become a polymath in all sampling scenar-
community in the additive manufacturing field, the applications in ios due to its enhanced surface area design. The operations of these
the field of additive manufacturing have increased significantly. One swabs in several situations as nasopharyngeal swabs, oropharyngeal
example is the production of organic material for medical testing. swabs, and even buccal swabs allow good specimen collection and
Furthermore, the research on the additively-manufactured heart accurate result determination. These swabs are now mostly 3D
was unveiled by Professor Tal Dvir from Israel, in 2019, and the mate- printed due to their complex design as traditional manufacturing
rial used is called “bio-ink. Though the size is that of a rabbit’s heart, techniques are expensive and inaccurate. Aggregating the statistics
further research is being conducted to make a fully functional 3-D from the manufacturing of swabs, the sudden rise in Additive
printed human heart (fully biocompatible with the body) [79]. This Manufacturing/3D printing technologies has augmented product
speaks to the current impact of AM in the manufacturing world and quality, as discussed in the present technologies. Design for additive
applies to our discussion of swabs. There is a vast amount of potential manufacturing (DfAM) is dependent on the speed of the material
for AM in the world today [80,81]. There could also be a plethora of deposition, optimization for shape and manufacturing process, and
biomedical applications that revolutionize organ donation and minimization of volume faction, and volume fraction is dependent on
replacement [82−86]. the voxel mesh optimization, and it helps in reducing the production
cost, furthermore, optimizes the overall design configuration. The
8. Conclusions COVID-19 pandemic has aided to achieve better and more efficient
swabs, like Fiberflex Rayon utilizing additive manufacturing. 3D
The studied swabs among cotton, rayon, polyester, nylon, and printing could bring many revolutions to medicine and the environ-
polyurethane depict distinctive results based on their performance in ment due to its functionality, lesser production time, and accurate
various situations and extraction from different substrate surfaces. design of the intended product.
11
Fig. 6. Manufactured swabs and their testing. a and b. Swabs design and manufactured swabs, respectively. Reprinted with permission from [99]. c. a closeup of three NP sticks
that depict the intricate geometries of the instrument. d. a batch of the NP swabs printed by Carbon3D’s DLS technology. e. Formlabs manufactured a variety of NP swabs with the
SLA technique of vat polymerization. Reprinted with permission from [100]. The images of the swabs in the different test setups. f. Tensile. g. Torsion. h. Break and i. Abrasion. A sim-
ilar nasal cavity mold as that shown in i was 3D printed and used for the combined torsion and flexure test. Reprinted with permission from [92].
Compliance with ethical standards
Research involving human participants and/or animals
This research did not involve the participation of any humans or

animals.
Consent for publication
All authors consent to the publication.
Availability of data and material
Please reach out to the corresponding Author: Prajwal Agrawal for

any more information.
Funding
Fig. 7. The usage of the open-source nasopharyngeal swab and press-fit handle.
Reprinted with permission from [99]. This research was funded by AMM Engineering Laboratory.
12
Declaration of Competing Interest industry: a review of the literature. Int J Environ Res Public Health 2013;10
(11):6169–83. doi: 10.3390/ijerph10116169.
[22] CDC, "Environmental Sampling | Background | Environmental Guidelines | Guide-
The authors have no relevant financial or non-financial interests lines Library | Infection Control", Accessed November 5, 2015. https://www.cdc.
to disclose. gov/infectioncontrol/guidelines/environmental/background/sampling.html.
[23] Harry K, Turner JC, Madhusudan KT. Comparison of physical characteristics and
collection and elution performance of clinical swabs. Afr J Microbiol Res 2013.
CRediT authorship contribution statement doi: 10.5897/AJMR12.1785.
[24] Dalmaso G, Bini M, Paroni R, Ferrari M. Qualification of high-recovery, flocked
swabs as compared to traditional rayon swabs for microbiological environmen-
Vedant Vashist: Data curation, Methodology, Validation, Writing tal monitoring of surfaces. PDA J Pharm Sci Technol 2008;62(3):191–9 PDA 62.
− original draft. Neil Banthia: Data curation, Formal analysis, Meth- [25] Weigmann, Hans-Dietrich H.. “cotton”. Encyclopedia Britannica, 18 Nov. 2022,
odology, Writing − original draft. Swapnil Kumar: Formal analysis, https://www.britannica.com/topic/cotton-fibre-and-plant. Accessed 2 Decem-
ber 2022.
Writing − original draft, Writing − review & editing. Prajwal [26] Mulligan CM, Kaufman SR, Quarino L. The utility of polyester and cotton as
Agrawal: Conceptualization, Funding acquisition, Resources, Supervi- swabbing substrates for the removal of cellular material from surfaces. J Forensic
sion, Writing − review & editing. Sci 2011;56(2):485–90. doi: 10.1111/j.1556-4029.2010.01659.x.
[27] Liao J, Ye C, Guo J, Garciamendez-Mijares CE, Agrawal P, Kuang X, Japo JO, Wang
Z, Mu X, Li W, Ching T, Santiago Mille L, Zhu C, Zhang X, Gu Z, Zhang YuS. 3D-
printable colloidal photonic crystals. Mater Today 2022;56:29–41 ISSN 1369-
Acknowledgements
7021. doi: 10.1016/j.mattod.2022.02.014.
[28] You HS, Lee SH, Ok YJ, Kang HG, Sung HJ, Lee JiY, Kang SS, Hyun SH. Influence of
V.V. and N.B. contributed equally to this work. We acknowledge swabbing solution and swab type on DNA recovery from rigid environmental surfa-
ces. J Microbiol Methods 2019;161:12–7. doi: 10.1016/j.mimet.2019.04.011.
the support from AMM Engineering Laboratory and it’s all its mem-
[29] LastObject. “5 ways cotton swabs impact the planet”, Accessed January 30, 2020.
bers for their support and help in finalizing this manuscript. https://lastobject.com/blogs/blog/5-ways-cotton-swabs-impact-the-planet.
[30] Agrawal P, Aggarwal S, Banthia N, et al. A comprehensive review on incremental
deformation in rolling processes. J. Eng. Appl. Sci. 2022;69:20. doi: 10.1186/
References s44147-022-00072-w.
[31] Kauffman GB. Rayon: the first semi-synthetic fiber product. J. Chem. Educ.
[1] Wang Z, Agrawal P, Zhang YS. 3D printing and bioprinting strategies applied 1993;70(11):887. doi: 10.1021/ed070p887.
toward orthopedics. In: Cui W, Zhao X, Liu S, editors. Biofabrication for orthope- [32] Osterblad M, J€arvinen H, Lo€nnqvist K, Huikko S, Laippala P, Viljanto J, Arvilommi
dics; 2022. doi: 10.1002/9783527831371.ch3. H, Huovinen P. Evaluation of a new cellulose sponge-tipped swab for microbio-
[2] Wang M, Li W, Hao J, et al. Molecularly cleavable bioinks facilitate high-perfor- logical sampling: a laboratory and clinical investigation. J Clin Microbiol
mance digital light processing-based bioprinting of functional volumetric soft 2003;41(5):1894–900. doi: 10.1128/jcm.41.5.1894-1900.2003.
tissues. Nat Commun 2022;13:3317. doi: 10.1038/s41467-022-31002-2. [33] Wigger C, Morris PS, Stevens M, Smith-Vaughan H, Hare K, Beissbarth J, Leach AJ.
[3] Krista Elliott. A Weird History of Earwax. The Joint Corp; 2020 https://www.the- A comparison of flocked nylon swabs and non-flocked rayon swabs for detection
joint.com/utah/cottonwood-heights/cottonwood-heights-45002/198849- of respiratory bacteria in nasopharyngeal carriage in Australian indigenous chil-
weird-history-earwax. dren. J Microbiol Methods 2019;157:47–9. doi: 10.1016/j.mimet.2018.12.013.
TagedP [4] Swab - Wiktionary, accessed 26 August 2022. Wiktionary; 2022 https://en.wik- [34] Esposito S, Molteni CG, Daleno C, Valzano A, Cesati L, Gualtieri L, Tagliabue C,
tionary.org/wiki/swab. Bosis S, Principi N. Comparison of nasopharyngeal nylon flocked swabs with uni-
[5] Harry KH, Turner JC, Madhusudhan KT. Comparison of physical characteristics versal transport medium and rayon-bud swabs with a sponge reservoir of viral
and collection and elution performance of clinical swabs. African Journal of transport medium in the diagnosis of paediatric influenza. J Med Microbiol
Microbiology Research 2013;7:4039–48. 2010;59(Pt 1):96–9. doi: 10.1099/jmm.0.015305-0.
[35] Comte J, Baechler S, Gervaix J, Lock E, Milon MP, Dele mont O, Castella V. Touch
[6] COVID-19 testing and protocol for UTMB healthcare teams. UtmbEdu 2020
https://www.utmb.edu/covid-19/health-care-workers/ppe-and-testing-infor- DNA collection - performance of four different swabs. Forensic Sci Int. Genet
mation/testing. 2019;43:102113. doi: 10.1016/j.fsigen.2019.06.014.
[7] Verdon TJ, Mitchell RJ, Oorschot RAH. Swabs as DNA collection devices for sam- [36] Krapp, Kristine “Polyester .” How Products Are Made. Encyclopedia.com. 29 Nov.
pling different biological materials from different substrates. J Forensic Sci 2022 <https://www.encyclopedia.com>.
2014;59(4):1080–9. doi: 10.1111/1556-4029.12427. [37] Speicher, DJ., Luinstra K., Smith EJ., Castriciano S., and Smieja M.. 2019. Non-
[8] Thomas S, Loveless P, Hay NP, Toyick N. Comparing non-woven, filmateci and invasive detection of viral antibodies using oral flocked swabs. 10.1101/536227
woven gauze swabs. J Wound Care 1993;2(1):35–41. doi: 10.12968/ [38] Bruijns BB, Tiggelaar RM, Gardeniers H. The extraction and recovery efficiency of
jowc.1993.2.1.35. pure DNA for different types of swabs. J Forensic Sci 2018;63(5):1492–9. doi:
[9] Young T, Templet T, Dube P, Dixon T. (2012), Collection device and material (U.S. 10.1111/1556-4029.13837.
Patent No. 8,334,134,B2). https://patents.google.com/patent/US8334134B2/en. [39] Daley P, Castriciano S, Chernesky M, Smieja M. Comparison of flocked and rayon
[10] West DM. How technology is changing manufacturing. Brookings 2016 June 2, swabs for collection of respiratory epithelial cells from uninfected volunteers
2016 https://www.brookings.edu/blog/techtank/2016/06/02/how-technology- and symptomatic patients. J Clin Microbiol 2006;44(6):2265–7. doi: 10.1128/
is-changing-manufacturing/. JCM.02055-05.
[11] Tran D. Can, (1987), Method for manufacturing a swab (U.S. Patent No. [40] Hansson O, Finnebraaten M, Heitmann IK, Ramse M, Bouzga M. Trace DNA col-
4,707,318), https://patents.google.com/patent/US4707318A/en lection − performance of minitape and three different swabs". Forensic Sci Int
[12] Lee, T. (2019) “The ’digital handmade’: how 3D printing became a new craft Genet Suppl Ser 2009;2(1):189–90. doi: 10.1016/j.fsigss.2009.08.098.
technology”. The Conversation. Accessed June 23, 2020. https://theconversation. [41] Wang Z, Agrawal P, Zhang YS. Nanotechnologies and Nanomaterials in 3D (Bio)
com/the-digital-handmade-how-3d-printing-became-a-new-craft-technology- printing toward Bone Regeneration. Adv. NanoBiomed Res. 2021;1:2100035.
77559 doi: 10.1002/anbr.202100035.
[13] Warnke P, Warning L, Podbielski A (2014) Some Are More Equal - A Comparative [42] Kelkar SS, Gautam P, Sahai S, et al. A detailed study on design, fabrication, analy-
Study on Swab Uptake and Release of Bacterial Suspensions. PLOS ONE 9(7): sis, and testing of the anti-roll bar system for formula student cars. SN Appl. Sci.
e102215. https://doi.org/10.1371/journal.pone.0102215. 2021;3:302. doi: 10.1007/s42452-021-04279-z.
[14] Pinkerton AJ. [INVITED] Lasers in Additive Manufacturing. Opt Laser Technol [43] “Foam swabs − why they’re banned in Wales”. Accessed July 2013, http://
2016;78:25–32. doi: 10.1016/j.optlastec.2015.09.025. www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/Foam%20swabs%
[15] Yakout M, Elbestawi MA, Veldhuis SC. A review of metal additive manufacturing 20-%20why%20they%27re%20banned%20in%20Wales.pdf.
technologies. Solid State Phenom 2018;278:1–14. doi: 10.4028/www.scientific. [44] Roscoe E. Schmerse, Jr. (1992). Swab (U.S. Patent No. 5,127,899). https://patents.
net/ssp.278.1. google.com/patent/US5127899.
[16] Haleem A, Javaid M. 3D printed medical parts with different materials using [45] Liao J, Ye C, Agrawal P, Gu Z, Zhang YS. Colloidal photonic crystals for biomedical
additive manufacturing. Clin Epidemiol Glob Health 2020;8(1):215–23. doi: applications. Small Struct 2021;2:2000110. doi: 10.1002/sstr.202000110.
10.1016/j.cegh.2019.08.002. [46] Blasius Jr William G Zygmont Jr Joseph F. Applicator swab. (U.S. Patent No.
[17] My-pills, “FAST spiral nasopharyngeal swabs”, Accessed June 13, 2020. http://www.abio- 4,718,889-A). https://portal.unifiedpatents.com/patents/patent/US-4718889-A.
genix.com/?elqTrackId=a1c26d66205e42ddb435c67ebe79c3ad&elqaid=4271&elqat=2. [47] Triva D.(2012). Methods of using flockedswab for collecting biological speci-
[18] Donald Ingber “Human organs-on-chips”, Hansjo € rg Wyss Institute for Biologi- mens. (U.S. Patent No. 8,317,728 B2). https://patents.google.com/patent/
cally Inspired Engineering - Harvard University, Accessed June 23, 2020. https:// US8317728B2/en.
wyss.harvard.edu/technology/human-organs-on-chips/ [48] Rajamurugan G, Sanjay AP, Krishnasamy P, Muralidharan B, Jain S. Drilling and
[19] Jeewandara TM, Wise SG, Ng MKC. Biocompatibility of coronary stents. Materials mechanical performance analysis on flax-sisal hybrid composite embedded
(Basel, Switzerland) 2014;7(2):769–86. doi: 10.3390/ma7020769. with perforated aluminum foil. J Reinforced Plast Compos 2020;39(23-24):902–
[20] CDC/NCIRD “Specimen collection guidelines”, Accessed January 10, 2020. 17. doi: 10.1177/0731684420937070.
https://www.cdc.gov/urdo/specimen.html [49] Lieberman D, Lieberman D, Shimoni A, Keren-Naus A, Steinberg R, Shemer-Avni Y.
[21] Ismaïl R, Aviat F, Michel V, Le Bayon I, Gay-Perret P, Kutnik M, Fe d e
righi M. Identification of respiratory viruses in adults: nasopharyngeal versus oropharyn-
Methods for recovering microorganisms from solid surfaces used in the food geal sampling. J Clin Microbiol 2009;47(11):3439–43. doi: 10.1128/JCM.00886-09.
13
[50] Watt JP, O’Brien KL, Katz S, Bronsdon MA, Elliott J, Dallas J, Perilla MJ, et al. Naso- [77] Edith Bracho-Sanchez (2019) "Researchers 3D-print heart from human patient’s
pharyngeal versus oropharyngeal sampling for detection of pneumococcal car- cells", CNN, accessed April 17, 2019, https://edition.cnn.com/2019/04/15/health/
riage in adults. J Clin Microbiol 2004;42(11):4974–6. doi: 10.1128/ 3d-printed-heart-study/index.html.
JCM.42.11.4974-4976.2004. [78] Kelkar SS, Gautam P, Sahai S, et al. A detailed study on design, fabrication, analy-
[51] Hammitt LL, Kazungu S, Welch S, Bett A, Onyango CO, Gunson RN, Anthony G. sis, and testing of the anti-roll bar system for formula student cars. SN Appl Sci
Scott J, James Nokes D. Added value of an oropharyngeal swab in detection of 2021;3:302. doi: 10.1007/s42452-021-04279-z.
viruses in children hospitalized with lower respiratory tract infection. J Clin [79] Gautam P, Agrawal PS, Sahai S, Kelkar SS, Mallikarjuna RD. Designing variable
Microbiol 2011;49(6):2318–20. doi: 10.1128/JCM.02605-10. ackerman steering geometry for formula student race car. International Journal
[52] Kim C, Ahmed JA, Eidex RB, Nyoka R, Waiboci LW, Erdman D, Tepo A, et al. Com- of Analytical, Experimental and Finite Element Analysis, 8. RAME Publishers;
parison of nasopharyngeal and oropharyngeal swabs for the diagnosis of eight March 2020. p. 1–11. doi: 10.26706/ijaefea.1.8.20210101.
respiratory viruses by real-time reverse transcription-PCR assays. PloS one [80] Szymczyk-Zio »kowska P, ºabowska MB, Detyna J, Michalak I, Gruber P. A review
2011;6(6):e21610. doi: 10.1371/journal.pone.0021610. of fabrication polymer scaffolds for biomedical applications using additive
[53] Melcher JR, Speichert DA. (1999), Swab and method of manufacturing and using it, manufacturing techniques. Biocybern Biomed Eng 2020;40(2):624–38. doi:
(U.S. Patent No. 5,915,746). https://patents.google.com/patent/US5915746A/en. 10.1016/j.bbe.2020.01.015.
[54] Murray, L.A.. Process for production of cotton swabs. US 6,905,567 B2. [81] Liao J, Ye C, Agrawal P, Gu Z, Zhang YS. Colloidal photonic crystals for biomedical
[55] Medical P. The history and evolution of the swab. Blog.Puritanmedproducts.Com applications. Small Struct 2021:2000110. doi: 10.1002/sstr.202000110.
2020 https://blog.puritanmedproducts.com/bid/357796/the-history-and-evolu- [82] Chatinier DN, Figler KP, Agrawal P, Liu W, Zhang YuS. The potential of microflui-
tion-of-the-swab. dics-enhanced extrusion bioprinting. Biomicrofluidics 2021;15:041304. doi:
[56] Frippiat C, Noel F. Comparison of performance of genetics 4N6 FLOQSwabsTM 10.1063/5.0033280.
with or without surfactant to rayon swabs. Journal of forensic and legal medi- [83] Wang Z, Agrawal P, Zhang YS. Nanotechnologies and Nanomaterials in 3D (Bio)
cine 2016;42:96–9. doi: 10.1016/j.jflm.2016.06.002. printing toward bone regeneration. Adv NanoBiomed Res 2021;2100035. doi:
[57] Heikkinen T, Marttila J, Salmi AA, Ruuskanen O. Nasal swab versus nasopharyn- 10.1002/anbr.202100035.
geal aspirate for isolation of respiratory viruses. J Clin Microbiol 2002;40 [84] Ezio Garciamendez-Mijares C, Agrawal P, García Martínez G, Juarez EC, Zhang
(11):4337–9. doi: 10.1128/jcm.40.11.4337-4339.2002. YuS. State-of-art affordable bioprinters: a guide for the DiY community. Appl
[58] Richards B, Skoletsky J, Shuber AP, Balfour R, Stern RC, Dorkin HL, Parad RB, Witt Phys Rev 2021;8:031312. doi: 10.1063/5.0047818.
D, Klinger KW. Multiplex PCR amplification from the CFTR gene using DNA pre- [85] Department: Clinical section - LA department of health. Louisiana Department of
pared from buccal brushes/swabs. Hum Mole Genet 1993;2(2):159–63. doi: Healtth; 2020 https://ldh.la.gov/assets/oph/Center-PHCH/Center-CH/infectious-
10.1093/hmg/2.2.159. epi/CV19/COVID19_Sample_Collection_Nasopharyngeal_and_NasalSwab.pdf.
€ ckiger U, Widmer AF. Throat swabs
[59] Mertz D, Frei R, Jaussi B, Tietz A, Stebler C, Flu [86] Medical P. Nasopharyngeal swab vs nasal swab: comparing methods. Nasophar-
are necessary to reliably detect carriers of staphylococcus aureus. Clin Infect Dis yngSwab vs Nasal Swab Comp Methods 2021 Retrieved from https://blog.puri-
An off Publ Infect Dis Soc Am 2007;45(4):475–7. doi: 10.1086/520016. tanmedproducts.com/nasopharyngeal-swab-vs-nasal-swab.
[60] Barr FS. and Collins G.F..(1964), Diagnostic swabs (U.S. Patent No. 3,368,549A). [87] Durrer J, Agrawal P, Ozgul A, et al. A robot-assisted acoustofluidic end effector.
https://patents.google.com/patent/US3368549A/en. Nat Commun 2022;13:6370. doi: 10.1038/s41467-022-34167-y.
[61] Yamada A, Emanishi J, Nakajima E, Nakajima K, Nakajima S. Detection of influ- [88] Martinez, M.R., Mendoza, R., Perry, D., Gabutan, E., Fyke, W., Faber, E., Saggi, S.J.,
enza viruses in throat swab by using polymerase chain reaction. Microbiol Tam, J., Chico-Calero, I., Centner, H., Engelthaler, D.M., Goetz, L.H., McDaniel, T.
Immunol 1991;35(3):259–65. doi: 10.1111/j.1348-0421.1991.tb01555.x. K., Murakami, N., Libien, J., Ingber, D.E., & Novak, R. (2021). Low-cost, injec-
[62] Chan KH, Peiris JSM, Lim W, Nicholls JM, Chiu SS. Comparison of nasopharyngeal tion molded, nasopharyngeal swabs for addressing global diagnostic supply
flocked swabs and aspirates for rapid diagnosis of respiratory viruses in chil- shortages. 10.1101/2021.07.19.21260235
dren. J Clin Virol Off Publ Pan Am Soc Clin Virol 2008;42(1):65–9. doi: 10.1016/j. [89] amp Callahan CJ, Lee R, Zulauf KE, Tamburello L, Smith KP, Previtera J, Cheng A,
jcv.2007.12.003. Green A, Abdul Azim A, Yano A, Doraiswami N, Kirby JE, Arnaout RA. Open
[63] Tabla La, Ortiz de V, Masia M, Antequera P, Martin C, Gazquez G, Bun ~ uel F, development and clinical validation of multiple 3D-printed NASOPHARYNGEAL
Gutierrez F. Comparison of combined nose-throat swabs with nasopharyngeal COLLECTION SWABS: Rapid resolution of a critical COVID-19 testing bottleneck.
aspirates for detection of pandemic influenza A/H1N1 2009 virus by real-time J Clin Microbiol 2020;58(8). doi: 10.1128/jcm.00876-20.
reverse transcriptase PCR. J Clin Microbiol 2010;48(10):3492–5. doi: 10.1128/ [90] amp Alghounaim M, Almazeedi S, Al Youha S, Papenburg J, Alowaish O, AbdulHus-
JCM.01105-10. sain G, Al-Shemali R, Albuloushi A, Alzabin S, Al-Wogayan K, Al-Mutawa Y, Al-
[64] Agrawal P. Additive manufacturing technologies: a pathway to organ printing. Sabah S. Low-cost polyester-tipped three-dimensionally printed nasopharyngeal
Medicon Eng Themes July 2022;3(1) VolumeIssue. doi: 10.55162/MCET.03.051. swab for the detection of severe acute respiratory syndrome-related coronavirus 2
[65] “Detection of SARS-CoV-2 in swabs of environmental surfaces.” 2020. Accessed (SARS-COV-2). J Clin Microbiol 2020;58(11). doi: 10.1128/jcm.01668-20.
June 23, 2020. https://www.eurofins-technologies.com/products/viruses.html. [91] Bennett, I., Bulterys, P.L., Chang, M., DeSimone, J.M., Fralick, J., Herring, M., Kabaria,
[66] MEDICA - World forum for medicine, “3D-printed swabs fill gap in COVID-19 H., Kong, C.S., Larson, B., Lu, O., Maxner, A., Meyer, E., Patterson, S., Pollack, S., Roll-
test kits", Accessed June 23, 2020 https://www.medicatradefair.com/en/News/ and, J., Schmidt, S., Seshadri, S., Swarup, K., Thomas, C., & Van Wert, R. (2020).
Archive/3D-printed_swabs_fill_gap_in_COVID-19_test_kits. The rapid deployment of a 3D-printed “latticed” nasopharyngeal swab for COVID-
[67] Businesswire, “Stratasys and origin partner to bring millions of 3D-printed naso- 19 testing was made using digital light synthesis. 10.1101/2020.05.25.20112201
pharyngeal swabs to healthcare providers for COVID-19 testing”, Accessed June [92] Tooker A, Moya ML, Wang DN, Freeman D, Borucki M, Wheeler E, Larsen G, Shusteff
23, 2020, https://www.businesswire.com/news/home/20200423005604/en/ M, Duoss EB, Spadaccini CM. Performance of three-dimensional printed nasopha-
Stratasys-Origin-Partner-Bring-Millions-3D-Printed-Nasopharyngeal. ryngeal swabs for COVID-19 testing. MRS Bull 2021;46(9):813–21 Epub 2021 Sep
[68] “Origin − manufacture the impossible”, Accessed June 23, 2020, https://www. 13. PMID: 34539055; PMCID: PMC8437332. doi: 10.1557/s43577-021-00170-9.
origin.io/npswab/. [93] Van der Elst LA, Gokce Kurtoglu M, Leffel T, Zheng M, Gumennik A. Rapid fabrication
[69] IndustryWeek, “Improving swab effectiveness using 3D printing", Accessed June of sterile medical nasopharyngeal swabs by stereolithography for widespread testing
13, 2020, https://www.industryweek.com/covid19/article/21128429/improv- in a pandemic. Adv Eng Mater 2020;22:2000759. doi: 10.1002/adem.202000759.
ing-swab-effectiveness-using-3d-printing. [94] Kumar, S. and Rajagopal, T., "Braking System for ATV," SAE Technical Paper
[70] Callahan CJ, Lee R, Zulauf K, Tamburello L, Smith KP, Previtera J, Cheng A, et al. 2020-01-1611, 2020, https://doi.org/10.4271/2020-01-1611
Open development and clinical validation of multiple 3d-printed sample-collec- [95] Kumar S, Bhattacharjee R, Jeyapandiarajan P. Design and development of longi-
tion swabs: rapid resolution of a critical COVID-19 testing bottleneck.”. medRxiv tudinal vehicle dynamics for an All-terrain vehicle. Mater Today Proc 2021;46
Preprint Server hEalth Sci 2020. doi: 10.1101/2020.04.14.20065094. (Part 17):8880–6 ISSN 2214-7853. doi: 10.1016/j.matpr.2021.05.085. https://
[71] Formlabs “3D Printed Test Swabs for COVID-19 Testing”, Accessed June 13, 2020, www.sciencedirect.com/science/article/pii/S2214785321036610.
https://formlabs.com/covid-19-response/covid-test-swabs/. [96] Kumar S, Atre SV. Design and optimization of brake disc using multi-objective
[72] Manufacturing F. Swab shortage: FATHOM & abiogenix bridge the gap with 3D genetic algorithm. FISITA World Congress 2021. https://www.fisita.com/library?
printed NP swabs. Prnewswire.Com 2020 https://www.prnewswire.com/news- code=Swapnil±Kumar.
releases/swab-shortage-fathom−abiogenix-bridge-the-gap-with-3d-printed- [97] Kumar S, Dash S. IOP Conf Ser Mater Sci Eng 2020;937:012047.
np-swabs-301051354.html. [98] Kumar S, Rajagopal TKR. Effect of Reynold’s number on effective heat transfer
[73] Gallup N., Pringle A.M., Oberloier S., Tanikella N.G., Pearce J.M. Parametric Naso- dissipation of braking system. Mater Today Proc 2021;46(Part 17):8455–60 ISSN
pharyngeal Swab for Sampling COVID-19 and Other Respiratory Viruses: Open 2214-7853. doi: 10.1016/j.matpr.2021.03.488https://www.sciencedirect.com/
Source Design, SLA 3-D Printing and UV Curing System. HardwareX 8(2020): science/article/pii/S2214785321025736.
e00135. https://doi.org/10.1016/j.ohx.2020.e00135. [99] Nicole Gallup, Adam M. Pringle, Shane Oberloier, Nagendra G. Tanikella, Joshua
[74] 3D Printing Media Network - The Pulse Of The AM Industry (2020), "Carbon joins M. Pearce, Parametric nasopharyngeal swab for sampling COVID-19 and other
COVID-19 relief efforts with 3D printed face shields, swabs and more", accessed respiratory viruses: Open source design, SLA 3-D printing and UV curing system,
March 25, 2020, https://www.3dprintingmedia.network/carbon-joins-covid- HardwareX, Volume 8, 2020, e00135, ISSN 2468-0672. HardwareX 2020. doi:
19-relief-efforts-with-3d-printed-face-shields-swabs-and-more/ 10.1016/j.ohx.2020.e00135. https://www.sciencedirect.com/science/article/pii/
[75] "How HP Is 3D printing critical medical supplies", HP (2022),Garage.Hp.Com, S2468067220300444.
https://garage.hp.com/us/en/innovation/hp-3D-printing-covid-19-aid.html. [100] Tareq MS, Rahman T, Hossain M, Dorrington P. Additive manufacturing and the
[76] Spallek J, Krause D. Process types of customisation and personalisation in design COVID-19 challenges: an in-depth study. J Manuf Syst 2021;60:787–98 ISSN
for additive manufacturing applied to vascular models. Proced CIRP 0278-6125. doi: 10.1016/j.jmsy.2020.12.021https://www.sciencedirect.com/sci-
2016;50:281–6. doi: 10.1016/j.procir.2016.05.022. ence/article/pii/S0278612520302351.
14

1 s2.0 S2666964122000467 Main

Uploaded by

Copyright:

Available Formats

1 s2.0 S2666964122000467 Main

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

1 s2.0 S2666964122000467 Main

Uploaded by

Copyright:

Available Formats

Annals of 3D Printed Medicine 9 (2023) 100092

Contents lists available at ScienceDirect

Annals of 3D Printed Medicine

A systematic review on materials, design, and manufacturing of swabs

TIP MATERIAL PROPERTIES PURPOSE Feasibility of Materials in ‘AM’

NAME OF THE DESIGN INVENTOR FUNCTIONAL FEATURES APPLICATIONS YEAR

3.2. Flocked swabs 4. Traditional swab manufacturing

3.3. Nematodic swabs 4.1. First process: pressurized hot rolling

Additive Manufacturing type Manufacturer Swabs Material and Type Refs.

Compliance with ethical standards

Research involving human participants and/or animals

This research did not involve the participation of any humans or

Consent for publication

All authors consent to the publication.

Availability of data and material

Please reach out to the corresponding Author: Prajwal Agrawal for

You might also like