Use of breathable silicone technology in an ostomy appliance flange

2021 ◽  
Vol 30 (Sup8) ◽  
pp. 25-35
Author(s):  
Peta Lager ◽  
Lisa Loxdale
Keyword(s):  
Preliminary Data ◽  
Transepidermal Water Loss ◽  
User Evaluation ◽  
Skin Damage ◽  
Healthcare Use ◽  
Skin Injury ◽  
Moisture Management ◽  
Peristomal Skin ◽  
Medical Adhesive ◽  
Over Time

Leaks and peristomal skin complications are highly prevalent among people with a stoma, reported by over 80% of ostomates within 2 years of surgery. This suggests that there is room for improvement in ostomy appliances, particularly in their hydrocolloid-based adhesive flanges. Hydrocolloid has an absorptive method of moisture management that, over time, risks maceration and skin stripping, potentially leading to moisture-associated skin damage (MASD) and medical adhesive-related skin injury (MARSI). The newly developed Genii ostomy appliances (Trio Healthcare) use novel Sil2 Breathable Silicone Technology to provide secure, effective adhesion and manage moisture levels by replicating natural transepidermal water loss (TEWL). This has the potential to increase appliance wear time, reduce incidence of MASD and permit atraumatic removal without adhesive remover, reducing the risks of MARSI, as well as time burdens on the user and economic burdens on the healthcare system. Meanwhile, the silicone flanges and water-resistant sports fabric pouches are lightweight, flexible and unobtrusive, and they are the first appliances to be available in colours to match different skin tones, all of which provides security, comfort, confidence and discretion. This article explores the features of Sil2 and Genii ostomy appliances, with reference to preliminary data from a user evaluation.

Using a novel breathable silicone adhesive (Sil2 technology) in stoma appliances to improve peristomal skin health: answering the key questions

2021 ◽  
Vol 30 (Sup8) ◽  
pp. 19-24
Author(s):  
Fiona Le Ber
Keyword(s):  
Skin Damage ◽  
Skin Injury ◽  
Moisture Management ◽  
Silicone Adhesive ◽  
Peristomal Skin ◽  
Medical Adhesive ◽  
Key Questions ◽  
Stoma Care

Fiona Le Ber answers some of the questions that stoma care nurses may have regarding this novel silicone adhesive based technology, which helps to avoid medical adhesive related skin injury (MARSI) and moisture-associated skin damage (MASD). Whereas hydrocolloid stoma appliances absorb moisture, this has a non-absorptive method of moisture management that prevents peristomal skin becoming damp and excoriated.

Using a novel breathable silicone adhesive (Sil2™ technology) in stoma appliances to improve peristomal skin health: answering the key questions

2020 ◽  
Vol 29 (16) ◽  
pp. S16-S21
Author(s):  
Fiona Le Ber
Keyword(s):  
Skin Damage ◽  
Skin Injury ◽  
Moisture Management ◽  
Silicone Adhesive ◽  
Peristomal Skin ◽  
Medical Adhesive ◽  
Key Questions ◽  
Stoma Care

Fiona Le Ber answers some of the questions that stoma care nurses may have regarding this novel silicone adhesive based technology, which helps to avoid medical adhesive related skin injury (MARSI) and moisture-associated skin damage (MASD). Whereas hydrocolloid stoma appliances absorb moisture, this has a non-absorptive method of moisture management that prevents peristomal skin becoming damp and excoriated

scholarly journals Developments in silicone technology for use in stoma care

2021 ◽  
Vol 30 (Sup8) ◽  
pp. 7-18
Author(s):  
Thomas Swift ◽  
Gillian Westgate ◽  
Julie Van Onselen ◽  
Stewart Lee
Keyword(s):  
Water Loss ◽  
Wound Care ◽  
Contact Layer ◽  
Transepidermal Water Loss ◽  
Skin Damage ◽  
Wear Time ◽  
Barrier Films ◽  
Moisture Management ◽  
Medical Adhesive ◽  
The University

Soft silicone's flexibility, adhesive capacity and non-toxic, non-odourous and hypoallergenic nature have made it an established material for adhesive and protective therapeutic devices. In wound care, silicone is a component of contact layer dressings for superficial wounds and silicone gel sheeting for reducing the risk of scarring, as well as of barriers for incontinence-associated dermatitis. Regarding stoma accessories, silicone is established in barrier films to prevent contact dermatitis, adhesive removers to prevent skin stripping and filler gels to prevent appliance leaks. Until recently, silicone has not been used in stoma appliances flanges, as its hydrophobic nature has not allowed for moisture management to permit transepidermal water loss and prevent maceration. Traditional hydrocolloid appliances manage moisture by absorbing water, but this can lead to saturation and moisture-associated skin damage (MASD), as well as increased adhesion and resultant skin tears on removal, known as medical adhesive-related skin injury (MARSI). However, novel silicone compounds have been developed with a distinct evaporation-based mechanism of moisture management. This uses colloidal separation to allow the passage of water vapour at a rate equivalent to normal transepidermal water loss. It has been shown to minimise MASD, increase wear time and permit atraumatic removal without the use of adhesive solvents. Trio Healthcare has introduced this technology with a range of silicone-based flange extenders and is working with the University of Bradford Centre for Skin Sciences on prototype silicone-based stoma appliance flanges designed to significantly reduce the incidence of peristomal skin complications, such as MARSI and MASD. It is hoped that this will also increase appliance wear time, reduce costs and improve patient quality of life.

Prevalence of medical adhesive-related skin injury at peripherally inserted central catheter insertion site in oncology patients

2018 ◽  
Vol 19 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Huihan Zhao ◽  
Yu He ◽  
Huiqiao Huang ◽  
Ying Ling ◽  
Xuemei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insertion Site ◽  
Skin Damage ◽  
Skin Injury ◽  
Oncology Patients ◽  
Cross Sectional ◽  
Skin Injuries ◽  
Frequent Event ◽  
Independent Risk Factors ◽  
Medical Adhesive

Introduction: The aim of our study was to identify the prevalence and risk factors of medical adhesive-related skin injuries (MARSI) at peripherally inserted central catheters (PICC) insertion site in oncology patients. Methods: A cross-sectional observational study lasting two weeks was carried out in four inpatient departments. Skin assessment data and photographs of skin were collected during PICC maintenance. Other related information came from medical records. The skin injuries were classified by dermatologists and PICC specialized nurses. MARSI prevalence was calculated and the associated factors were analyzed statistically. Results: All 419 patients were included. The prevalence of total MARSI at PICC insertion site was 125, (29.83%), including mechanical skin injury (73, 17.42%), contact dermatitis (CD) (39, 9.31%), moisture-associated skin damage (11, 2.63%), folliculitis (2, 0.48%). Multivariate analysis identified two independent risk factors for MARSI including age ≥50 y (p = 0.031, odds ratio [OR] = 4.521, 95% confidence interval [CI] [1.389, 20.620]) and hematologic malignancies (p = 0.000, OR = 2.514, 95% CI [1.590,3.97]. Oxaliplatin and arsenic trioxide infusion through PICC, history of skin allergies was associated with CD, with p = 0.020, OR = 3.492, 95% CI (1.220, 9.990); p = 0.003, OR = 4.565, 95% CI (1.661,12.547); p = 0.000, OR = 12.333, 95% CI (3.669, 41.454), respectively. Conclusions: MARSI at PICC insertion site is a frequent event among oncology patients. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.

scholarly journals Developments in silicone technology for use in stoma care

2020 ◽  
Vol 29 (6) ◽  
pp. S6-S15 ◽  
Author(s):  
Thomas Swift ◽  
Gillian Westgate ◽  
Julie Van Onselen ◽  
Stewart Lee
Keyword(s):  
Water Loss ◽  
Wound Care ◽  
Contact Layer ◽  
Skin Damage ◽  
Wear Time ◽  
Barrier Films ◽  
Moisture Management ◽  
Skin Tears ◽  
Medical Adhesive ◽  
The University

Soft silicone's flexibility, adhesive capacity and non-toxic, non-odourous and hypoallergenic nature have made it an established material for adhesive and protective therapeutic devices. In wound care, silicone is a component of contact layer dressings for superficial wounds and silicone gel sheeting for reducing the risk of scarring, as well as of barriers for incontinence-associated dermatitis. Regarding stoma accessories, silicone is established in barrier films to prevent contact dermatitis, adhesive removers to prevent skin stripping and filler gels to prevent appliance leaks. Until recently, silicone has not been used in stoma appliances flanges, as its hydrophobic nature has not allowed for moisture management to permit trans-epidermal water loss and prevent maceration. Traditional hydrocolloid appliances manage moisture by absorbing water, but this can lead to saturation and moisture-associated skin damage (MASD), as well as increased adhesion and resultant skin tears on removal, known as medical adhesive-related skin injury (MARSI). However, novel silicone compounds have been developed with a distinct evaporation-based mechanism of moisture management. This uses colloidal separation to allow the passage of water vapour at a rate equivalent to normal trans-epidermal water loss. It has been shown to minimise MASD, increase wear time and permit atraumatic removal without the use of adhesive solvents. Trio Healthcare has introduced this technology with a range of silicone-based flange extenders and is working with the University of Bradford Centre for Skin Sciences on prototype silicone-based stoma appliance flanges designed to significantly reduce the incidence of peristomal skin complications, such as MARSI and MASD. It is hoped that this will also increase appliance wear time, reduce costs and improve patient quality of life.

Preventing medical adhesive-related skin injury (MARSI)

2021 ◽  
Vol 30 (15) ◽  
pp. S48-S56
Author(s):  
Jan Hitchcock ◽  
David A Haigh ◽  
Nuria Martin ◽  
Siân Davies
Keyword(s):  
Health Professionals ◽  
Clinical Settings ◽  
Skin Damage ◽  
Skin Injury ◽  
Consensus Document ◽  
Medical Adhesive ◽  
Community Facilities

Medical adhesive-related skin injury (MARSI) is an overlooked and underestimated problem. While awareness of this issue is growing, it is not fully understood by health professionals in a variety of clinical settings. Medical adhesive products are often applied and removed incorrectly, which, albeit unintentionally, causes skin damage. In many cases, MARSI should be considered a preventable injury. Organisations should have processes in place to educate health professionals in acute and community facilities in preventing MARSI; these processes should include the use of products that help to prevent these injuries, including medical adhesive removers. This article will explore this topic and relate it to the most recent consensus document.

scholarly journals Peristomal Medical Adhesive-Related Skin Injury

2019 ◽  
Vol 46 (2) ◽  
pp. 125-136 ◽  
Author(s):  
Kimberly LeBlanc ◽  
Ian Whiteley ◽  
Laurie McNichol ◽  
Ginger Salvadalena ◽  
Mikel Gray
Keyword(s):  
Skin Injury ◽  
Medical Adhesive

Enhancing community capacity to improve cancer care delivery and the effect on patient-reported outcomes, healthcare utilization and total costs of care.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6522-6522
Author(s):  
Manali I. Patel ◽  
David Ramirez ◽  
Richy Agajanian ◽  
Hilda H. Agajanian ◽  
Jay Bhattacharya ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Health Plan ◽  
Cancer Care ◽  
Patient Reported Outcomes ◽  
Care Delivery ◽  
Mean Difference ◽  
Healthcare Use ◽  
Difference In Difference ◽  
Patient Reported ◽  
Over Time

6522 Background: To curb rising expenditures and improve patient-reported outcomes (PROs), we designed an intervention with patient, caregiver, provider, and payer input. The intervention is based on prior work using a lay health worker (LHW) to assess advanced cancer patients' symptoms. In this study, we trained the LHW to refer patients to palliative care and/or behavioral health services in response to positive assessments and expanded the intervention to all cancer stages. We implemented the intervention with a health plan and a community oncology group serving elderly racially/ethnically diverse patients to test the effect on symptoms, healthcare use, and total costs. Methods: We enrolled all newly diagnosed health plan beneficiaries with solid and hematologic malignancies from 10/2016 to 11/2017 and compared outcomes to all cancer patients diagnosed in the year prior to the intervention (control arm). Our primary outcome was change in patient-reported symptoms using the Edmonton Symptom Assessment Scale and Personal Health Questionnaire-9 at baseline, 6 and 12 months post-enrollment. Secondarily, we compared 12 month healthcare use and costs. All generalized linear regression models were adjusted for age, stage, comorbidities, diagnosis, and follow-up. Results: 425 patients were in the intervention; 407 in the control. In both groups, mean age was 79 years; 48% were non-Hispanic White, 43% Hispanic, 3% Black, 6% Asian/Pacific Islander; 60% had advanced stages; 28% had breast, 28% had gastrointestinal, and 10% had thoracic cancers. Intervention patients had significantly decreased symptom burden over time as compared with the control (Mean Difference: intervention (-0.77 +/- 0.28 p = 0.01) vs. control: (0.45 +/- 0.25 p = 0.06)); difference in difference: (-0.68 +/- 0.25 p = 0.007)). Depression scores also significantly decreased over time among intervention patients as compared with the control (Mean Difference: intervention (-1.10 +/- 0.38 p = 0.04)) vs control: (1.21 +/- 0.34 p = 0.01); (difference in difference: -2.03 +/- 0.3 p < 0.001)). As compared to the control arm, intervention patients had lower inpatient admissions (0.7 vs. 0.5 p = 0.01) and emergency department visits per thousand patients per year (0.6 vs. 0.42 p = 0.02), and lower median total healthcare costs ($32,270 versus $25,512 p = 0.01). Conclusions: An LHW intervention significantly improved patient-reported outcomes and the value of cancer care delivery and may be a solution to improve burdensome and costly care for patients.

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