It is important to help support and improve rehabilitation after a laryngectomy. It may take your patients a few days or weeks to get used to the HME and attachment procedure, but by selecting the best fitting adhesive, they can maximise their comfort when wearing an HME.
The lack of conditioning effects of the nose and loss of breathing resistance after a total laryngectomy can result in reduced pulmonary function. By using an HME, the inspiratory temperature and moisture increase, resulting in an improved endotracheal climate. HME use has been seen to improve well-being and pulmonary health in laryngectomees and long-term compliance further improves these results. Provox adhesives are attached to the skin around the tracheostoma in order to provide attachment of a Provox HME. The Provox adhesives are made from hypo-allergenic materials of different types dependant on the range.
Application of the adhesive
Other products that are recommended for proper application of the adhesive are Provox Cleaning Towel (to clean the skin before putting on an adhesive) and Provox Skin Barrier (to protect the skin against adhesive and prevent skin irritation). Additionally, some patients may require the use of Provox Silicone Glue to improve the seal of the adhesive to the skin. Provox Adhesive Remover (to remove glue from the skin) is also recommended to help when removing the adhesive either at the end of the day or between adhesive changes. It is important to look at the individual patient before recommending an adhesive from the wide range available.
There are 6 different types of Provox adhesive baseplates:
The ideal adhesive depends on your patient’s skin, stoma shape and depth and the adhesion strength they need. Provox HMEs can be attached into a variety of available Provox adhesives (Provox OptiDerm, FlexiDerm, XtraBase, StabiliBase and StabiliBase OptiDerm). Successful use of the adhesive depends on stoma characteristics, speech characteristics, on how the patient uses the adhesive and how well the skin is prepared before adhesive application. So, encourage your patients to try a few different Provox adhesives, as this will help them to decide which adhesive(s) best suits their needs.
This adhesive is a very flexible material that has strong adhesive properties to provide a good seal around the patient’s stoma. It is a sticky, yet soft and flexible adhesive. It is ideal for use during the day, or if a patient is taking it easy. The FlexiDerm range is available in 3 different shapes to choose from to suit your patient’s stoma position and size for better adhesion and to help prevent air leakage.
The hydrocolloid material of the OptiDerm adhesive is a substance that forms a gel with water. The gel itself functions as a glue when pre-warmed between your hands before applied to the skin. It is intended for patients with sensitive skin or with skin that is not yet healed properly. This range is suitable for patients after surgery or radiation therapy. The OptiDerm range is available in 3 different shapes to choose from to suit your patient’s stoma position and size for better adhesion and to help prevent air leakage.
This adhesive has a convex shaped base, designed to facilitate and improve skin attachments for deep tracheostomas. It is also recommended if a patient is using Provox FreeHands HME. XtraBase has a stronger adhesive property and can be used during the day or if your patient is active.
This adhesive has a specially designed firm base with vertical stabilising bars that provide support to the tracheostoma. It is especially suited for deeper tracheostomas and an ideal choice if your patient is using Provox FreeHands.
This adhesive is for extra support when the skin is sensitive. It has a specially designed firm base with vertical stabilising bars that provide support to the tracheostoma. The OptiDerm material is suitable for patients with sensitive skin.
This adhesive is a night-time solution for laryngectomy patients that helps them sleep comfortably, while soothing their skin and improving lung health. Provox Luna baseplate is made from hydrogel and is the same that is used in some burns dressings. It is deliberately soft and light in comparison to the daytime baseplates as it allows HME use with minimal impact on the skin.
The matrix below can help you in selecting the right adhesive(s) for your patient.
|Provox Adhesive||Deep stomas||Irregular stomas||Stability||Flexibility||Sensitive Skin||Stickiness||Durability||Use with FreeHands HME|
|Provox FlexiDerm, round||●ooo||●ooo||●●oo||●●●o||●●oo||●●●o||●●oo||●●oo|
|Provox FlexiDerm, oval||●●oo||●●oo||●●oo||●●●o||●●●●||●●●o||●●oo||●ooo|
|Provox OptiDerm, round||●ooo||●ooo||●ooo||●ooo||●●●●||●ooo||●●oo||●ooo|
|Provox OptiDerm, oval||●●oo||●●oo||●ooo||●ooo||●●●●||●ooo||●●oo||●ooo|
|Provox StabiliBase Optiderm||●●●●||●ooo||●●●●||●ooo||●●●●||●ooo||●●●o||●●●o|
●●●● Maximum compatibility ●ooo Less compatibility Alternatively you can download our Provox Adhesive flowchart to use and share with your patients.
Scheenstra et al. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate. Head Neck 2011 Jan;33(1):117-24 Tervonen H, Back L, Juvas A, Rasanen P, Makitie AA, Sintonen H, et al. Automatic speaking valve in speech rehabilitation for laryngectomized patients. Eur Arch Otorhinolaryngol. 2005;262(10):816-20. Dirven R, Kooijman PG, Maal TJ, Hilgers FJ, Berge SJ, Marres HA. An external neck brace to support the peristomal fixation of an automatic stoma valve (ASV): 3D stereophotogrammetrical assessment. Acta Otolaryngol. 2010;130(7):851-8. Van der Houwen EB, van Kalkeren TA, Post WJ, Hilgers FJ, van der Laan BF, Verkerke GJ. Does the patch fit the stoma? A study on peristoma geometry and patch use in laryngectomized patients. Clin Otolaryngol. 2011;36(3):235-41. Ackerstaff et al. Long-term compliance of laryngectomized patients with a specialized pulmonary rehabilitation device: Provox Stomafilter. Laryngoscope. 1998 Feb;108(2):257-60. Ackerstaff et al. Heat and moisture exchangers as a treatment option in the post-operative rehabilitation of laryngectomized patients. Clin Otolaryngol Allied Sci. 1995 Dec;20(6):504-9. Pedemonte-Sarrias G, Villatoro-Sologaistoa JC, Ale-Inostroza P, López-Vilas M, León-Vintró X, Quer-Agustí M. [Chronic adherence to heat and moisture exchanger use in laryngectomized patients.] Acta Otorrinolaringol Esp. 2013 Jul-Aug;64(4):247-52. Hilgers FJ, Dirven R, Wouters Y, Jacobi I, Marres HA, Van den Brekel MW. A multicenter, prospective, clinical trial evaluating a novel adhesive baseplate (Provox StabiliBase) for peristomal attachment of postlaryngectomy pulmonary and voice rehabilitation devices. Laryngoscope. 2012;122(11):2447-53.
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