Developments in silicone technology for use in stoma care

Abstract

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.

Development of Surgical and Visualization Procedures to Analyze Vasculatures by Mouse Tail Edema Model

“…Previous non-transparent sheet insertion surgeries only prevented the rapid onset of wounding and scar formation. In case of non-transparent silicone application, it was also utilized for surgical operation of stoma reconstructing its efficient functions [ 63 , 64 ]. In that aspect, the current transparent sheet application is regarded as one of the first silicone-mediated procedures for visualization and improving stability of the operated area.…”

Silicone medical adhesive removal for central venous catheter care optimization in patients with hematological diseases

“…The latter has a higher efficiency potential due to more gentle skin interaction effect. E.g., in abdominal surgery, the use of medical adhesives based on liquid silicones in the intestinal stoma care has reduced the incidence of skin irritations and local infections [7,8]. So far, despite the development of skin care products and related consumables in various medical specialties, no data has been reported concerning the use of different anti-glues in CVC care.…”

Evaluating the Irritant Factors of Silicone and Hydrocolloid Skin Contact Adhesives Using Trans-Epidermal Water Loss, Protein Stripping, Erythema, and Ease of Removal

“…Silicone as a material has had plenty of prior application in this field due to its flexible, nontoxic, adhesive properties. Unlike most silicone products on the market, however, Sil2 is hydrophilically modified via the incorporation of water-absorbent polymer additives to increase the potential for moisture vapor diffusion meaning it is designed to offer a less-occlusive surface than other technologies . This has been shown to be of benefit for stoma patients, reducing peristomal skin complications and improving their quality of life .…”

“…Unlike most silicone products on the market, however, Sil2 is hydrophilically modified via the incorporation of water-absorbent polymer additives to increase the potential for moisture vapor diffusion 16 meaning it is designed to offer a less-occlusive surface than other technologies. 17 This has been shown to be of benefit for stoma patients, reducing peristomal skin complications and improving their quality of life. 18 Other studies have added polymer additives such as poly(methyl methacrylate) to alter the mechanical properties of silicone rubbers to make them suitable for maxillofacial prosthesis 19 —however, to our knowledge, this is the most complete study of a novel silicone-composite product.…”