Silicone-based stoma accessories in clinical practice

Abstract

Advanced silicone technology has transformed the treatment of wounds and peri-wound skin. Recently, there has been interest in the use of silicone-based products in stoma care. Peristomal skin issues are a common problem, and can have a negative impact on the patient's quality of life, so helping the ostomate maintain good skin health is crucial. The author, a stoma care nurse, regularly sees 3-4 patients each week in her stoma care clinic with damaged or broken peristomal skin. This article explores the 'Trio' range of silicone-based accessories, discussing how these products compare with the traditional hydrocolloid, how they are applied and used. A series of case studies illustrates the circumstances in which these products may be applied.

Developments in silicone technology for use in stoma care

“…This new material has a proven ability to effectively both adhere to and protect peristomal skin, without causing damage from maceration or excoriation. Compared with equivalent materials, its non-absorbent mechanism of moisture management prevents degradation and the increase of adhesion over time, thus maximising wear time and minimising traumatic removal (Cronin, 2016).…”

“…For example, silicone adhesives do not deteriorate and become tacky over time. This is in contrast to hydrocolloid adhesives, which, as they absorb moisture, can become difficult to remove without potentially damaging fragile skin (Chadwick 2014;Cronin, 2016). Hydrocolloids also do not absorb wound exudate effectively, resulting in maceration and/or excoriation of the wound (Chadwick, 2014;Cronin, 2016).…”

“…Although common, these complications can generally be prevented or resolved with correct use of the most appropriate stoma appliance (also known as a bag or pouch) and stoma care accessories for the patient's particular needs. A number of silicone-based stoma care accessories have been developed that have been shown to be effective at addressing these complications, including barrier films, adhesive removers and fillers (Cronin, 2016). Silicone is non-toxic non-alcohol based, and thus non-irritant, as well as able to repel water and chemical attack, all of which help these accessories maintain skin integrity, appliance adherence and patient comfort (White, 2014).…”

“…Older filler pastes took some time to set before the flange could be applied. However, siliconebased filler gels set in just 20 minutes of application via a process known as room-temperature vulcanisation, triggered by the moisture and humidity that emanates from the skin surface (White et al, 2014;Cronin, 2016). Silicone gels are also waterproof, transparent and tacky to the touch.…”

“…They have a tacky quality that allows them to adhere to dry surfaces and a low surface energy that provides instant adhesion. They are non-toxic, non-odorous and have a low allergy potential, as well as being impermeable to bacteria and incapable of being absorbed into the body, all of which makes them comfortable and hygienic to wear (Meuleneire and Rücknagel, 2013;Cronin, 2016).…”