Comparative Study Between Peristomal Patches in Patients with Definitive Tracheostomy

Abstract

Introduction To prevent or diminish pulmonary problems in laryngectomized patients, continuous use of a heat and moisture exchanger (HME) is recommended. Therefore, automatic speaking valves are also often combined with an HME to enable hands-free speech. In order to keep these devices in place, most commonly, peristomal patches are used.

Objective This prospective clinical 2 × 2 crossover study aims at assessing the added value of a new patch for HME application, the Provox StabiliBase OptiDerm (SBO). The device combines the stable and conical base of the Provox StabiliBase with the skin-friendlier hydrocolloid Provox OptiDerm (OD) patch.

Methods Thirty-two laryngectomized patients were included in this multicenter study. Participants were asked to compare SBO to OD, and to the patch they normally use. The primary outcome measure was patient preference.

Results Overall, 60% of the participants had preference for their normally used patch, 23% preferred the SBO and 17% indicated no preference. When comparing the SBO to the OD, 43% preferred the SBO, 40% the OD and 17% had no preference.

Conclusion Most patients preferred their normally used patch and SBO was favored by a subgroup. Provox StabiliBase OptiDerm seems to be a valuable addition to the existing patches and further increases patients' options for HME application.

Keywords

laryngectomy - rehabilitation - patch - patient preference

• References

• 1 Shelly MP, Lloyd GM, Park GR. A review of the mechanisms and methods of humidification of inspired gases. Intensive Care Med 1988; 14 (01) 1-9
• 2 Parrilla C, Minni A, Bogaardt H. , et al. Pulmonary Rehabilitation After Total Laryngectomy: A Multicenter Time-Series Clinical Trial Evaluating the Provox XtraHME in HME-Naïve Patients. Ann Otol Rhinol Laryngol 2015; 124 (09) 706-713
• 3 Zuur JK, Muller SH, de Jongh FH, van Zandwijk N, Hilgers FJ. The physiological rationale of heat and moisture exchangers in post-laryngectomy pulmonary rehabilitation: a review. Eur Arch Otorhinolaryngol 2006; 263 (01) 1-8
• 4 Hilgers FJ, Aaronson NK, Ackerstaff AH, Schouwenburg PF, van Zandwikj N. The influence of a heat and moisture exchanger (HME) on the respiratory symptoms after total laryngectomy. Clin Otolaryngol Allied Sci 1991; 16 (02) 152-156
• 5 Hilgers FJ, Ackerstaff AH, Van As CJ, Balm AJ, Van den Brekel MW, Tan IB. Development and clinical assessment of a heat and moisture exchanger with a multi-magnet automatic tracheostoma valve (Provox FreeHands HME) for vocal and pulmonary rehabilitation after total laryngectomy. Acta Otolaryngol 2003; 123 (01) 91-99
• 6 Op de Coul BM, Ackerstaff AH, van As-Brooks CJ. , et al. Compliance, quality of life and quantitative voice quality aspects of hands-free speech. Acta Otolaryngol 2005; 125 (06) 629-637
• 7 van der Houwen EB, van Kalkeren TA, Burgerhof JG, van der Laan BF, Verkerke GJ. In vitro evaluation of the iValve: a novel hands-free speech valve. Ann Otol Rhinol Laryngol 2011; 120 (12) 814-819
• 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 (03) 235-241
• 9 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) 2447-2453
• 10 Ackerstaff AH, Hilgers FJ, Balm AJ, Tan IB. Long-term compliance of laryngectomized patients with a specialized pulmonary rehabilitation device: Provox Stomafilter. Laryngoscope 1998; 108 (02) 257-260
• 11 Ackerstaff AH, Hilgers FJ, Aaronson NK, Balm AJ, van Zandwijk N. Improvements in respiratory and psychosocial functioning following total laryngectomy by the use of a heat and moisture exchanger. Ann Otol Rhinol Laryngol 1993; 102 (11) 878-883
• 12 Hilgers FJ, Ackerstaff AH, Balm AJ, Gregor RT. A new heat and moisture exchanger with speech valve (Provox stomafilter). Clin Otolaryngol Allied Sci 1996; 21 (05) 414-418
• 13 Dolan P. Modeling valuations for EuroQol health states. Med Care 1997; 35 (11) 1095-1108
• 14 Dirven R, Wouters Y, Vreeken R, Maal TJ, Marres HA. Three-dimensional stereophotogrammetrical analysis of peristomal fixation of adhesive base plates during hands-free speech among laryngectomised patients related to tracheostoma volumes. Clin Otolaryngol 2012; 37 (02) 124-129