Heat and Moisture Exchangers and their attachment devices are important medical devices for pulmonary and voice rehabilitation after total laryngectomy. Their positive impact is evident, particularly when adhering to HME use.1,2 Adherence to HME use and efficiency of tracheoesophageal voice production can be challenged by medical adhesive-related skin injuries (MARSI) and peristomal Skin Complications.3
Understanding of the skin and of factors that influence the skin in general and peristomal skin after total laryngectomy in particular helps identify patients that may be at risk for the development of MARSI. Availability of new peristomal adhesives based on modern adhesive materials and technology, careful adhesive selection and appropriate application and removal techniques can also help prevent MARSI and maintain the integrity of the peristomal skin.3 Healthy peristomal skin forms the foundation for adherent HME use and an airtight seal for efficient tracheoesophageal speech.
This video includes tips to get the adhesive to stay on all day. It also has tips and tricks for getting a good seal, to minimize skin irritation and what available for sensitive or irritated skin.
This video covers the features and benefits of different adhesive materials such as hydrocolloid, hydrogel and acrylic. It helps us understand how the material interacts with the skin as well as how it affects application and removal techniques.
1Bien S, Okla S, van As-Brooks CJ, Ackerstaff AH. The effect of a Heat and Moisture Exchanger (Provox HME) on pulmonary protection after total laryngectomy: a randomized controlled study. Eur Arch Otorhinolaryngol. 2010;267(3):429-35.
2Parrilla C, Minni A, Bogaardt H, Macri GF, Battista M, Roukos R, et al. Pulmonary Rehabilitation After Total Laryngectomy: A Multicenter Time-Series Clinical Trial Evaluating the Provox XtraHME in HME-Naive Patients. Ann Otol Rhinol Laryngol. 2015;124(9):706-13.
3Atos Medical, Whitepaper: Healthy peristomal skin: a foundation for successful voice and pulmonary rehabilitation, 2023