Tracheostoma adhesives/plasters/housings are applied to the tracheostoma so that various aids (HME, tracheostoma valve, shower protector) can be attached to it. The adhesive also seals the tracheostoma airtight and facilitates speaking through a voice prosthesis. Tracheostoma adhesives have a 22-mm connector to which the aids are applied. Various types and shapes of plaster are available, as well as various options for combining them with cannulas, to suit the particular patient’s type of skin and the desired strength of adhesion.
Strength of adhesion
Basically, the one thing all patients want is a plaster that is strong enough to stay in place the whole day long. However, this has to be balanced against the impact on the skin, which is not always able to cope with such a strong adhesive. For this reason, plasters with various strengths of adhesion and a variety of skin-friendly plasters have been developed.
The material thickness and load-bearing ability of a tracheostoma plaster can be adjusted to suit the individual requirements. There are thin ones that are easy to shape, ones that are reinforced with plastic, and adhesive plastic discs.
Plaster size / shape
Depending on the anatomy of the patient's neck, the tracheostoma may be positioned in an indentation between the two bases of the sternocleidomastoideus muscle or in the middle of a flat neck profile. The sizes and shapes of the plasters vary accordingly.
Adhesive technology – tracheostoma plasters
The adhesive strength of the tracheostoma plaster and the load-bearing ability of the skin are influenced significantly by the correct and careful preparation of and care for the skin, and by the careful and thorough removal of plaster and adhesive. The following has proven itself in practice:
- Clean all secretions on the tracheostoma and remove any scabs with water, and a mild soap if required.
- Degrease the area of the skin around the tracheostoma where the plaster is to be applied, e.g. using an alcohol swab.
- Apply a layer of skin protection, e.g. Ski-Prep.
- Depending on the desired adhesive strength and skin type: apply an additional silicone adhesive around the tracheostoma and allow to surface dry.
- Warm the plaster to activate the adhesive.
- Carefully position and apply the plaster over the tracheostoma, as centrally as possible. This may be easier if the plaster is carefully folded in half first. After applying the plaster: massage the plaster over the skin for more intensive adhesion without creating bubbles or wrinkling the skin under the plaster.
- While the plaster is in place: suck off or wipe away any secretion on the inside of the tracheostoma plaster without delay to prevent the adhesive from working loose. Use as little pressure as possible when talking.
- To remove the plaster: brush e.g. REMOVE over the plaster to loosen the adhesive. Slowly pull off the plaster from one side, applying more Remove to the adhesive as you do so.
- Remoisturize the skin.