Medical Design Briefs - October 2021 - 6

Hydrocolloid Innovation
impression
technique.3
A former U.S. Army dentist, Dr.
Sears used agar to make impressions for
restorative dental applications, such as
inlays and fixed bridges.4 For wound
care, the initial hydrocolloid application
came in the 1960s from Dr. James Chen
of E.R. Squibb & Sons. Dr. Chen developed
a hydrocolloid medical adhesive
application for dental surgery.5 By the
late 1960s, hydrocolloids
way into stoma care applications
found their
for
patients with ostomies.6 As wound care
expert Liza G. Ovington, PhD, wrote:
A precursor to hydrocolloid dressings
called Stomahesive® was marketed by
E.R. Squibb to ostomy patients for protection
of the skin around the stoma site.
Stoma nurses started making subjective
observations about the condition of the
skin beneath the Stomahesive. In particular,
they noted that irritated or excoriated
peristomal skin appeared to heal
beneath the Stomahesive product. In
addition, ostomy patients began to write
to Squibb to say what a difference this
product was making in their lives.7
Today, medical hydrocolloid adhesives
remain the gold standard for stoma
care, and they are also used in dressings
to treat chronic wounds, skin tears, pressure
ulcers, burns, acne blemishes, incisions,
and scars.
Material Innovation and Processing
Advances
Hydrocolloids with Beveled Edges:
Next-generation extrusion technology is
enabling hydrocolloid PSA manufacturers
to offer dressings with longer wear
times. Newer hydrocolloid extruders
make materials more efficiently, with better
quality and less waste. For example,
they can create hydrocolloid materials
with sleek beveled edges. Beveled edges
help the dressing border to stay flat and
smooth on the patient's skin. Without a
beveled edge, hydrocolloid dressings
may have edge lift and can get caught on
clothing. This limits dressing effectiveness
and wear time. New extruder systems
have better tension control and
cooling capabilities, giving PSA manufacturers
greater opportunities to work with
temperature-sensitive materials.
Hybrid Hydrocolloids with Advanced
Fluid-Handling Capabilities: Another
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innovation in the hydrocolloid family is
the invention of hybrid materials that
are both hydrocolloid and acrylic PSA.
Avery Dennison Medical's
patented
Thin Absorbent Skin Adhesive™
(TASA™) is an example of one such
development. This adhesive can be coated
onto various carrier materials, including
polyurethane films and nonwovens.
Whereas traditional hydrocolloid adhesives
typically are 0.3-1.0 mm thick,
TASA is 0.1 mm thick. Also, it provides
both breathability and absorption. This
advanced fluid-handling capability en -
ables wear times as long as seven days.
Hydrocolloid formulation and processing
advances have enhanced the patient
experience on multiple fronts, improving
each of the following hydrocolloid types.
Traditional Nonintegrated: These hydrocolloids
are similar to the original formulations
of the 1970s. Primarily used for
stoma care, they are capable of absorbing
large amounts of fluid, swelling as they do.
This swelling results in a strengthened,
more secure seal of the stoma flange
against the patient's abdomen.
Advanced Integrated: These hydrocolloids
contain a crosslinked PSA network,
enabling the dressing to maintain its
integrity and not break down in the
wound. An advanced integrated hydrocolloid
dressing maintains a stable
weight before, during, and after it has
absorbed moisture. The absorbed liquid,
such as perspiration or wound exudate,
quickly integrates into the dressing's
suspended particles, which form a
gel-like substance. The dressing's integrated
framework holds everything to -
gether, completely intact, throughout
the prescribed wear time.
Additive Containing: Hydrocolloids can
be formulated to contain a wide variety of
additives to encourage healing, moisturize
skin, prevent odors, relieve pain, and
block ultraviolet rays. For example, some
hydrocolloid materials for stoma and
wound care applications contain cyclodextrins
to capture odor molecules when
in contact with moisture. Others contain
essential oils, antimicrobials, vitamins,
glycerin, or topical pain relievers.
Moldable: These hydrocolloids have a
consistency similar to a bendable, stretchable
putty. They are designed so that the
healthcare provider or patient can shape
the hydrocolloid to suit their individual
end use. For example, an ostomy appliance
kit often includes hydrocolloid
material pieces in the shape of small oval
or circular rings. The patient or caregiver
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can stretch and mold the material, shaping
it to fit precisely over the patient's
stoma. The hydrocolloid forms a seal
around the stoma, and the ostomy bag
flange is then placed over it. The moldability
of this hydrocolloid component
helps to prevent leakage of urine or feces
onto the peristomal skin or clothing.
Hydrocolloids and Healing
Hydrocolloid dressing materials are
formulated and processed so that they
will adhere, absorb, and conform. Here
is a look at how hydrocolloid wound care
developments address the following
healthcare challenges:
* Patient pain and stress from chronic or acute
wounds - Hydrocolloid dressings are
soft and gentle against the wound bed.
They absorb moisture without drying
out, so that the wound bed maintains a
healing level of moisture and does not
stick to the dressing. Hydrocolloids facilitate
autolytic debridement by providing
a moist environment to support the
body's natural process for reducing and
softening eschar. Additives in hydrocolloids
also help lessen pain.
* Wound odor - Additives such as cyclo -
dextrins are natural, noncytotoxic
odor-fighting components. When integrated
into hydrocolloid dressings or
stoma flanges, they prevent odors
from forming from wound exudate or
bacteria. This helps alleviate patient
stress and ensure their confidence and
sense of discretion regarding their
wound and stoma care.
* Ostomy care issues - The skin around a
stoma can be vulnerable to irritation,
especially if an ostomy appliance leaks.
Hydrocolloid materials help create a
secure seal around the stoma to prevent
leakage. If a leak does occur, the
hydrocolloid works to absorb excess
moisture and keep the peristomal skin
moist and healthy. Additives such as
moisturizers can be integrated into
hydrocolloids to enhance skin health.
* Wound dressing disintegration - Ad -
vanced integrated hydrocolloids are
designed to remain stable, secure, and
intact while they absorb fluids and manage
moisture. These hydrocolloid materials
are engineered to prevent the risk
for dressing breakdown into the wound.
* Difficult-to-heal wounds - Hydrocolloid
adhesives can be coated onto a variety
of substrates and converted into different
shapes for treatment of chronic
wounds on different parts of the body.
For example, there are bordered sacral
Medical Design Briefs, October 2021
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Medical Design Briefs - October 2021

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