title: Does the patch fit the stoma? A study on peristoma geometry and patch use in laryngectomized patients.
abstract: OBJECTIVE
  To determine the geometry of (peri)stomas of laryngectomized patients in relation to patch use. This data will enable improvement of tracheostoma interfaces, specifically addressing patients currently unable to use stoma patches. The low use of Heat-and-Moisture-Exchange (HME) filters and (hands-free) speech valves, although very important to the quality of life of laryngectomized patients, is mainly attributed to poor fit of the adhesive patches to the stoma site. Current patch shapes are not based upon an objective (peri)stoma geometry because this geometry is unknown.
  
  
  METHODS
  Observational anthropometric study of the (peri)stoma of laryngectomized patients.
  
  
  METHODS
  Ten hospitals or institutes in eight countries.
  
  
  METHODS
  About 191 laryngectomized patients, at least 1 year post operative.
  
  
  METHODS
  (Peri)stomas were photographed and measured. Patients completed a questionnaire on patch-use. Concavity of commercially available patches was measured.
  
  
  RESULTS
  In countries with a financial reimbursement system 58% of the patients use patches, compares to only 9% in other countries. Patches stay in situ for an average of 33.3 h. Patch and non-patch users differ on five out of ten measured geometrical parameters. Most striking differences are that patch users have much shallower peristomas (13 versus 18 mm), and stomas far more parallel to the anterior neck plane. The deepest commercially available patch is only 7 mm deep.
  
  
  CONCLUSIONS
  This study provides detailed (peri)stoma geometry data of a divers population, and for the first time in relation to patch-use. It reveals a serious mismatch between patients and patches. With these data new patches can be developed that could dramatically improve rehabilitation after laryngectomy.
authors.affiliation: Departments of Biomedical Engineering, University Medical Center Groningen, University of Groningen, The Netherlands. e.b.van.der.houwen@med.umcg.nl
authors.forename: E B
authors.initials: EB
authors.lastname: van der Houwen
authors.forename: T A
authors.initials: TA
authors.lastname: van Kalkeren
authors.forename: W J
authors.initials: WJ
authors.lastname: Post
authors.forename: F J M
authors.initials: FJ
authors.lastname: Hilgers
authors.forename: B F A M
authors.initials: BF
authors.lastname: van der Laan
authors.forename: G J
authors.initials: GJ
authors.lastname: Verkerke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010613:Pharyngostomy / Q000295:instrumentation*; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D013060:Speech; D011795:Surveys and Questionnaires