Müller Rainer, Meißner Heike, Böttcher Gunter, Jatzwauk Lutz, Kant Ludwig, Schulz Matthias C, Reitemeier Bernd
Department of ENT, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstr 74, 01307, Dresden, Germany.
Support Care Cancer. 2015 Oct;23(10):3089-93. doi: 10.1007/s00520-015-2682-0. Epub 2015 Mar 13.
At the moment, there is an inadequate margin fit of commercially available stoma buttons. The aim of the present study was to develop a customized short tracheal cannula based on digital data. Furthermore, the applied material has to be evaluated considering germ colonization and appropriate cleaning procedures.
Computed tomographies of 53 patients who underwent laryngectomy were surveyed. Based on the digital data, a customized short tracheal cannula was created and manufactured from silicone. The new cannula was incorporated in ten patients and worn for 4 weeks. A clinical examination of an otolaryngologist and subjective assessment of the patients were carried out. Furthermore, microbiological test considering germ colonization was performed.
The customized short tracheal cannula could be incorporated in all patients. The clinical results showed no irritation or mucosal lesions. The subjective individual evaluation by the patients was promising. The proposals for improvement could be considered. The microbiological examination revealed a higher contamination of the silicone compared to the silver cannulas. Both chemical and mechanical decontamination showed sufficient results.
A workflow for development and manufacturing of a customized short tracheal cannula from digital data could be established. The cannula is compatible to standard equipment and routine cleaning procedures. Clinical studies are required to evaluate the potential benefit for patients.
目前,市售的造口钮边缘贴合度不足。本研究的目的是基于数字数据开发一种定制的短气管套管。此外,必须考虑细菌定植和适当的清洁程序来评估所应用的材料。
对53例行喉切除术患者的计算机断层扫描进行了研究。基于数字数据,制作并由硅胶制造了定制的短气管套管。将新套管纳入10例患者并佩戴4周。进行了耳鼻喉科医生的临床检查和患者的主观评估。此外,还进行了考虑细菌定植的微生物学检测。
定制的短气管套管可纳入所有患者。临床结果显示无刺激或粘膜损伤。患者的主观个体评估很有前景。可以考虑改进建议。微生物学检查显示,与银质套管相比,硅胶的污染程度更高。化学和机械去污均显示出足够的效果。
可以建立一种从数字数据开发和制造定制短气管套管的工作流程。该套管与标准设备和常规清洁程序兼容。需要进行临床研究以评估对患者的潜在益处。