Developments in silicone technology for use in stoma care

YesSoft silicone's flexibility, adhesive capacity and non-toxic, non-odourous and hypoallergenic nature have made it an established material for adhesive and protective therapeutic devices. In wound care, silicone is a component of contact layer dressings for superficial wounds and silicone gel sheeting for reducing the risk of scarring, as well as of barriers for incontinence-associated dermatitis. Regarding stoma accessories, silicone is established in barrier films to prevent contact dermatitis, adhesive removers to prevent skin stripping and filler gels to prevent appliance leaks. Until recently, silicone has not been used in stoma appliances flanges, as its hydrophobic nature has not allowed for moisture management to permit trans-epidermal water loss and prevent maceration. Traditional hydrocolloid appliances manage moisture by absorbing water, but this can lead to saturation and moisture-associated skin damage (MASD), as well as increased adhesion and resultant skin tears on removal, known as medical adhesive-related skin injury (MARSI). However, novel silicone compounds have been developed with a distinct evaporation-based mechanism of moisture management. This uses colloidal separation to allow the passage of water vapour at a rate equivalent to normal trans-epidermal water loss. It has been shown to minimise MASD, increase wear time and permit atraumatic removal without the use of adhesive solvents. Trio Healthcare has introduced this technology with a range of silicone-based flange extenders and is working with the University of Bradford Centre for Skin Sciences on prototype silicone-based stoma appliance flanges designed to significantly reduce the incidence of peristomal skin complications, such as MARSI and MASD. It is hoped that this will also increase appliance wear time, reduce costs and improve patient quality of life

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Modelling energy utilization for laying type Pullets

Three trials were carried out to determine energy metabolized (EM) requirement model for starting and growing pullets from different strains, at five ambient temperatures and different percentage feather coverage. In Trial I, metabolizable energy requirements for maintenance (MEm) and efficiency of energy utilization were estimated using 64 birds of two different strains, Hy-Line W36 (HLW36) and Hy-Line Semi-heavy (HLSH), from 9 to 13 weeks of age. The effects of ambient temperature (12, 18, 24, 30 and 36ºC) and percentage feather coverage (0, 50 and 100%) on MEm were assessed in the second trial, using 48 birds per temperature per strain (HLSH and HLW36) from 9 to 13 weeks of age. Trial III evaluated ME requirements for weight gain (MEg) using 1,200 birds from two light strains (HLW36 and Hisex Light, HL) and two semi-heavy strains (HLSH and Hisex Semi-heavy, HSH) reared until 18 weeks of age. According to the prediction models, MEm changed as a function of temperature and feather coverage, whereas MEg changed as a function of age and bird strain. Thus, two models were developed for birds aged 1 to 6 weeks, one model for the light strain and one for the semi-heavy strain. Energy requirements (ER) were different among strains from 7 to 12 weeks, and therefore 4 models were elaborated. From 13 to 18 weeks, one single model was produced for semi-heavy birds, since ER between semi-heavy strains were not different, whereas two different models were elaborated for the light layers. MEg of light birds was higher than MEg of semi-heavy birds, independent of age