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Device Technologies and Biomedical Robotics

Device Technologies and Biomedical Robotics - Poster Session A

Poster I11 - A Low-Cost Die Cutter for Efficiently Producing Hydrocolloid Dressings for Nasal Prongs Using in Nasal Continuous Positive Airway Pressure (nCPAP)

Thursday, October 24, 2024
10:00 AM – 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  Time is a vital resource in the neonatal intensive care unit (NICU). Interventions such as nasal continuous positive airway pressure (NCPAP), are most effective when applied immediately after birth, with delays as small as 15-30 minutes significantly increasing the likelihood a newborn will require invasive interventions such as intubation to treat respiratory distress. In a critical care setting, where time is invaluable, it is vital to eliminate inefficiencies which may delay care or waste valuable staff time. One such inefficiency is the manual preparation of hydrocolloid dressings used with nasal prongs for NCPAP, which are necessary to prevent air leakage and reduce the risk of nasal trauma associated with the prongs. Currently staff in many NICUs are forced to hand-cut dressings with scissors, a time-consuming task, due to a lack of compatible precut dressings or commercially available tools to automate this process. We decided to address this issue by developing a semi-automated tool which reduces the time needed to produce each hydrocolloid dressing by 91.7% and creates 12.5% more dressings from each 4-inch by 4-inch sheet of DuoDERM® as compared to hand-cutting. This allows for major savings on the time and material costs of producing hydrocolloid dressings, freeing time for clinical staff to allocate to other necessary tasks and much needed rest.

Materials and

Methods:  We began the process of developing this tool by interviewing respiratory therapists in the University of Cincinnati Medical Center (UCMC) NICU. They expressed the need for a device that is fast, efficient, automated or semi-automated, and preferably not reliant on an external power source. Based on these specifications, we considered two possible means of accomplishing this task: laser cutting and die cutting.

Laser cutting was tested at the University of Cincinnati’s 1819 Innovation Hub using an Epilog Helix laser cutter. A template for cutting the hydrocolloid dressings was designed in Autodesk Fusion (v2.0.18441, Autodesk, Inc., San Francisco, California, USA) and cut into a 4-inch by 4-inch sheet of DuoDERM®. A variety of power and speed settings were trialed.

The die cutting test was started by modeling different layouts in Autodesk Fusion to maximize the number of dressings created per sheet of DuoDERM®. After a layout was selected, a polycarbonate (Piedmont Plastics) die base was waterjet by 1819 Innovation Hub staff using an OMAX Maxiem 1530 JetMachining® Center. Stainless steel knifing (Bohler) was fit into the base by Artistic Die (Cincinnati, Ohio 45206, USA). Ejection rubber was created using Dragon Skin 10 skin-safe silicone and a custom mold printed in-house using polylactic acid (PLA) filament (Prusament PLA, Prusa Research a.s., Partyzánská, Prague, Czech Republic) on an Original Prusa MK4 (Prusa Research a.s.) desktop 3D printer. The die was operated via an AccuCut Mark 3 Die-Cutting Machine (AccuCut, Omaha, Nebraska, USA).

Results, Conclusions, and Discussions: We found that DuoDERM® was able to be laser cut using a power setting of at least 90% and a speed setting of 50% or less. However, the laser left burnt residue along the edges of the dressings, making them unfit for medical use. Therefore, laser cutting was ruled out.

Die cutting proved to be much more fitting. Based on the hydrocolloid dressing dimensions, the DuoDERM® sheet dimensions, and the required blade width, we determined that a maximum of 18 dressings can be produced per DuoDERM® sheet. However, manufacturing constraints require at least 0.125” spacing between parts, preventing 18 features from fitting on a single die. We therefore designed a die which produces nine dressings at a time, with cutouts spaced such that the die can be used twice on each DuoDERM® sheet, producing a total of 18 dressings (Figure 1). The die is made of heat and pressure-tolerant materials allowing it to be sterilized by autoclaving. To operate the die, we elected to use the AccuCut Mark 3, a compact hand-operated roller press. This press allows users to easily cut 18 dressings in less than 90 seconds without requiring an outlet or other power source (Figure 2).

We presented our device to UCMC NICU staff on May 14th, 2024. We received positive feedback from staff about the design of our device, with staff expressing their appreciation for the device’s ease of use and the significant time it saves. However, minor size modifications (reducing the distance between the two punchouts) were requested to improve compatibility with UCMC NICU equipment before it could be implemented in clinical practice.

In a setting where every minute matters, we have created a novel tool that streamlines the process of creating hydrocolloid dressings, greatly reducing the time and staff burden associated with this task. This increase in efficiency ultimately has the potential to improve patient outcomes in the NICU.

Acknowledgements (Optional):