Patent Publication Number: US-2019175386-A1

Title: Dressing for concealing a structure on a human body

Description:
RELATED APPLICATIONS 
     This application is a continuation of PCT Patent Application No. PCT/GB2017/051652 having International filing date of Jun. 7, 2017, which claims the benefit of priority of United Kingdom Patent Application No. 1609954.1 filed on Jun. 7, 2016. The contents of which are incorporated by reference as if fully set forth herein. 
    
    
     FIELD AND BACKGROUND OF THE INVENTION 
     The present invention relates to surgical, medical or other anatomical dressings that may be applied to the human body. In particular, the invention relates to such dressings that may be applied for use in intimate situations, during bathing, or during swimming, for example to conceal a stoma or cover scarring on the human body. 
     Ostomy is a common surgical procedure used to create an artificial opening (or “stoma”) in the body for the discharge of body wastes. Typically in such a procedure, a structure (i.e. the stoma) is formed on the surface of the abdomen to allow waste to discharge from the body. 
     Patients who have undergone an ostomy (known as ostomates) typically wear products such as ostomy pouches or plugs throughout the day to collect body wastes. These products can be obtrusive and uncomfortable, particularly in intimate situations or during bathing or swimming. Some ostomates experience a level of social stigma, and may feel uncomfortable in situations where their stoma or ostomy product is more likely to be noticeable. 
     Aspects and embodiments of the present invention are set out in the appended claims. These and other aspects and embodiments of the invention are also described herein. 
     SUMMARY OF THE INVENTION 
     According to at least one aspect described herein, there is provided a dressing for concealing a structure on a human body, the dressing comprising: a patch arranged to be placed on the body; wherein the patch has an indentation for receiving the structure so as to conceal the structure when the patch is placed on the human body. 
     By providing an indentation in the patch, the dressing may conceal, and preferably also disguise, a structure such as a stoma on a human body. Furthermore, such concealing may be hygienically advantageous. 
     The patch may comprise a first side arranged to be placed against the body and a second side arranged to face away from the first side. The indentation may be provided in the first side of the patch and may be arranged to extend towards at least a portion of the second side of the patch. The indentation may cause at least part of the second side to protrude outwardly, away from the first side, preferably wherein the peripheral edges of the patch are thinner than the portion of the patch in which the indentation is provided. At least a portion of the first side of the patch is spaced from the second side of the patch by a distance greater than the depth of the indentation. The patch may have a thickness of between 5 mm and 2 mm, and preferably at least 3 mm. 
     The indentation is arranged to receive a structure, for example wherein the structure is a stoma. The indentation may be substantially circular when viewed from below. Preferably, the indentation has a diameter of between 20 mm and 60 mm, and more preferably the diameter is between 25 mm and 50 mm. The indentation may be arranged so that it may be worn with an existing stoma cap or plug. 
     The patch may be further arranged to allow gases to be vented out of the indentation via the second side, for example wherein one or more apertures are provided on the second side of the patch. An odour resistant membrane (which is optionally absorbent) is preferably provided, which may comprise activated carbon, where the membrane is arranged in the indentation such that gases are vented through the membrane. The dressing may further comprise means for sealing the one or more apertures so as to inhibit gases from being vented from the indentation. 
     The dressing may further comprise an anti-bacterial component arranged to fit within the indentation. The anti-bacterial component may comprise a generally annular ring arranged to fit over the structure so as to substantially surround the structure, preferably such that the ring is in direct contact with the structure, more preferably wherein the ring is removable and disposable. The anti-bacterial component may comprise silver, such as silver nano-particles. 
     The dressing may further comprise means for retaining a disposable bag for receiving waste from the structure. The retaining means may be in the patch thereby to conceal the disposable bag when the patch is placed on the body. The retaining means may be a chamber within the patch, or an indentation in the patch, such as a channel. The channel may be arranged to extend around at least a part of the indentation, around a major part of the indentation, and/or the channel may be generally annular and be arranged to encircle the indentation. The retaining means is preferably provided in fluid communication with the indentation. Optionally, the dressing further comprises the disposable bag. 
     The patch may further comprise a three-dimensional formation arranged to face away from the body. The formation is preferably arranged to coincide with the position of a protrusion in the second side of the patch formed by the indentation and/or by the retaining means, such that the protrusion is disguised by the formation when viewed from the second side of the patch. 
     According to at least one aspect described herein, there is provided a dressing for concealing a structure on a human body, the dressing comprising: a patch arranged to be placed on the body; wherein a three dimensional (3D) formation is provided on at least part of the patch, said three dimensional formation being arranged to face away from the body when the patch is placed on the body so as to conceal the structure. 
     By providing a 3D formation on the patch, structures on the body and/or other components of the dressing may thereby be concealed. Furthermore, the patch may have an attractive appearance. 
     The formation may be arranged as a decorative formation and/or may have an irregular shape. The patch may be formed from a single piece of material, and may comprise silicone. At least part of the patch may be covered by a film or coating, preferably a lubricious, low coefficient of friction coating, for example but not exclusive to, MED10-6670, whereby to provide protection to that part of the patch that is not placed on the body. Alternatively or additionally, the film may be a polyurethane film. 
     The first side of the patch may be arranged to adhere to the body, preferably wherein the patch is arranged to adhere to skin, for example wherein an adhesive is provided on at least part of the patch. The first side may be provided with a bio-grade adhesive, preferably where the adhesive is a silicone gel adhesive. The adhesive is preferably capable of being reapplied to the body, for example such that the dressing can be reused at least once. 
     The patch may be arranged to have a thickness that reduces towards its peripheral edges so as to effect a generally smooth tactile transition between the patch and the body. 
     According to at least one aspect described herein, there is provided a method of manufacturing a dressing as described herein, comprising: obtaining one or more dimensions of a structure to be concealed; forming a patch arranged to cover an area greater than the area covered by the structure on the body; providing an indentation in the patch; wherein the indentation is configured to receive the structure when the patch is placed on the body, whereby to conceal the structure. 
     The indentation may be sized to correspond with the one or more dimensions of the structure thereby to receive the structure. A three-dimensional formation may be formed, or otherwise provided, on the patch, said formation having one or more features for disguising the indentation. Preferably, the features of the formation are specified by a user of the patch. 
     According to at least one aspect described herein there is provided a method of manufacturing a dressing as described herein comprising: forming a patch having provided thereon a three-dimensional (3D) formation; wherein the formation is arranged to face away from the body. 
     Preferably, the patch is formed from a single piece of material, for example silicone. The three-dimensional formation (or shape/design) may be provided by the intended user of the dressing and/or the three-dimensional formation may be created from a two-dimensional shape or design provided by the intended user of the dressing, for example. The three dimensional formation may alternatively be created from a range of designs provided by the manufacturer. 
     An adhesive may be provided on at least part of the patch that is arranged to be placed on the body. A protective film or coating may be provided over at least part of the patch, preferably said at least part of the patch that is arranged to face away from the body. 
     According to at least one aspect described herein, there is provided a machine-readable map, or machine-readable instructions, configured to enable a 3D printer (or any printer or manufacturing device/system) to manufacture at least part of a dressing or mould as herein described. 
     The invention extends to a dressing and/or a method of manufacturing a dressing substantially as described herein and shown in the accompanying figures. 
     As used herein, the term ‘patch’ preferably connotes a piece of material that may be used to cover part of a human body, for example in a medical context to cover a scar, wound or stoma. 
     As used herein, the term ‘structure’ preferably connotes a protrusion or otherwise deformed area on a human body resulting from a previous wound or surgical procedure, such as scar tissue or a stoma. 
     As used herein, the term ‘indentation’ preferably connotes a recess, hollow, depression, scoop, dent or notch, for example. 
     As used herein, the term ‘medical-grade’ preferably connotes materials having met certain necessary standards relating to biocompatibility during manufacture, such as toxicity testing. 
     As used herein, the term ‘anti-bacterial’ preferably connotes being active against bacteria, for example destroying, inhibiting or supressing the growth or reproduction of bacteria. 
     As used herein, the term ‘conceal’ preferably connotes to cover, disguise, obscure, screen, mask or camouflage, for example. 
     Any apparatus feature as described herein may also be provided as a method feature, and vice versa. Furthermore, any feature in a particular aspect may be provided independently and/or applied to other aspects, in any appropriate combination. 
     It should also be appreciated that particular combinations of the various features described and defined in any aspects can be implemented and/or supplied and/or used independently. 
     As used herein, means plus function features may be expressed alternatively in terms of their corresponding structure. 
    
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
       The present invention will now be described, purely by way of example, with reference to the accompanying figures, in which: 
         FIG. 1  shows schematic rear and side views of a dressing in one example of the present invention; 
         FIG. 2  shows schematic rear and side views of a dressing comprising a patch having a vent; 
         FIG. 3  shows schematic rear and side views of a dressing comprising a patch and an anti-bacterial component; 
         FIG. 4  shows an exploded view of another example of a dressing during application; 
         FIG. 5  shows an exploded view of another example of a dressing arranged to conceal a stoma; 
         FIG. 6  shows an exploded view of several of the parts of the dressing of  FIG. 5 ; 
         FIGS. 7 a , 7 b , 7 c , and 7 d    show the dressing of  FIG. 5  applied to the body of a user; 
         FIGS. 8 a , 8 b , 8 c , 8 d , 8 e , and 8 f    show different examples of possible formations arranged on dressings; 
         FIG. 9  shows a schematic flow diagram of a method of manufacturing a dressing; 
         FIG. 10  shows schematic rear and side views of a dressing comprising a channel; and  FIG. 11  shows an exploded view of the dressing of  FIG. 10 . 
     
    
    
     DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION 
       FIG. 1  shows schematic rear and side views of an exemplary dressing  100  in the form of a “patch”  110 . The patch comprises a first side  112  and a second side  114 . The first side  112  is arranged to be placed on the body of a user, and the second side  114  is arranged to face away from the first side  112 . As such, the first and second sides may be considered to be opposing. At least part of the second side  114  is spaced away from the first side  112 , such that the patch  110  protrudes away from the patient&#39;s skin. 
     In its simplest form, the patch  110  may comprise a single piece of material, such as a cast silicone piece. The patch  110  should be arranged to be capable of being placed on the body of a user, preferably such that it adheres to the skin of a user, as will be described later on. 
     The first side is arranged to receive a structure, such as a stoma  20  (as illustrated in  FIG. 4 ) and may therefore comprise an indentation  116 , for example a recess or notch. The indentation  116  is circular to accommodate the stoma, and the diameter and the depth of the indentation  116  may be selected in dependence on the size of the stoma  20 . Alternatively, a range of standard diameters of indentation  116  may be available, which may range from 20 mm to 60 mm, or more preferably 25 mm to 50 mm, for example. A non-circular indentation  116  may alternatively be used if the patient has an irregular-shaped stoma  20 . The indentation  116  allows the patch to be applied over a stoma without pressing on the stoma, allowing the stoma to be concealed and hence disguised by the dressing. Preferably, the depth of the indentation  116  is arranged to provide a gap of at least 3 mm, between the distal end of the stoma  20  and the patch  110 . The part of the patch coinciding with the indentation may have a thickness of between 5 mm and 2 mm, and preferably at least 3 mm. 
     The patch  110  can be used to cover a stoma hygienically without being used in combination with an ostomy product or leaving the stoma exposed, either of which are required when conventional disguising products (such as specialist underwear) are used. Advantageously, the dressing is much less obtrusive than a conventional ostomy product and may have significant aesthetic appeal. 
     An adhesive is, ideally, used to adhere the patch  110  to a patient&#39;s skin. Preferably, the adhesive is provided evenly across the first side  112 , (preferably avoiding the indentation). It may alternatively be provided as a separate substrate, as described below. The adhesive alternatively is preferably a medical grade and bio-compatible adhesive, and may be selected so as to have a strong bond with the skin so as prevent the patch coming loose or peeling. The strength of the bond should however not be so strong as to cause significant trauma or skin maceration when the patch is removed. The adhesive is preferably hypoallergenic and/or should not substantially affect skin pH or moisture levels. A pressure-sensitive adhesive may be used, wherein the adhesive may be applied to the patch  110  using pressure sensitive adhesive (PSA) heat lamination methods. Preferably, the adhesive provides sufficient residual adhesion to allow the patch to be reused at least once following removal. The first side  112  of the patch  110  may be provided on a release liner, which may be removed to allow the patch to be applied. A silicone gel adhesive is an example of a possible adhesive that could be used, which is preferred due to its high breathability and flexibility. 
     The second side  114  of the patch  110  comprises a three-dimensional formation  115 , which in  FIG. 1  is represented as a surface with a raised profile. The second side  114  may be arranged to reduce in thickness towards its edges  114   a,  such that the edges of the second side  114  form an acute angle with the edges of the first side  112 . This allows the patch to blend unobtrusively into the skin and reduces the possibility of the patch accidentally being lifted off. The patch may be arranged to be as thin as possible, but will be limited by the size of the structure being concealed (and hence the depth of the indentation  116 ). In general, the middle (and thickest) portion of the patch has a thickness of between 10 mm and 30 mm, and tapers to a thickness of around 2 mm-3 mm on the edges  114   a.    
     Referring to  FIG. 2 , in which corresponding reference numerals have been used to show corresponding parts, schematic rear and side views of another exemplary dressing  200  comprising a patch  210  and having a vent  217  are shown. The vent  217  allows gas to escape from a stoma via indentation  216 . One or more ventilation apertures  217   a  (which may be, for example, approximately 1.5 mm in diameter) may be provided from the vent  217  to the second side  214  of the dressing  200  to allow gases to escape. The vent  217  may be implemented in various ways, as will be described by way of example below. The dressing  200  is otherwise identical to the dressing  100  as previously described. 
       FIG. 3  shows schematic rear and side views of another exemplary dressing  200  comprising a patch  310  and an anti-bacterial component  318 . Corresponding reference numerals have been used to show corresponding parts. The anti-bacterial component  318  is arranged in an indentation  315  on the first side  312  of the patch  310 , which is otherwise substantially similar to the dressing  200  previously described. The anti-bacterial component  318  may be substantially annular or “ring-shaped” and is ideally shaped to fit around the stoma so as to surround the stoma and also to be in contact with the skin around the stoma  20  (which may be referred to as ‘peristomal skin’), so as to protect against infection. The anti-bacterial component  318  is arranged to fit closely around the stoma, being preferably spaced no further than 1 mm away from the sides of the stoma. This inhibits leakage of the waste from the stoma onto the peristomal skin. The anti-bacterial component  318  may be provided with adhesive to adhere to the skin and/or to the patch  310 . 
     The anti-bacterial component  318  is preferably made of a soft and/or flexible material to avoid irritating the peristomal skin. The anti-bacterial component  318  also preferably comprises silver being arranged to act as a bactericide. For example, the anti-bacterial component  318  may be made of silicone having diffused silver nanoparticles. Experimental anti-bacterial components  318  comprising 8-10 nm silver particles at 99.9% purity have been shown to kill  E. coli  colonies placed in contact with the anti-bacterial components  318  at a much faster rate than colonies placed in contact with a control sample. Infectious conditions of the peristomal skin are common, and can significantly affect a stoma patient&#39;s quality of life. The provision of the anti-bacterial component  318  helps to reduce the likelihood of such infections occurring. Prior art ostomy devices do not contain an anti-bacterial component. 
     The anti-bacterial component  318  may be disposable, and may be removable such that the dressing  300  may be worn with or without it. The anti-bacterial component  318  may be arranged to cover at least 5-20% of the stoma, and may therefore have a thickness of between 1-10 mm, or more preferably between 2-3 mm, for example, preferably wherein the anti-bacterial component  318  is arranged to fit securely (or tightly) around the base of the stoma. The anti-bacterial component  318  may optionally be located in a recess provided at the opening of the indentation  316 , or alternatively may fit closely between the walls of the indentation  316 . 
       FIG. 4  shows an exploded view of an exemplary dressing  400  comprising a patch  410  prior to application to the abdomen  10  of a user. Corresponding reference numerals have been used to show corresponding parts. The dressing  400  includes an anti-bacterial component  418  arranged to fit over a stoma  20 . The second side  414  of the patch  410  has a three-dimensional formation  415 , which may be arranged as a decorative design. For example, a mandala design may be used. The formation  415  may comprise decorative elements extending above a substantially flat or planar base layer provided by the second side  414 . The formation  415 , and therefore the dressing  400 , preferably extends over a much wider area than the stoma  20 . For example, a stoma  20  having a diameter of 20 mm may require a dressing having a minimum width/diameter of at least 110 mm; a stoma  20  having a diameter of 50 mm may require a dressing having a minimum width/diameter of at least 130 mm (e.g. a minimum width in any direction across the dressing, or minimum diameter where the dressing is generally circular in shape). The size and placement of the dressing  400  may be chosen to promote the ability of the user to move freely without the dressing coming away from the body. 
     A bulbous or otherwise raised element  411  of the formation  415  may optionally be used to conceal the indentation  416  for the stoma  20 . In the dressing  400  shown in  FIG. 4 , the raised element  411  (and therefore the indentation  416 ) is provided centrally in the formation  415  and dressing  400 . The raised element  211  and/or the indentation  416  may alternatively be provided off-centre. The raised element  311  may be incorporated into the formation  415  in a decorative way, for example by being incorporated into the formation  415  as the bulb of a flower or as the centre of a mandala design, as shown in  FIG. 4 . The raised element  411  concealing the indentation  416  may be the part of the formation  415  that is furthest from the skin, so as to minimise the thickness of the rest of the dressing  400 . 
     The second side  414  of the patch  410  may be coated with a film  414   b  (shown in  FIG. 4  as a separate layer), such as a polyurethane film, to protect the patch, to allow it to be washable and/or to improve the surface finish and/or texture of the patch  410 . The film is preferably breathable and presents a barrier to bacteria. An example of a suitable film is AU25 or EU50 film made by Delstar Technologies (RTM). In an alternative, a lubricious coating with a low-coefficient of friction may be used, such as MED10-6670 made by NuSil Technology™. 
     In the dressing shown in  FIG. 4 , venting may be controlled by an odour absorbent membrane  417   c,  which is arranged to fit into the indentation  416  to control the flow of any gases out of the indentation  416  via one or more ventilation apertures  417   a.  In this example, the odour absorbent membrane  417   c  is provided as part of a film, and may be laminated or heat welded into polyurethane film, for example. The membrane  417   c  comprises activated carbon. The ventilation apertures  417   a  are preferably arranged unobtrusively within the formation  415 . For example, in the dressing shown in  FIG. 4 , the ventilation apertures  417   a  are incorporated in a substantially annular arrangement in the raised element  411 . 
       FIG. 5  shows an exploded view of another exemplary embodiment of a dressing  500  for covering a stoma  20 . Corresponding reference numerals have been used to show corresponding parts. In  FIG. 5 , the adhesive is shown as a separate layer  513  located between a first side  512  of the patch  510  and a release liner  519 . The adhesive is provided in a substantially ring-shaped layer  513  such that is no adhesive provided around the indentation  516 . The release liner  519  may be manufactured with the adhesive before the adhesive is bonded to the patch  510 . To apply the dressing  500 , the release liner  519  may be pulled back to expose the adhesive. 
     In the dressing  500 , a removable vent cap  517   b  (not shown in  FIG. 5 ) may optionally be provided over one or more ventilation apertures  517   a  and/or a vent  517  (indicated in  FIG. 5 ). The dressing  500  may otherwise be substantially functionally identical to the dressing  400  described in relation to  FIG. 4 . The vent cap  517   b  may be removed to expose the vent  517  and allow gas to escape from the indentation  516 . Preferably, the vent cap  517   b  seals the vent  517  when fitted. The provision of a vent cap  517   b  may allow for a larger vent  517  to be used. 
       FIG. 6  shows an exploded view of several of the parts of dressing  500 , where the vent cap  517   b  is shown. An exemplary vent  517  for use in an ostomy pouch may be used with the dressing  500 , such as the Osto EZ Vent® venting device. The vent  517  can be provided in combination with an odour absorbent membrane (not shown) and/or a mesh filter  517   d  which may be located beneath the vent  517 , being sealed by the vent cap  517   b.  The vent cap  517   b  is preferably arranged to be accommodated unobtrusively as part of a formation  515 . In the dressing  500 , the vent cap  517   b  is arranged to fit over a raised element  511 , which contains the ventilation apertures  517   a  on which the vent  517  is located. 
       FIG. 7 a - d    shows the dressing  500  of  FIG. 5  applied to the abdomen  10  of a user thereby concealing the stoma  20 . 
       FIGS. 8 a -8 f    show different dressings  600 ,  700 ,  800 ,  900  with alternative exemplary formations  615 ,  715 ,  815 ,  915 . Corresponding reference numerals have been used to show corresponding parts. As these figures show, a dressing may have a non-circular shape. As  FIG. 8 a    shows, a formation  615  may comprise a single three-dimensional shape provided over the second side of the patch as an alternative to the second side providing a base layer. In this case, a raised section containing an indentation may be unobtrusively provided in part of the shape. 
       FIG. 8 b    shows a dressing  700  with a more protruding profile, which may be suitable for larger stomas. 
     The exemplary formation  815  shown in  FIG. 8 c    comprises a raised section  811 , which may optionally be used to conceal an indentation. If provided, such a raised section  811  may be provided off-centre in the formation  815  and may be surrounded with various decorative elements in a similar theme, thereby to improve the concealment of the raised section (and thereby improve the concealment of the stoma). The colour of a patch may optionally be varied, for example to match a patient&#39;s skin tone.  FIGS. 8 d  and 8 e    show perspective and side views of the dressing  800  of  FIG. 8 c   .  FIG. 8 f    shows a dressing  9000  having a further formation  915 . 
     As mentioned, the patch preferably comprises silicone, and preferably a single cast piece of silicone. A bio-grade silicone should be used, such as “silicone liquid rubber” supplied by Dow Corning™ or Scapa™ or Nusil Technology™. 
       FIG. 9  shows a schematic flow diagram of a method of manufacturing a dressing. The patch may be customised based on a preferred formation (optionally specified by a user) and the dimensions of the user&#39;s stoma. In step  951 , a 2D drawing of a preferred design or formation may be provided by the user. In step  952 , the 2D design may be drawn up in 3D, for example using a CAD package, and may be modified to incorporate a suitable indentation for a stoma. In step  953 , a mould for the formation may be rapid prototyped (for example, by being 3D printed), and used to cast silicone, producing a patch having a formation corresponding to the 3D design. In an alternative, the patient may choose a formation from a range of existing designs. The bactericidal component may be cast in a similar way, with additional processing steps of introducing and dispersing the silver nanoparticles. For hygiene, the patch (and/or optionally the mould) are manufactured in a clean room. 
     The colour of the patch may be controlled using dyes or additives introduced into the silicone during casting. The colour may be selected in dependence on the formation used. For example, a black colour may be used in tattoo-like formations, and a colour matching skin tone may be chose in minimalistic formations. 
       FIG. 10 , in which corresponding reference numerals have been used to show corresponding parts, shows schematic rear and side views of a further example of a dressing  1000 . The dressing  1000  includes a patch  1010  having a relatively large indentation  1016 , which has a generally rectangular shape with opposing circular segments on either side of a long edge of the rectangular shape. The size and shape of the indentation allow products applied to the stoma (such as a covering or a separate venting device) to be easily fitted into the indentation, as well as the stoma itself. In the dressing  1000 , the vent is formed from three ventilation apertures  1017   a,  which extend from a centre of the indentation  1016  to a second side  1014  of the dressing. 
     The patch  1010  further comprises a further indentation (or recess) shaped as a generally circular channel  1020  in the first side  1012 , where the channel extends around the indentation  1016  so as to surround the indentation. The channel is recessed into the first side, and is arranged to retain a bag (or tube) for receiving waste (i.e. faecal output) from a stoma in the indentation. A fluid connection  1022  is provided from the indentation to the channel to allow waste to flow into the channel, where the fluid connection is recessed into the first side. 
     The bag (not shown) is generally tubular in shape and is arranged generally to conform to the shape of the channel. Preferably, the bag extends throughout a major part of the channel  1020 . This may extend into the indentation  1016  (via the fluid connection  1022 ) proximate the stoma to receive waste, or alternatively it may be engaged with a separate product (such a venting device) engaged with the stoma (which is received into the indentation as well as the stoma). The bag retained in the channel is removable and disposable, where a user can remove the dressing  1000  and extract the bag or tube from the channel  1020  manually. The bag accommodates at least 50 ml of waste, and preferably more than 60 ml of waste. 
       FIG. 11  shows an exploded view of the dressing  1000  of  FIG. 10 . Corresponding reference numerals have been used to show corresponding parts. As previously described, the patch  1010  is formed from silicone and includes a three-dimensional formation  1015  on a second side  1014 . The second side is covered by a spray coating  1014   b  (which does not seal the ventilation apertures  1017   a ) for protection and to improve the surface finish and appearance of the dressing. The first side  1012  of the patch is covered with a layer of silicone adhesive  1013  to adhere the patch  1010  to a human body. The adhesive is preferably reusable and waterproof. The adhesive is provided with a release liner  1019  for protecting the adhesive until use. Neither the adhesive nor the release liner extend over the indentation. An odour absorbent membrane  1017   c  is arranged to fit into the indentation so as to extend over the ventilation apertures  1017   a . The membrane  1017   c  consists of a membrane of activated carbon with a protective coating or laminate. An anti-bacterial component (as previously described) may optionally also be used with the dressing  1000 . 
     It will be appreciated that the channel  1020  may be implemented in a variety of different ways, for example as a helical channel extending away from the indentation  1016  (in which case there is no separate fluid connection  1022 ) or as a separate chamber with a fluid connection to the indentation. The channel may extend only around a part (i.e. not all of the way around) the indentation, such that the channel may be generally semi-circular in shape. 
     A plurality of fluid connections  1022  may alternatively be included in the dressing. Rather than being recessed into the first side  1012 , the fluid connection(s) may be internal to the patch. In an alternative, waste may be stored within the indentation itself. In such embodiments, a large indentation may be provided, and consequently the dressing may be of a larger size than in previously described embodiments. 
     The user may remove and replace the bag in other alternative ways, for example by (reversibly) dissembling the patch at a mid-point, or by uncovering an aperture for accessing the bag in the second side  1014 . The bag may alternatively be formed as an inner liner of the channel  1020 . 
     It will be appreciated that the dressing described may not only be used by ostomates, but also by any other users having structures, which may be undesirable or unsightly, extending above their skin as a result of a previous wound or surgical procedure. Examples of such other structures include scars or deformities, which may be incorporated into suitably sized indentations  16  to be concealed. A channel or other further indentation may be provided to allow waste (such as discharges of blood or pus) to be received from these structures. 
     The dressing may also be used without an indentation  16  or any deodorising material (for example, the membrane  417   c ) when used for scarring or deformities on the surface of the skin. As such, in this case the first side of the patch is simply a flat adhesive face which can adhere straight on to the body. In this embodiment, adhesive may only be provided on certain areas of the first side, so as to avoid any risk of irritation of the area to be concealed. 
     Optionally, the vent may be provided as an integral part of the patch, for example, the vent may surround a raised element. The vent may comprise an odour absorbent membrane and a plurality of outlets provided in the patch and film. 
     As briefly mentioned, the patch and/or a mould for the patch of one or more embodiments described herein may optionally be manufactured by way of ‘3D printing’ whereby a three-dimensional model is supplied, in machine-readable form, to a ‘3D printer’ adapted to manufacture said patch and/or mould. This may be by additive means such as extrusion deposition, Electron Beam Freeform Fabrication (EBF), granular materials binding, lamination, photopolymerization, or stereolithography or a combination thereof. The machine-readable model comprises a spatial map of the object or pattern to be printed, typically in the form of a Cartesian coordinate system defining the object&#39;s or pattern&#39;s surfaces. This spatial map may comprise a computer file which may be provided in any one of a number of file conventions. One example of a file convention is a STL (Stereo Lithography) file which may be in the form of ASCII (American Standard Code for Information Interchange) or binary. STL files specify areas by way of triangulated surfaces with defined normals and vertices. 
     An alternative file format is AMF (Additive Manufacturing File) which provides the facility to specify the material and texture of each surface of the patch and/or mould as well as allowing for curved triangulated surfaces. The mapping of the patch and/or mould may then be converted into instructions to be executed by 3D printer according to the printing method being used. This may comprise splitting the model into slices (for example, each slice corresponding to an x-y plane, with successive layers building the z dimension) and encoding each slice into a series of instructions. The instructions sent to the 3D printer may comprise Numerical Control (NC) or Computer NC (CNC) instructions, preferably in the form of G-code (also called RS-274), which comprises a series of instructions regarding how the 3D printer should act. The instructions vary depending on the type of 3D printer being used, but in the example of a moving printhead the instructions include: how the printhead should move, when/where to deposit material, the type of material to be deposited, and the flow rate of the deposited material. 
     Any part of the dressing, patch, and/or mould described herein may be embodied in one such machine-readable model, for example a machine-readable map or instructions, for example to enable a physical representation of said part of the dressing to be produced by 3D printing. This may be in the form of a software code mapping of one or more components and/or instructions to be supplied to a 3D printer (for example numerical code). 
     It will be understood that the present invention has been described above purely by way of example, and modifications of detail can be made within the scope of the invention.