Written and maintained by CASRAI Editorial Board
Last updated
General product information only, not medical advice. A person’s own care team decides which cover, if any, suits them.
Short answer
A stoma cover is a fabric, foam or filter item that sits over the opening in the neck (the stoma) of a person who breathes through it, such as after a laryngectomy or with a tracheostomy tube. Hospital sources say it keeps dust out and helps warm and moisten the air. Head-to-head evidence on which type works best is weak.
Definition and scope
This page covers covers for the airway stoma in the neck. After a laryngectomy, which is surgical removal of the larynx, a person breathes through that opening instead of through the nose and mouth (UETMIS, Montreal and Quebec). Covers for an abdominal ostomy pouch are a different product and are not discussed here.
The THANC Guide glossary describes a stoma cover as typically a fabric, bib-like item that keeps the stoma clean and healthy by keeping dust and other particles out and warming the air during breathing. In tracheostomy care the same product is usually called a bib or bib protector. Terminology matters when reading supply catalogues and leaflets: “stoma cover”, “stoma bib”, “tracheostomy bib” and “bib protector” are used for related products, and heat and moisture exchangers (HMEs) are listed alongside them.
How stoma covers are used in practice
The UC Davis Otolaryngology patient sheet on laryngectomy stoma care says covering the stoma helps prevent dust particles from entering the airway and retains the warmth of the air breathed. It lists dirt, dust, bugs, cold winter air and hot dry air as things a cover protects against, and notes that covers come in many sizes and thicknesses. Gauze, cotton or crocheted covers are named, and a cover can be tied around the neck; a crocheted bib is described as popular. Scarves, turtleneck tops and cotton U-neck undershirts are also mentioned as ways to cover the stoma.
The Hull University Teaching Hospitals NHS leaflet for tracheostomy tube users (reference HEY1097/2025, updated 31 December 2025) names two kinds of covering for a tracheostomy tube: a bib protector and a heat and moisture exchanger (HME) filter system. Hands-on guidance comes from the person’s own care team.
Types of stoma cover and tracheostomy bib
A Quebec health technology assessment (UETMIS, CHUM and CHU de Quebec) groups the main types as laryngofoam and HMEs on one side, and cloth, foam and Buchanan bibs on the other. The table sets out what each named source says about each family.
| Type | What the sources say |
|---|---|
| Cloth or crocheted bib (tracheostomy bib) | UC Davis: can be tied around the neck, crocheted bib popular. Hull: a bib protector is one of the two coverings named for a tracheostomy tube. Quebec clinician survey (30 respondents): reusable cloth bib was the cover most often recommended, 70% totally or partly agreed. |
| Gauze or cotton cover | UC Davis lists gauze, cotton or crocheted covers. |
| Foam cover (laryngofoam) | Quebec assessment: foam protectors made up 84 to 89% of the covers supplied through the provincial program from 2014-2015 to 2016-2017. 47% of surveyed clinicians recommended foam covers. |
| Buchanan bib (cloth and foam) | Named as a main type by the Quebec assessment; recommended by 23% of surveyed clinicians, the least of the types asked about. |
| Heat and moisture exchanger (HME) | Hull: an HME filter system is the other covering named alongside the bib protector. Quebec: single-use HME recommended by 63% of surveyed clinicians. See the related guide on HME filters for tracheostomy. |
What the evidence shows
The Quebec assessment reviewed 27 documents: 2 guidelines, 1 systematic review, 6 randomised trials, 7 prospective non-randomised studies, 1 retrospective study and 10 laboratory studies. Most were judged to be of low quality, few compared different cover types, and it did not find conclusive evidence on the efficacy, clinical effectiveness or safety of the various types. Some results favoured HMEs over no protection, cloth or foam covers. However, 17 of the 24 primary studies were sponsored by an HME manufacturer, and the authors noted likely publication bias favouring HMEs. The authors called for objective criteria for matching a cover to the patient.
The assessment was completed in 2018 and presented at HTAi in June 2019.
Where it matters for labs, clinics and supply decisions
For staff who write specifications, maintain formularies or answer supply questions, the sourced points are these.
- Terminology. Check whether a request means a laryngectomy stoma cover, a tracheostomy bib or an HME; the sources treat them as related but distinct families.
- Evidence. No source reviewed shows one type to be superior. Material that claims superiority for a type should be read with the industry-sponsorship finding in mind.
- Program rules. In Quebec, covers for laryngectomised patients are supplied through a dedicated program, Service d’aide aux laryngectomises (SAL); its allocation included cloth and foam covers while HME supply was limited. Coverage rules differ by region, so local program documents govern.
- Clinical choice. The choice of cover belongs to the treating team. For related device topics see the guides on the tracheostomy tube, the electrolarynx and the Blom-Singer voice prosthesis.
Common misunderstandings
- A stoma cover is not an ostomy pouch cover. Searches for “stoma cover” also return abdominal ostomy products; this page concerns the neck stoma.
- A cover is not decoration or a scarf only. Scarves can cover the stoma, but sources describe the purpose as keeping particles out and retaining warmth and moisture.
- “Popular” is not “proven best”. Cloth bibs were most often recommended in the Quebec survey, yet the review found no conclusive evidence ranking cover types.
Frequently asked questions
What is a stoma cover?
A fabric, foam or filter item worn over the airway stoma in the neck. The THANC Guide glossary describes it as typically a fabric, bib-like item that keeps dust and other particles out and warms the air during breathing.
Is a stoma cover the same as a tracheostomy bib?
The terms overlap. In tracheostomy care the same kind of product is usually called a bib or bib protector, while “stoma cover” is the common term after a laryngectomy. The Hull leaflet also names HME filter systems as a covering for tracheostomy tubes.
What types of stoma cover are there?
The Quebec assessment names laryngofoam and heat and moisture exchangers on one side, and cloth, foam and Buchanan bibs on the other. UC Davis also lists gauze, cotton and crocheted covers.
Which type is best?
No source reviewed ranks the types. The Quebec assessment found no conclusive evidence on efficacy, clinical effectiveness or safety of the various types, and 17 of its 24 primary studies were sponsored by an HME manufacturer.
Is a stoma cover the same as an ostomy pouch cover?
No. Covers for an abdominal ostomy pouch are a different product. This page concerns the airway stoma in the neck.
Sources
- UC Davis Health, Otolaryngology, “Care of Your Laryngectomy Stoma” patient sheet, health.ucdavis.edu, checked 30 October 2026.
- Hull University Teaching Hospitals NHS Trust, “Information for users of tracheostomy tubes” (HEY1097/2025), hey.nhs.uk, checked 30 October 2026.
- Deblois S, L’Esperance S, Coulombe M, Lepanto L, Rhainds M. “Stoma cover use by fully laryngectomized patients”, UETMIS CHUM and CHU de Quebec, HTAi 2019 presentation, chumontreal.qc.ca, checked 30 October 2026.
- THANC Guide, glossary entry “Stoma Cover”, thancguide.org, checked 30 October 2026.
