eXaSkin Plus is the only high-density, highly-adaptable bolus available in paste form, allowing you to form a fully customised, patient-specific bolus in just 3 minutes. Designed for precise skin treatment with photons, eXaSkin eliminates the need for complex 3D printing systems or modifications to your routine workflow — making it the most practical and clinically effective bolus solution available.
RMS Medical Supplies is the exclusive authorised UK distributor for eXaSkin Plus, manufactured by Anatomical Geometry (AnatGe).
Key Benefits
Adapts completely to the skin surface for precise dosage application
Avoids the rebuild-up effect even in the presence of air
Eliminates the build-up area with less bolus thickness
Bolus thickness selection is no longer relevant — density, shape and thickness data are obtained by the TPS from CT imaging
Auto-fixable to thermoplastics to improve positioning and reproducibility
Does not dry, shrink or break
Customisable in less than 3 minutes — no 3D printers, no additional equipment, no additional staff or technical knowledge required
Suitable for use in highly-critical regions including the scalp, hands, neck, outer ear, facial contours and genitals
Biocompatible, latex-free and safe for use in MRI
How to Use eXaSkin
Watch the following videos to see eXaSkin in action:
eXaSkin has been specifically designed to be used with photons (6MV), eliminating the need for electrons and the associated challenges of their management. This bolus optimises photon application compared to other boluses available on the market and facilitates the safe implementation of advanced treatment techniques, such as VMAT.
Is a water-equivalent density bolus necessary when using photon beams?
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When using photon beams, a water-equivalent density bolus is not essential. The key is that the bolus can be calculated and its density is accurately accounted for by the treatment planning system. eXaSkin meets all these requirements and, with its higher density (approximately 1.53 g/cc), eliminates the build-up region with thinner layers.
The thickness of our eXaSkin sheet is not entirely uniform — is this a problem?
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As eXaSkin is placed on the patient during the planning CT, the TPS captures data on its density, shape and thickness from the CT images. Non-uniform thickness should not be a concern. However, it is critical not to simulate the bolus sheet in the planner or manually assign its density.
What is the equivalence between a 0.5cm or 1cm silicone bolus and eXaSkin?
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eXaSkin introduces a novel bolus concept that removes the need to select thicknesses based on lesion depth. Due to its higher density, eXaSkin achieves a bolus effect with just 2mm of thickness. Direct equivalence with conventional boluses cannot be established, as eXaSkin delivers the dose to any skin depth regardless of its thickness.
We have noticed small air bubbles while preparing an eXaSkin sheet — what should we do?
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Although eXaSkin offers excellent conformability, air bubbles may appear, particularly if the patient loses weight or the tumour mass reduces in volume. eXaSkin has been shown to minimise the rebuild-up effect even with air bubbles up to 1cm, preventing underdosing of the treatment area. If necessary, ultrasound gel can be used as a filler.
How can we secure eXaSkin Plus to the skin for highly lateralised lesions?
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eXaSkin can be combined with thermoplastic masks, greatly enhancing positional reproducibility during treatment sessions. When thermoplastic masks are not feasible, tubular elastic bands or medical adhesive tape can be used. Immobilisation cushions such as Moldcare® are also highly recommended to ensure consistent positioning.
Is eXaSkin Plus reusable?
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The same eXaSkin Plus bolus can be used throughout the entire treatment course for a single patient.
Is eXaSkin Plus biocompatible and latex-free?
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Yes — eXaSkin Plus is biocompatible with no toxicities identified in testing conducted in accordance with ISO 10993, and is latex-free.
Can eXaSkin Plus be used in MRI?
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eXaSkin Plus contains no water or conductive elements. It is safe for use in MRI as it does not conduct electricity or heat up when exposed to a magnetic field.
Have a question not answered here? Contact our team and we’ll be happy to help.
To request further information about eXaSkin Plus or to place an order, please contact our team.
