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You choose the right trach -pad!!! Larissa Special Style Trach pads are hand made with high quality of cotton fabric . Our designs are very soft and confortable,these trach pads are a wonderful alternative to split gauze. The top layer is a cotton print ,the middle layer is an absorbent fleece and the botton layer wich rest against the skin is a ORGANIC cotton, available in two sizes 2.5"X2.5" 3"X3" custom sizes available upon request. All pads are designed to be washed and reusable,wash after each use,machine or hand wash lay flat to dry .DO NOT use a fabric softener the pads will be less absorbent. We highly recoment upon receipt your trach pads that you wash them before your FIRST USE.