Effect of adhesive retention on maxillofacial prostheses. Part I: skin dressings and solvent removers.

STATEMENT OF PROBLEM The success of most maxillofacial prostheses depends on retention by medical adhesives. Products such as Smith-Nephew's Skin-Prep (SP) are available that can be used on the skin that could improve prosthesis adhesion protective dressing. The removal of adhesive from the skin is also problematic, so solvents, such as Uni-Solve adhesive remover (US), are often used. PURPOSE This study measured the removal force of silicone elastomer strips with 2 adhesives from the skin of human subjects during the day, as affected by the use of SP and US, and determined the site of adhesive failure. MATERIAL AND METHODS Silicone rubber strips were applied in a predetermined random order to the ventral arm surfaces of 20 human subjects. US was applied to half the sites 1 day before testing. SP was also applied to half the sites just before Epithane-3 (E3) or Secure(2) Medical Adhesive (SMA) were used to adhere the strips. They were peeled from the skin 6 hours later in an Instron at a rate of 10 cm/min. RESULTS A 3-way within-group MANOVA revealed significant differences without interactions between adhesives (SMA=96.3 N.m, E3=24.1 N.m; P<.0005) and between use or nonuse of SP (SP=65.8 N.m, no SP=54.6 N.m; P<.0005). The use of US was not significant (no US=61.8 N.m, with US=58.6 N.m; P=.197). SMA adhered to the prostheses, whereas E3 adhered to the skin, leaving a residue (Fisher exact test; P<.0003). CONCLUSION The combination of SMA and SP showed the highest adhesive bond strength. Overall, SMA was 3 to 5 times more retentive than E3. SP improved adhesion of both SMA (15%) and E3 (27%). SMA was still far more retentive. US had no effect on retention. SMA remained on the prostheses, whereas E3 left a difficult-to-remove residue on the skin.