![]() ![]() ![]() ![]() Very few good scientific articles are available on potentially increased risk of infection when applying unsterile dressings onto a surgical wound. In no single case has the unsterilized tape covering the fresh surgical wound ever provoked an infection.” In a comment to the article by Bundy et al, 24 Krupp 26 stated that “We have been using unsterilized surgical adhesive tape such as Micropore or Mefix for covering clean surgical wounds, sutured or stapled, for about 20 years with excellent results. Bundy stated that “Wound closure in this manner would benefit the patient in the field, in the emergency room, or in third world countries where the supply of sterile tape is limited.” ![]() Redelmeier also demonstrated that removing the outer exposed layer of the tape roll significantly reduced the bacterial burden and that the inner layer only sporadically contained bacteria, which was in accordance with Bundy’s findings. Redelmeier et al 25 and Harris et al 3 also collected tape rolls from various hospital locations, confirming that rolls used for catheter fixation contained microbes likely to contribute to catheter infections. Bundy also documented that surgical tapes shelved in surgical suite cabinets for 2 weeks had considerable contamination of their exposed dry surface, but the unexposed adhesive surface and the unexposed dry surface after unwinding had virtually no contamination. However, the combination is not used widely, perhaps because sterile Micropore has not hitherto been made available by the manufacturers.” Several authors provided practical tips on how to sterilize surgical tape, 7, 22, 23 while Berkowitz 2 pointed out that adhesive tape could be a potential source of nosocomial bacteria.īundy 24 proposed the use of pre-packaged unsterile surgical tape as a safer and cheaper means of wound closure, documenting close-to-sterility quality in prepacked clean rolls of tape. Taube et al 22 reports “.this method of skin closure has many advantages. 15 Publications have demonstrated good results from using microporous tape in addition to-or even instead of-subcuticular suturing, 8, 10, 16, 20– 22 but these studies all used a sterile version of microporous tape. 19 The tape has somewhat more elastic properties than the strips, and may therefore convey less shearing forces onto the skin. The use of 3M Steri-Strips for superficial wound closure has been widely published. Microporous tape has stood the test of time and comes in both sterile versions (adhesive strips, 3M Steri-Strips) and unsterile versions (tape rolls, 3M Micropore). 7 Several publications also suggested a decrease in wound infections when using tape instead of sutures for outer layer closure particularly in contaminated wounds, 16, 17 but organic suture material at the time was associated with more infection than synthetic suture material. 14, 15 Its elastic yet adhesive properties even when moistened makes it well tolerated by most patients and provides strength without blistering. 8– 13 Microporous tape gained popularity because its structure allows sufficient moisture to evaporate to create a favorable microenvironment for the skin, with less bacterial proliferation than under occlusive barriers. Enthusiastic reports followed in the early 1960s. 7 The Minnesota, Mining and Manufacturing Company (3M) succeeded in the mid-1950s in developing a well-tolerated hypoallergenic acrylate adhesive, 7 which in combination with a microporous nonwoven layer of rayon fibers led to the introduction of the microporous adhesive surgical tape. 6Īdhesive bandaging materials have been used throughout medical history but have been associated with skin irritation and hypersensitivity reactions. Gillman subsequently promoted the closure of surgical wounds with regular tape from the local stationary store, claiming that as this tape contained both phenol and latex, it was virtually self-sterilizing, and that no infections were observed. Elek and Conen 5 showed that the multiple skin penetrations of suturing and the presence of foreign material increased the risk of wound infection. Sutureless closure of surgical excisions was initially promoted in the 1950s, as Gillman et al 4 demonstrated the epithelial downgrowth that occurs along sutures, resulting in unsightly scarring. Scientific Rationale behind Unsterile Surgical Adhesives ![]()
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