This question is often asked because non-sticking tape can lead to some rather embarrassing situations. Usually it is not the fault of the tape itself. Manufacturers generally produce a pretty reliable product that does its job… provided the “working conditions” are proper. And there is the “rub:” the working conditions!!! Here are some no-nos:
Moisture on the skin: Tape will not stick properly if there is moisture on the skin. After washing, dry the skin with a hair dryer—towels may leave your skin damp.
Insufficient application pressure: In order to stick, pressure must
be applied, particularly at the edges.
Water-soluble foreign matter on the skin: Such as residual soap, skin prep, dried perspiration or mucus. Perspiration and mucus should be washed off with water. If wiped off, a thin coating of dried matter is left on the skin. Stomal output or perspiration will dissolve this film and undermine the adhesive.
Touching the adhesive before application: Moisture, skin cells and other material transfer from your fingers and reduce adhesion.
Loose solid particles on the skin: Such as powder, flaky skin or an overabundance of dead skin cells. The best remedy is to stick down and peel off tape before applying a dressing, thus removing the loose material.
Subjecting the adhesive bond to stress immediately after a dressing is applied: It takes time for the adhesive to flow into the microscopic irregularities of the skin and develop 100 percent contact and maximum adhesion.
Stretching of the skin under the adhesive area: Adhesives will release when the surface to which they are attached is stretched. If your dressing always comes loose in the same place, chances are that your normal body movements are stretching the skin at that point. You might try to stabilize the skin by applying a one-inch (or more) wide tape beyond the edge of the dressing.
Low surface energy level of the skin: Adhesives will only stick to surfaces that have a higher surface energy level than the adhesive. A very high level results in a permanent bond; nearly equal levels produce a very weak or no bond. Oils and waxy materials, including lotions, mineral oil and moisturizing soaps, such as Dove, are absorbed by the skin, making it nice and soft, but also reducing the surface energy of the skin to a point where little or no adhesion results.
Sometimes a more aggressive adhesive is required: The bandage or foam tapes should be used in such cases.
A majority of alleged tape adhesion problems are really due to physical skin injury: The skin consists of two layers, the epidermis (outer layer) and the dermis (inner layer). If the tape is placed on the outer layer with tension, the constant pull on the outer layer can cause a strain in the bond with the lower layer, inducing irritation or causing an actual separation, forming blisters. The same effect will also take place if swelling occurs after an adhesive backed pouch is in place. To prevent this type of injury, gently place the tape without tension and then press down with firm rubbing motion.
Skin damage may also be caused by rapid removal of adhesive tapes. If you pick up a corner of the tape and push the skin away from the adhesive, skin trauma is reduced substantially.
Redness of the skin may also be caused by chemical irritants that are trapped between the adhesive and the skin. Usually the irritant is residual soap (Ivory is a known offender), skin preps that are not completely dry, deodorants, antiseptics and other outer skin coatings such as lotions and sunscreens.
Chemical substances from within the body may also cause irritation. When these byproducts are trapped under nonporous tape, the increased concentration at the skin surface may cause a problem. Another cause of skin irritation may be small quantities of pouch contents on the skin that are not removed. The enzymes present with an ileostomy do not know the difference between you and a piece of steak. With a urostomy, alkaline (high pH) urine does the most damage. Certain foods, such as cranberry juice, may lower the pH and minimize the problem. If skin prep is used for protection, be sure it is non-water soluble.
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