Light-Deactivated Adhesives – Solution to Maintaining Dressing Integrity and Protecting Skin for Incisional Negative Pressure Wound Therapy (iNPWT)

This presentation overviews a novel adhesive technology that encompasses strong adhesive properties, becoming gentle and easy to remove after exposure to near UV light (non-ambient light). Post-operative surgical site complications (SSCs) and infections (SSIs) are costly issues in healthcare and can greatly impact patient recovery.  Incisional negative pressure systems are prescribed to help minimize SSIs and SSCs, especially for higher-risk patient populations. These systems are intended to remain on a patient for up to 7 days and are applied post-operatively over incision sites, requiring the dressing to stay in place during the length of treatment. This typically requires a strong performing adhesive in the dressing. Strong adhesives present issues such as Medical Adhesive Related Skin Injuries (MARSI) and other complications upon dressing removal. This presentation overviews a switchable adhesive technology that supports minimizing the potential of MARSI and other complications at the time of dressing change while supporting long-wear time use. 
 

Transcript: 

Hello. I am Dr. Jonathan Cayce, and I am the Clinical Research Scientist at DeRoyal Industries, where I work with clinicians to publish real-world evidence using our solutions, as well as I investigate new technology that we plan to use to address clinician problems.

Today I'm here to talk about our poster that's called Light-Deactivated Adhesive: The Solution to Maintaining Dressing Integrity and Protecting Skin. The objective of this study was to characterize a light-sensitive adhesive that releases when exposed to near UV light by comparing its peel strength in the active and deactivated state to other medical-grade adhesives used in incisional negative pressure wound therapy.

Surgical site infections and surgical site complications represent a serious healthcare concern. Most often, patients experience prolonged hospitalization and reduced quality of life when they suffer one of these complications. In severe cases, a patient can lose a limb or their life. These complications place a $3.5 to $10 billion financial burden on the US healthcare system.

Incisional dressings keep the incision site clean and protect it. To do this, the dressing must have adequate adhesive strength to stay in place throughout use. The strong adhesive strength of the dressing can cause medical adhesive-related skin injuries or MARSI that can impair wound healing and prolonged care. Passive dressings may require more frequent changes, increasing the risk of MARSI. Clinical research shows that incisional negative pressure wound therapy can prevent surgical site infections and surgical site complications in specific patient populations. Current dressings balance adhesive strength with the risk of MARSI and discomfort to allow a seven-day wear time.

This study characterizes a new light-sensitive adhesive that provides the strength of an acrylic adhesive during use, but when exposed to a near UV light or non-ambient light, it releases at peel strengths less than silicone. This enables a long-lasting negative pressure wound therapy dressing that maximizes patient comfort at the time of dressing removal. To do this, we compared the light-deactivated adhesive and the active and deactive condition to two acrylic adhesives and a silicone adhesive used in common legally-marketed incisional negative pressure wound therapy dressings. All testing occurred on the volunteer's ventral left and right forearm using two by one inch samples, with half of the sample adhered to the arm, and the other half was clamped into a mechanical testing system and pulled at a constant rate until released from the skin.

We repeated each test eight times, in groups of five, with test articles randomly placed on the right and left arm. For statistical analysis, we used a one-way analysis of variance, followed by a pairwise T-test to determine statistical significance between groups. We corrected all P values for multiple comparisons to avoid statistical error. As you can see, on Figure 2 is a representative peel strength result for each of the conditions we tested. The data shows that the unexposed light-sensitive adhesive has the longest test and peak peel strength, followed by the two acrylic adhesives. In the exposed condition, the peel strength is minimal.

Figure 3 summarizes the data utilizing a box and whisker plot. The unexposed condition was found to have equivalent peel strength to acrylic A and statistically superior peel strengths to acrylic B and the silicone. In the exposed condition the peel strength is significantly less than all other conditions tested. These results demonstrate that the light-sensitive adhesive demonstrates the necessary peel strength to maintain dressing integrity during use, minimizing the risk of infection and dehiscence. And the exposed state demonstrates the ability for gentle removal commonly associated with silicones, allowing the minimization of pain, the minimization of risk of MARSI, and it simplifies the dressing removal for clinicians.

In conclusion, this study demonstrates the light-deactivated adhesive performed similarly to acrylic adhesives, but releases more gently than silicone after exposure to a near UV flashlight. This technology enables a dressing that meets the long-lasting wear time requirement for incisional negative pressure wound therapy while simplifying dressing removal, minimizing the risk of MARSI, and most importantly, maximizing patient comfort during removal. Thank you for listening to my presentation. I hope you enjoyed it.