Objective: In the treatment of pressure ulcers and leg ulcers it is necessary to achieve an effective balance between adhesive and skin-protective properties. We speculated that addition of a tackifying agent (TA) to ceramide 2-containing hydrocolloid dressings would increase their adhesiveness under dry conditions and reduce their adhesiveness under wet conditions because dry tack converts to wet tack after water absorption.
Method: We prepared ceramide 2-containing hydrocolloid dressings with varying amounts of TA. Basic characteristics of the test ceraminde dressings, such as initial tack force and peeling force, were evaluated using standard methods. Peeling force and stratum corneum (SC) removal on healthy human skin were also evaluated at 20 minutes, 7 hours, and 72 hours. In addition, the effect of 10 repeated applications on transepidermal water loss (TEWL) was investigated on the skin of hairless mice under dry and wet conditions. Statistical analyses were performed using one-way analysis of variance followed by Dunnett's multiple comparison test. A p-value of <0.05 was considered statistically significant.
Results: On a stainless steel substrate, initial tack force and 180° peeling force increased as TA content increased. Twenty minutes after application on human skin, peeling force and SC removal increased with increasing TA content. When TA contents were over 10%, significant differences in peeling force and SC removal were obtained compared with ceramide 2-containing hydrocolloid dressings without TA (p<0.05). However, a TA content-dependent increase in peeling force was not evident 7 hours and 72 hours after application. Under dry conditions, TEWL increased with repeated application and peeling. Conversely, no significant increases in TEWL were evident under wet conditions after 10 repeated applications and peelings.
Conclusion: Our data demonstrate that the initial attachment of ceramide 2-containing hydrocolloid dressings to the skin increases with addition of TA. Skin damage can be avoided by conversion of the adhesive system to wet tack with water absorption.
Declaration of interest: Masushi Kohta and Tetsuji IwasakI are employees of ALCARE Co., Ltd., Japan. This project was supported by an unrestricted grant from ALCARE.
Keywords: adhesive force; ceramide 2-containing hydrocolloid; pressure ulcer prevention; skin damage; stratum corneum.