Does any adhesive really work?

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Permalink Reply by Andy Barnes on June 30, 2008 at 7:22pm

I work out side and have had my infusion site as well the CGM sensor/transmitter lift off from sweat. What I have found that works for me is after incerting the sensor b/4 pulling the white tab I spray mastisol and then pull the white tab and stick it down then use polyskin II over the entire unit to keep the transmiter down. The clinical specialest with Medtronic said mastisol will also hold the transmiter down but have not tried it yet. Call the 800 # and Medtronics will send you a adhesive kit with several types of adhesives including mastisol. Good luck.

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Permalink Reply by Charlie on July 1, 2008 at 6:22pm

That sounds like a good strategy. I'll try it!

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Permalink Reply by Mike on July 18, 2008 at 6:10am

Dear Charlie,

I have had type one diabetes forty-one years and have been a MiniMed pump user for over twelve years - currently using a model 715. One other issue: like you, my cooling system works way too well; I sweat when I work.

I too have tried several attachment methods. The best I have found I 'discovered' from a friend who is damn-near quadriplegic and has to attach an external catheter every few days. This is the combination, which works best for me and is 95% successful during sweating bouts:

After doing all prep work (i.e. filling reservoir, priming pump/tubing, cannula into inserter, peeling backing from mesh-backed adhesive strip, etc), I paint Uro-Bond III 5000 Silicone Adhesive in a square area around the site where I will insert the cannula. I also paint the adhesive on the adhesive 'wings' of the cannula itself. After waiting about a minute, I then eject the cannula and cover with the adhesive strip. I then add the second (thinner) adhesive strip over the cannula. I create a strain-relief in the tubing and secure it with Durapore tape (I find this tape works better than any of the 'water-proof' varieties).

PS. The Uro-bond adhesive is available at AllegroMedical.com. It is a very viscous rubber based cement, so apply carefully. It will clean up easily with isopropyl alcohol or rup off when it dries. They make a thicker Uro-bond, but I find that it dries out too easily.

Regards,
Mike

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Permalink Reply by Charlie on July 18, 2008 at 7:22am

Wow, this sounds creative. I'm going to add this to my experimental attempts in adhesion. I have so many adhesive products lined up on my shelf now, it looks like a pharmacy!

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Permalink Reply by EmFortyTwo on July 21, 2008 at 6:23am

Hey Charlie,
I, like you, have just started the CGM from minimed (LOVE IT! - but would you agree that the needle is huge and a bit scary?), and I sometimes have trouble with it coming off. I find this is the worst when I try to stick it to me in high humidity situations. I have only tried the IV 3000 from Smith and Nephew though. I use two of them, one for the front and one for the back. I wish they made one that was twice as big, as I think I would have more luck if I could just place one. Of course, I am sure that someone makes tape this big, I just don't know who and doubt my insurance will cover it even if I do find it, so I have been making due with what I have gotten for free.
Be careful about the stuff you put underneath the insertion site though - as I was figuring out how to use the thing myself, in the directions it says not to put anything, including sticky adhesives or tape, underneath where the catheter is actually going in. I am not sure why they have this warning, but I figure they must have a reason. Do you think it might affect the readings or something?
Anyways, good luck in your search, and be sure to let us know if you come up with any good ideas!

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Permalink Reply by Heather on July 30, 2008 at 7:48pm

I've been having the same problem with adhesives. I started CGM in April. I have a two year old and we go to the pool often. I've lost a couple sensors at the pool and have gotten very frustrated. I found that using mastisol and the Nexcare tegaderm dressing is the ABSOLUTE best. It is very waterproof, so I'm assuming that would help with the sweating issue too. The IV300 and Polyskin dressings will fall off, even using mastisol. The mastisol, I got through Medtronic and I could only call in an order. It is not listed in the online store. As stated earlier, Medtronic will send you a sample of mastisol and the tegaderm dressing in the adhesive hit. I just finished swim lessons with my son and I got in the pool Monday through Friday for two weeks and the adhesive did not budge. Good luck!

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Permalink Reply by Charlie on July 31, 2008 at 5:12pm

Heather, thanks for the tip. The mastisol I tried came in expensive single-use ampules and I ended up wasting most of each ampule. Is that what you use, or have you found it in a recloseable bottle?

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Permalink Reply by Mitzi Yavoski on July 31, 2008 at 7:12pm

Have you tried saturating the white adhesive of the sensor with IV prep, after insertion? You just have to be still until it dries.
If the mastisol does not work, benzoin (a brown liquid used in hospitals for adhesion) helps. It may be a little hard to find (unless you know a nurse.....)
If you put any of these where the sensor punctures the skin, you can alter the enzyme on the sensor, probably affecting the accuracy of your readings.
I'm an educator living in TX, so those I work with have sweat issues too.
Mitzi

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Permalink Reply by Heather on July 31, 2008 at 7:19pm

When I received the free adhesive kit, it also came with the ampules. Once I actually purchased it from Medtronic I made sure to ask about the packaging because you are right, you waste so much. I was able to order a bottle from medtronic and it has a flip top lid and all I use is a drop on a Q-tip and it works well.

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Permalink Reply by Roger on July 31, 2008 at 5:51pm

Charlie,

I use Skin Tac by Torbot. Very effective. If you give it a try, also get their TacAway adhesive remover.

Thank you,
Roger

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Permalink Reply by Frank Kolakowski on August 1, 2008 at 3:08pm

If you are really sweating....I am not sure anything will work.

IV3000 does not cut if for me. Never tried duct tape :)
Tegaderm dressings work better for me. Most of the time, I can get the sensors to stick 6 days.
If I am working outside on a hot day I might get 3 hours.

I generally place the sensors in my abdomen, 2-4 inches right or left of the mid line.

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Permalink Reply by Liz on August 2, 2008 at 6:09pm

For covering the sensor & transmitter once it's inserted, try Smith & Nephew's Opsite Flexifix. It comes in a roll in either 2" or 4" widths, 33 yards long. Get the 4". Cut what you need (I tend to cut a 4" length so I have a square piece to work with) and you will need only that one piece. It's very slightly thicker than IV300 or Tegaderm, but you won't notice that on your skin.

I just started the sensors in JUne and was constantly having to change the dressings (IV3000 was the worst, Tegaderm a little better) due to sweat, or because a teeny edge peeled up and then pulled lose from there. The Flexifix works perfectly. I have not had any edge peel up. I actually have a hard time getting it off when I want to! If you use a sensor past the recommended 3 days and need to remove the dressing to charge the transmitter, be careful removing the Flexifix.

Other hints I've learned elsewhere are:

Get a roll of paper tape. As soon as the sensor is inserted, use a piece to tape it down, avoiding the little prongs that the transmitter connects to. This will keep it stable while you wait to attach the t ransmitter.

Put a tiny bit of Vaseline over the top of the transmitter so the dressing doesn't stick to it, making it easier to remove without yanking your transmitter (and sensor) out.

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