Replies to This Discussion

Permalink Reply by Scott K. Johnson on May 1, 2011 at 8:57pm

Hi Andrew,

There are a bunch of different things to try. There are a few things like SkinPrep, SkinTac, or IVPrep, which are like alcohol pads, but with a substance that helps adhesives stick. They work great for some, not so great for others. For some, one brand works well, the other doesn't, etc. You know how it goes - your mileage may vary and all that.

There is also a liquid called Mastisol that some people like. Same type of deal, you put it on before putting the sensor or set on, and it's supposed to help it stick.

I've also found that my skin works best with the cloth tape type sets, so like the Dexcom and Medtronic QuickSets. But it doesn't stick as well with the more plastic types, like the Navigator sensors or CLEO infusion sets.

Bottom line? There are a TON of different options out there, and you might have to try a few different combo's to get it to work for you. I might have a few different pads (SkinTac or SkinPrep/IV Prep) I can send you to try. Many of the pump companies will send out samples of stuff too - be sure to call and talk with their clinical support staff if you have trouble with stuff sticking. They can recommend some stuff too.

Keep trying, don't give up!

Permalink Reply by Andrew Tumsuden on May 1, 2011 at 9:05pm

which would you recommend for alcohol wipes?

Permalink Reply by Scott K. Johnson on May 1, 2011 at 9:20pm

Well, from my experience, the alcohol wipes are pretty much all the same - they're just to make sure the site is clean. I don't think it matters much in terms of what brand you get or anything like that.

For the other ones, the SkinTac, SkinPrep, IVPrep, you'll have to try them and see which you like best. Get some samples (ask the pump company, or I can send you a couple to try).

Permalink Reply by Andrew Tumsuden on May 1, 2011 at 9:26pm

yea thats what i mean those which are most used or most recommended because ill likely have to buy them myself which is fine as long as they work just curious which get the most praised?

Permalink Reply by Scott K. Johnson on May 1, 2011 at 9:28pm

Gotcha. Man, I really couldn't say. Maybe someone else has thoughts on that?

Permalink Reply by Andrew Tumsuden on May 1, 2011 at 9:29pm

i was just checking prices and man they are mighty expensive know anywhere cheap online to get them?

Permalink Reply by Scott K. Johnson on May 1, 2011 at 9:58pm

I don't use them anymore, so I haven't had to buy them in years. I'm not sure where the best place to get them might be...

Permalink Reply by Andrew Tumsuden on May 1, 2011 at 10:15pm

well the cheapest i found was like $6.30 a box for skin prep but skin tac was alot more expensive but they tend to do the samething so i ordered 4 since they charge you good for shipping should be set for a little while

Permalink Reply by Scott K. Johnson on May 1, 2011 at 10:34pm

Cool. Keep us posted. Remember, if those don't do the trick for you, there are other options.

Permalink Reply by Rickst29 on May 2, 2011 at 12:16am

Per my long post below, they're NOT the same thing.

I can't tell if you bought "Skin Tac" or "Skin-Prep", but if it doesn't help -- then go ahead and try the other. You might be delighted by the alternate product.

But there's something I don't understand- you're having an issue with the prices for these wipes, but you didn't FAINT when you bought a roll of FlexiFix?

Permalink Reply by Rickst29 on May 2, 2011 at 12:09am

Skin-Prep gets the most "rah-rah" around here. It's made by the same company, Smith+Nephew, which makes IV-Prep....

And they say, right on the packaging, that THIS ONE is made to prevent tape stripping, adhesive failure, and skin irritation following the attachment of long-term (multi-day) applicances like the Dexcom Sensor. The secret to using Skin-Prep is to get it completely dry, it will be non-sticky if you touch it with after proper drying.

IV-Prep, in contrast, is for IV's and similar short-term appliances (left in place for less than one day.) Mastisol is a glue, not a barrier film. It's pretty good for fixing Dexcom edges which are starting to fail and "flip up". Being a glue, if you touch it with your finger, your finger WILL stick. But it can wear out over time, from contact with body sweat. And some people (like me) react very badly to the formula.

Skin-Tac advertises itself as a barrier (like Skin-Prep), but their literature says that it should feel "tacky" -- so it's got glue-like properties too. Because it's GLUE, and I react to nearly every one of these glues, I've never used it.

SinceI started using Skin-Prep, properly dried (completely "bone dry and cracking" with a hair dryer before you set the Dexcom in place, not at all sticky), I've never needed any add-on glue. But I use strips of FlexiFix as "helper tape" on all four sides of the Transmitter housing, completely covering the edges, and that's a major factor in my results too.

My Skin-Prep application covers the entire area, under both the Sensor pad AND the FlexiFix tape. (FlexiFix has glue as well, and I need protection underneath.) But I can cover the entire area with just one wipe.

YMMV, but IV-Prep is definitely not going to be as good a choice as Skin-Prep.

Alcohol is a very poor disinfectant. The "scrubbing" action, with a wet, sterile pad, does some cleaning-- but a few people (like me) who take the notion of a 14-day puncture wound "very seriously" add on another step. A REAL disinfectant, just like you'd be getting for surgery in an ER. Here's what I do:

#0. Soap wash and rinse for clean hands INCLUDING under the fingernails (a CLEAN tooth brush is good for under there).

#1. soap wash the target area with scrubbing, good rinse. Pat Dry. (With a fresh hand towel, not a "used" one.)

#2. PVI or CHG disinfectant. PVI, the "orange stuff" widely used for minor surgery procedures in the USA, is over-the-Counter at any drugstore. CHG, which is sold in various BRIGHT artificial colors, has replaced PVI in most EU treatment settings (because it is much, much less likely to cause an allergic response). But it needs a Scrip in the USA. I've used both. I started with PVI, but I've gone ahead an acquired a Scrip for CHG, and I now use that instead. I've bought it as both "BRIGHT PINK" and "BRIGHT BLUE" liquids.

Whichever you choose, if you bother with this "step", you need to keep the entire area area wet with the liquid compound for 30+ seconds. If you've ever had a minor procedure done in an ER, try to remember the total disinfectant "washing time" which they used before cutting. Do the same!

#3: Now IPA. You're not using this as a disinfectant, so 70% is fine. You're using it to remove the PVI/CHG residue.

#4: Now let it air dry, then do the Skin-Prep, with the hairdryer already turned on "low" and pointed away from your body. IMMEDIATELY after wiping the area well, turn the hair dryer into your application zone from about 45% below. The wipes use IPA as a carrier fluid. At the beginning, when it's really runny, gravity will pull down the liquid down from the from the top of your application area, making it flow towards the bottom. This is bad, the hair dryer (tilted upwards) helps to keep the thickness even as it drys.

"Completely dry" means that it's turned a bit shiny, from nearly microscopic cracks which occur during the drying process. Looks for that shiny "crackled" look, the set the hairdryer down.

#5. Shot in the Sensor. Plug in the Transmitter and use the lever to push it down (TWO clicks, not just one). Execute "START SENSOR".

#6. Optional: Cut a donut, or multiple rectangles, of "helper tape" to cover the Dexcom pad edges.