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Adhesion and Irritation

The goal of a preparatory wipe, which you use right before inserting an infusion set, is to reduce irritation and/or keep the set on for the expected two days between set changes. If you are finding that the infusion sets are falling off too soon, or if your child’s skin is reacting negatively to the infusion set adhesive, then skin preparatory wipes may be useful.

How Irritating!
Skin reaction to infusion set with insulin pumps
When the infusion set is removed, if you find that your child’s skin is red, inflamed, raised, “bubbly”, or blistered, it may be reacting to some component of the cannula or the adhesive.

In the case of sensitivity to the tape/adhesive, your child’s diabetes health care team may recommend the use of barrier wipes. Barrier wipes do just that: they provide a protective barrier between the infusion set and the skin, so that the troublesome components in the infusion set tape/adhesive don’t come in direct contact with your child’s skin. Examples of barrier film products available in Canada include: Cavilon™, Coloplast, SkinPrep™ and SkinTac™. With these products, you apply a liquid barrier film that dries quickly to form a breathable, transparent coating on the skin. They are designed to protect skin from (among other things) fluids, tape trauma, and friction.

Coloplast, SkinPrep™ and SkinTac™ all contain alcohol, and so act as both a cleanser and a protective barrier. That is, if you use these products before inserting an infusion set, you may be able to skip cleansing with an alcohol wipe. (Check with your child’s diabetes health care team for individual recommendations.)

On the other hand, Cavilon™ wipes provide a sting-free, alcohol-free barrier film. So they are a great alternative if your child finds that alcohol-containing products sting on contact, or if you find that alcohol wipes tend to dry out your child’s skin too much. Since Cavilon™ wipes don’t contain alcohol, they act simply as a barrier, without any cleansing properties. Therefore, it’s important to include a cleansing step before using Cavilon™ wipes. If economics are important to you, you may also be interested to know that Cavilon™ wipes do tend to be more expensive than other alcohol-based barrier wipes.

tips from the trenches of type 1 diabetes
When my son was three and started wearing an insulin pump, we tried all sorts of prep swabs, but found that most of them caused skin irritation for him. Since we didn’t generally have problems with irritation with the sets themselves, and since his sets seem to stay on fine, for the first few years we just used soap and water before a set change. This worked fine for us for quite a while. More recently, he seems to have developed a sensitivity: when we remove an infusion set we often find a red circle, exactly matching the shape and size of the infusion set tape. So we started using barrier wipes...  with great success – his skin under the infusion set looks exactly the same as the surrounding skin, no irritation at all.
~Michelle


In the case of a reaction to the cannula, since the cannula is inserted under the skin, barrier wipes are not likely to solve the problem. Your child’s diabetes health care team may recommend an infusion set manufactured by a different company, using different components. You may also find it valuable (as we have!) to chat with the pump specialists at insulinpumps.ca for further information on infusion set options.


Getting Into a Sticky Situation

using SkinPrep prior to infusion set insertionIn addition to providing a protective barrier film, some of the above products also increase adhesion. To keep infusion sets “stuck where you put ‘em” longer, you could try an adhesive barrier wipe, such as SkinPrep™, or SkinTac™. These products essentially provide a “sticky” layer between the infusion set and the skin; this increased adhesion keeps the infusion set on longer. If your child is involved in athletic activities which tend to create “sweaty situations”, or if he spends lots of time in the water, then you may find that skin preparatory wipes are a critical part of your child’s diabetes care routine. If you also use a topical anesthetic cream, you apply it (and remove it) before the use of any skin prep wipes. The skin prep wipes are the final step before you insert the infusion set.

tips from the trenches of type 1 diabetes
Antiperspirant can also help keep infusion sets attached to the skin longer. Simply apply it to the site area, wash off the excess, then insert the infusion set as usual. This may help reduce sweat production in this area, allowing the infusion set to stay on longer.
~Danielle






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The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.


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