Archive December 2018 XIX, No. 12

Ideas That Work: Skin Care

Adhesive Removal: Go Low and Slow

LOW AND SLOW
Hospital for Special Surgery, New York, N.Y.
LOW AND SLOW To keep skin intact when removing adhesives, pull back the adhesive at a low horizontal angle, away from the corner or edge, slowly separating it from the skin.

Extra care is needed when removing adhesives in the OR, especially when caring for patients with fragile or delicate skin. A few tips to avoid tearing skin when you pull drapes, monitoring lines and tape off patients:

  • Always apply adhesives to dry skin. Before applying the drapes and adhesive, let prepped skin fully dry to prevent potential skin irritation. Similarly, when you clean the patient with sterile saline after the procedure, wait for the skin to dry before putting on the post-op dressing and adhesive.
  • Use low tension. Don’t stick one end of an adhesive to the skin before pulling it taut and stretching it across the application area. Hold it lightly and place it gently on the skin.
  • Easy does it. During removal, slowly pull up the edge of an adhesive and slowly roll it as you remove it. Never pull up or rip it off quickly.
  • Pick the right product. Silicone dressings and adhesives are much gentler to remove than standard tape and bandages.

We emphasize and re-emphasize these pointers during annual competencies, where staff practice removing various adhesive products from overripe plums, tomatoes and peaches, which have the feel of sensitive human skin. New surgeons and surgical residents must also complete a 30-minute in-service on proper skin care. The nurse in charge of the session applies both regular and silicone adhesives to their arms at the beginning of the talk. At the end, the nurse has the surgeons rip the adhesives off each other, so they get a (literal) sense of why silicone is the better option and a (literal) feel for the importance of taking care of their patients’ skin.

Tracy Willett, MSN, MBA, RN, NEA-BC, CNOR
Natalie Trezza, MSN, RN, CNOR
Hospital for Special Surgery
New York, N.Y.
willettt@hss.edu
trezzan@hss.edu

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