Adhesive retention of silicone and chlorinated polyethylene for maxillofacial prostheses.

Statement Of Problem: A key factor of a successful facial prosthesis is the retention of the prosthesis to the patient's skin, especially when there is no mechanical means and the retention depends primarily on medical skin adhesives. Studies determining which medical adhesives provide the best bond strength for maxillofacial prostheses are needed.

Purpose: The purpose of this study was to quantify the force required to detach strips of Silastic Adhesive A/MDX4-4,210 silicone elastomer with a urethane liner (A/M-U) and experimental chlorinated polyethylene elastomer (CPE) from the skin of human subjects coated with a protective dressing using 1 of 2 medical adhesives.

Material And Methods: With IRB approval, 8 A/M-U and CPE rubber strips (total of 208) were applied in a predetermined random order to the left and right ventral forearms of 26 human subjects. Skin-Prep Protective Dressing (SP) was applied to half of the sites just before Epithane-3 (E3) and Secure(2) Medical Adhesive (SMA) were used to adhere the strips. Strips were peeled 6 hours later in a universal testing machine at 10 cm/min. Data are reported in newton/meter (N/m). The data was compared using a 3-way, within-groups, multivariate analysis of variance (MANOVA) and the Fisher exact test (alpha=.05). Values for N/m under various conditions relating to the subjects were compared by the Tukey HSD Test for unequal N (alpha=.05). Data are reported as mean (SD).

Results: Statistical analysis revealed no differences (mean (SD)) and no significant interactions between the independent variables (A/M-U = 94.6 (62.1) and CPE = 98.4 (69.6) N/m, SP = 93.0 (58.8) and no SP = 99.8 (72.1) N/m, E3 = 97.6 (69.8) and SMA = 95.3 (61.8) N/m; P=.984). Debonding occurred at the skin interface for both adhesives, as evidenced by residue on prosthetic materials (Fisher exact test; P<.005).

Conclusions: The adhesive bond strengths of both SMA and E3, with and without the presence of SP, were not significantly different between A/M-U and CPE maxillofacial prosthetic materials. Adhesive failure occurred at the skin interface.