Introduction: Adhesive tape is commonly used to secure endotracheal tubes (ETT) during general anaesthesia. Although a variety of adhesives are used in practice, few studies have investigated the likelihood of different adhesives in producing facial skin injury. Given that differences in cost exist between adhesives that are often used interchangeably, it would be prudent to use the most economical option.
Material and methods: A single-centre, prospective, randomised controlled non-inferiority trial of patients undergoing general anaesthesia with an ETT was conducted. Patients were randomised in a blinded fashion to use Durapore (DP) on either the right or left side of the face to secure the ETT, with Hy-Tape (HT) on the contralateral side. Skin photographs were taken prior to tape application and following tape removal. These were evaluated by three dermatologists to determine presence or absence of facial skin erythema, scaling, oedema, and tearing. Differences were compared using McNemar's test. For outcomes analysis, a non-inferiority margin of 20% difference was used with respect to the 95% CI.
Results: Among 112 patients, 33.0% were male, with a mean (SD) age of 55.6 (15.9) years. Comparing DP vs. HT, noninferiority was demonstrated in the patients with skin erythema (1.8% difference, 95% CI: -5.6 to 9.2, P = 0.79), oedema (3.6% difference, 95% CI: -2.8 to 10.0%, P = 0.34), scaling (5.4% difference, 95% CI: -4.1 to 14.8, P = 0.31), and tearing (0.9% difference, 95% CI: -5.2 to 7.3, P > 0.99).
Conclusions: There is a non-inferior difference in the proportion of patients with facial skin erythema after use of DP vs. HT to secure the ETT.
Keywords: endotracheal intubation; medical adhesives; skin injury; general anaesthesia.