(WHS-P51) SKIN BARRIER DISRUPTION MEASURED BY TRANSEPIDERMAL WATER LOSS (TEWL) CORRELATES WITH TOTAL PROTEIN RECOVERED FROM RETAINED MEDICAL ADHESIVE TEST ARTICLES
Friday, May 17, 2024
7:30 AM – 5:00 PM East Coast USA Time
BACKGROUND. A key metric of skin health and function is transepidermal water loss (TEWL), which increases when the integrity of the stratum corneum is compromised; TEWL is commonly used in clinical studies to measure the effects of repeated application and removal of medical adhesives. Disruption of the skin barrier can occur in people who have undergone ostomy surgery and must repeatedly apply & remove the adhesives used to affix ostomy pouching systems to the peristomal skin. Historically, skin barrier disruption demonstrated by TEWL has been observed to increase over sequential skin stripping events. However, our studies have been limited to observation of the in vivo physiologic response, without determination of mechanism of injury. In this work, we set out to determine if the amount of protein recovered from acrylate-based adhesive tapes, used as test articles in a repeated stripping study in healthy volunteers, correlated with TEWL values measured after each tape’s removal from abdominal skin. METHODS. Following acclimation in an environmentally controlled room, baseline TEWL was measured at each anatomical site. Coupons of medical adhesive were applied to the abdomens of 18 healthy volunteers (mean age 54, 17 females) either once or twice every 24 hours. The location of application was randomized across volunteers. After each removal, TEWL was measured following acclimation. Medical adhesive test articles were retained and frozen at -80C until assaying for protein content. Test articles were divided into two groups and one of two extraction protocols was performed to remove protein from the tapes for subsequent quantification. To measure total protein, tapes were eluted in 1M NaOH for 1h, neutralized with 1M HCl, and assayed using the Lowry assay. To measure soluble protein, tapes were incubated in phosphate buffered saline (pH 7.2) for 1h and protein was quantified using a Bicinchoninic acid (BCA) assay. The protein concentrations were calculated and analyzed using linear regression using TEWL versus additional study and subject variables. RESULTS & CONCLUSIONS. It was found that while the concentrations of individual tapes were not significantly different, the cumulative protein mass removed with sequential stripping events was found to be directly correlated with the TEWL readings (p < 0.001). These findings therefore suggest a direct correlation to the physiologic TEWL measurement of skin barrier disruption following repeated tape stripping with acrylate-based medical tapes. Future work will investigate whether or not this behavior is also observed with other types of medical adhesives (e.g. hydrocolloid, silicone, rubber, etc.).