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Those of us with type 1 diabetes who use insulin pumps and continuous glucose sensors need to keep this gear firmly affixed to our hides. These medical devices are critical to our minute-to-minute health, and by God, they are pricey too, so we can’t afford to waste supplies.
Of course, all pumps and sensors come with a Band Aid-style adhesive pad to adhere the device to your skin. We’ve heard rumors that these adhesives are all basically made the same, but we also know that some D-devices seem to stay affixed better than others. There’s a
For most of us, keeping these devices stuck requires the use of some form of preparatory skin wipes. These are small, liquid-adhesive-soaked cloths that come packaged in pocketable pouches, reminiscent of the hand wipes KFC used to issue with each bucket of chicken. Coating the target skin with a wipe adds an extra layer of “glue” to help anchor the device.
In fact, skin wipes used to be standard issue with pump infusion sets. But somewhere over the last decade either the device adhesives got better or the health insurance companies got cheaper. They no longer provide free prep wipes, leaving patients who need them with the fuss and expense of procuring yet one more item on their own.
There’s quite a range of these wipes available, and while we love choice, the field of options can be overwhelming. To help you choose, we decided to undertake a head-to-head comparison field test of the four leading contenders: AllKare, No-Sting Skin-Prep Wipes, Skin-Tac, and Sureprep.
We purchased boxes of all four brands on Amazon in the midst of the COVID-19 crisis, so delivery time ranged from two weeks to a month. It seems these wipes aren’t considered an essential item, even though “health and household” items are supposed to be one of the six essential categories the home delivery giant is prioritizing.
Once they finally arrived, I used each product two times, non-consecutively, on my tummy, to help secure my Unomedical AutoSoft XC Tandem infusion sets. To save money, I stretched my sets to four full days wear each time.
Here’s my report on each of the wipes, in alphabetical order:
You can find the popular AllKare Protective Barrier Wipes online.
Turns out AllKare is a brand name of ConvaTec, which also owns the Unomedical brand. That happens to be the same company that makes my infusion sets.
The basics:
- Cost on Amazon: $12.70 for a box of 50 wipes
- Price per wipe: 25 cents each
- Pouch size: 2-inch by 2¼-inch
- Pad size: 2½-inch by 1-inch, folded almost in half, thin dot-perforated material
Bragging points: The packaging is all business and warnings and no trumpeting of features. Of interest, however, the package insert tells us that we are to keep the product away from open flames. Hmmm, these must be quite flammable.
Opening and first impressions: The AllKare packet is a plastic envelope that differs from the paper foil-like material all the others use. The notched-on-one-side packet opens readily, and inside is a small thin pad that’s literally dripping with liquid adhesive.
Smell: I found that the AllKare wipe has a very strong nail polish remover smell.
Sticky factor: Spreading it on the skin, it coats like liquid plastic, leaving the skin shiny like a newly hatched lizard. It also sticks to the fingers rather alarmingly. I had flashbacks to the time I superglued my fingers together. That didn’t happen, but I had to friction “roll” the layers of glue off my fingers to clean them. Once on the skin and dry, however, it doesn’t feel overly sticky, and doesn’t interfere with normal insertion or smoothing of the infusion set pad.
Don’t use water to clean this off your fingers, because it only makes the situation worse! The company makes an antidote companion product called AllKare Adhesive Remover, which might be a must-have for regular use. (Amazon pricing is $15.94 for a box of 50.)
Skin reaction: On first use, the insertion was painless. On the second there was some mild stinging that lasted for several minutes, something I never experience when attaching infusion sets directly to my skin with no wipe used. Over the wear period, the AllKare caused some mild itching and skin redness on both occasions that I used it.
Duration: The first set stayed well-secured to my skin for the full four days. But by the end of the fourth day on the second test, the set’s tape had come completely loose and the set was staying attached only by virtue of the cannula!
Post-game: After four days, the first set was no more difficult to remove than it is with no skin prep, and the “glue” on the skin around the site had either worn off from friction with clothing or washed away in morning showers, so there was no need for the antidote.
Smith & Nephew is a family pharmacy business dating back 160 years. Their No-Sting Skin Prep Wipes were some of the first on the market.
The basics:
- Cost on Amazon: $20.05 for a box of 50
- Price per wipe: 40 cents each
- Pouch size: 2-inch by 2¼-inch
- Pad size: 2¾-inch by 1¼-inch, folded in half, medium-thick, honeycomb pattern material
Bragging points: It’s not supposed to sting. This is stated clearly on the packaging in multiple languages.
Opening and first impressions: The No-Sting packet is notched on both sides, and peels open readily from either side. The pouch is stamped with an expiration date, the only one of the four products I tested with the date shown on the individual packets (the Sureprep and Skin-Tac have expiration dates printed on the boxes, and the AllKare’s expiration date is anyone’s guess). My No-Stings are good until September of 2022. The pads themselves are pleasantly damp, but not sopping wet.
Smell: A mild medicinal odor.
Sticky factor: The No-Sting leaves the fingers sticky-free and didn’t offer resistance to the smoothing of the infusion set tape to eliminate wrinkles. There was a visible layer on the skin, but one had to wonder: Is it doing any good at all? Of course, the product is advertised more as a barrier wipe to protect sensitive skin from adhesives, rather than as a supplemental glue product like the others in our lineup. The package insert says, “No-Sting Skin-Prep is a sterile liquid film-forming product” designed to protect skin from irritation. However, they do state that it “forms an attachment site for adhesive dressings.”
Skin reaction: Despite the name, both insertions stung like bees. The second time, despite follow-up dosing of significant quantities of dry red wine (internally), the site was achy for a considerable time.
Duration: As with most of our lineup, the sets stayed well-secured to my skin for the full four days on both test runs.
Post-game: After four days, the set was no more difficult to remove than it is with no skin prep.
The Skin-Tac brand is made by a company called Torbot Group, with a 50-year history of manufacturing medical surgery supplies.
The basics:
- Cost on Amazon: $13.88 for a box of 50
- Price per wipe: 28 cents each
- Pouch size: 2½-inch by 3-inch
- Pad size: 5-inch by 1¼-inch, quad-folded, medium-thick, honeycomb pattern material
Bragging points: The Skin-Tac box brags that the product is “travel friendly.” While technically true, it’s actually the largest and bulkiest packet in the lineup.
Opening and first impressions: As with the Sureprep, there’s no notch for tearing the pouch open. But unlike the Sureprep, it tears readily. The large pad isn’t overly wet and almost feels dry when applying to the skin.
Smell: The Skin-Tac has a very mild, vaguely sweet, medicinal smell — bizarrely, like a hospital in a flower garden.
Sticky factor: It’s wickedly sticky. In fact, my fingers did stick together, just from what little they got on them holding the wipe. And like the AllKare, cleaning it off my fingers was both a challenge and an annoyance. I found the Skin-Tac grabs the infusion set pad so quickly and so firmly that there’s no opportunity to smooth out wrinkles. On my second wear, my T-shirt stuck to the skin around the insertion area too.
Skin reaction: No sting on insertion either time, and no discomfort during the wear period.
Duration: The sets stayed well-secured to my skin for the full four days on both test runs.
Post-game: Even after four days, the sets were a challenge to remove. They were squarely locked onto the skin, with not a hint of a loose edge to peel up to remove the site. That said, the extra “glue” that got on my skin around the site had either worn off from friction with clothing or washed away in morning showers. People using this product might want to invest in its sister product, TacAway Adhesive Remover Wipes, as the best option for cleaning fingers after applying these wipes, although the back of the pouch says that rubbing alcohol will also work.
Sureprep wipes are made by a company called Medline that makes a great variety of healthcare specialty products, from lab supplies to orthopedics.
The basics:
- Cost on Amazon: $13.99 for a box of 50 wipes
- Price per wipe: 28 cents each
- Pouch size: 2-inch by 2½-inch
- Pad size: 2¾-inch by 1¼-inch, folded in half, thin slot-perforated material
Bragging points: The box says that Sureprep is “effective protection between adhesives and skin, helps tape and film adhesion, and is non-irritating.” Sureprep also has a flammability warning, this time right on the box.
Opening and first impressions: Unlike the AllKare, the pouch isn’t notched and takes a bit of elbow grease to tear open. Inside is a dryish pad.
Smell: I found that Sureprep wipes have a strong medicinal alcohol odor.
Sticky factor: Sureprep, although seemingly dry, readily spreads on the skin, depositing a shiny layer, and doesn’t stick to the fingers. I was able to easily smooth my infusion set pad.
Skin reaction: Both insertions resulted in an “ouch!” and some angry, inappropriate language. The first time I used it, despite the better part of a bottle of wine prior to insertion, the discomfort lasted for quite some time. On the second insertion, the site ached for an even longer time. So much for non-irritating. But beyond the startup irritation, the product gave me no issues over the four days.
Duration: Both sets stayed well-secured to my skin for the full four days on both test runs — although it needs to be stated that I live in a dry climate and rarely lose a set to heat or sweat.
Post-game: As before, after four days, the set was no more difficult to remove than with no skin prep, the shiny sheen on the skin around the site had faded to normal, so there was no need for an antidote remover wipe.
The plastic envelope of the AllKare got me wondering if it might provide for better long-term storage than its competitors, which use a paper foil product similar to eyeglass cleaner pads that always seem to dry out faster than I can use them.
That said, I actually have a box of old Smith & Nephew I.V. Prep wipes (an antiseptic cousin of the skin wipe that used to be standard issue with pump infusion sets) that expired back in December of 2017, and they are still wet and ready.
For this test, I left a pair of each of our test wipes on the low, wide, black dash of my Dodge Challenger while my car was parked facing the hot New Mexico sun daily for about a month. For a control, I also included an Equate lens-cleaning wipe. The results?
- The control: Dry enough to write a letter to my mother on.
- AllKare: Completely dried out and unusable, a surprise as I had thought the alternate material might increase storage life.
- Skin-Tac: Completely dried out and unusable
- Smith & Nephew No-Sting: Still wet and ready
- Sureprep: Starting to dry out, but still serviceable.
Which is best? Well, that depends on how you define best. The best bang for the buck is the AllKare. The most storage durable, based on accelerated aging is hands down, the Smith & Nephew. The best for ultimate stickiness is Skin-Tac, but for some, that may be overkill. The best for sticky skin, and clean fingers, is the Sureprep.
In the end, except for the AllKare, which gave my skin a reaction and in one case didn’t hold the set for four days, I found that all four were generally effective. Of course, everyone’s skin is different and just because my skin didn’t like AllKare, doesn’t mean you’ll have the same problem. Likewise, you might have a reaction to one of these products that gave me no trouble.
But just because you choose one doesn’t mean you need to, you know, “stick” with it forever.
Wil Dubois lives with type 1 diabetes and is the author of five books on the illness, including “Taming The Tiger” and “Beyond Fingersticks.” He spent many years helping treat patients at a rural medical center in New Mexico. An aviation enthusiast, Wil lives in Las Vegas, N.M., with his wife and son, and one too many cats.