PERFORATED ADHESIVE TAPE FOR UMBILICAL HERNIAS

ROBERT COHEN, M.D.

STUDIO CITY, CALIF.

PURPOSE of this report is to introduce a multiple perforated

THE adhesive tape for use in strapping acquired umbilical hernias in in-
fants, and to show that it is more beneficial than the plain adhesive tape
that is in common use at the present time.
The accepted procedure in treating acquired umbilical hernias men-
tioned in standard pediatric and surgical textbooks is that of first digitally
reducing the hernial protrusion and then securing it by the use of ad-
hesive plaster over the area. Technical variations are usually mentioned,
but all in all the discrepancies in the advantages of one over the other
is so small that it will not be mentioned.
On removing the standard brands of tape after a period of seven to
ten days, various dermatologic manifestations will be found, depending
on such factors as domestic care, allergic conditions, sensitive skin and
climatic influence.
The more common conditions seen are erythematous zones, excoria-
tions, capillary bleeding, pinpoint vesiculations and pustulations, im-
petigo, wrinkling of the skin and sudamina miliaria. Some of these con¬
ditions cause a delay of one to three days before retaping can be done in
order that healing of the lesions may take place. The days lost added up
over a period of six months constitute a long enough interval to delay
the closure of the hernia even to the point of weakening the hernia
because of lack of support.
According to Ylppo1 84 per cent of the premature infants have either
umbilical or inguinal hernias, and Homans2 states that in the infancy
period the umbilical hernias are common. The latter fact is self evident
to those in pediatric practice.
It is good standard pediatric practice to assist by the use of prophylac¬
tic taping of the umbilical hernia until spontaneous closure ensues or

Mr. E. E. Dickson of Johnson and Johnson and Dr. J. Henderson, Director

of their Clinical Research Department, supplied this tape marked #3358, experi-
mental type.
1. Ylppo, A.: Ztschr. f. Kinderh. 24:1, 1919.
2. Homans, J.: A Textbook of Surgery, ed. 4, Springfield, Ill., Charles C
Thomas, Publisher, 1936.

Downloaded From: http://archpedi.jamanetwork.com/ by a Oakland University User on 06/07/2015

 until the infant becomes a candidate for surgical repair. The good it does
warrants every possible assistance to this procedure.
Adhesive tape with multiple perforations was tried on 50 infants hav¬
ing acquired umbilical hernias and compared with 50 controls on whom
the standard nonperforated adhesive brands on the market today was
used. The tape used was 2 inches (5.08 cm.) wide, multiple perforated,
l/s inch (0.32 cm.) in diameter and spaced at x/i inch (1.27 cm.) in¬
tervals. There were four perforations to the \vidth.
These facts were noted in the comparison with the plain tape: 1. It
allowed more surface ventilation by exposing more normal skin for
aeration. 2. A photographic exposure meter showed that twenty times
more light passed through the perforated type. 3. Less adhesive
plaster
was used. 4. A 2 by 6 inch (5.08 by 15.2 cm.) perforated tape weighed

o o O O O q o

O o O O o o O

o o o o o o
o

o o o o O o o

Perforated tape: its application.

1.8 grains (0.11 Gm.) less than a strip of the same dimensions unper-
forated.
On removal of the perforated tape after a usage of seven to ten days
it was noted that: 1. Rows of dotted normal skin ¡/¡j inch in diameter
corresponding to the perforations of the tape were present. They seemed
to assist in fixing the tape better by acting as small islands for anchoring.
2. There was 50 per cent less irritation of the skin in respect to erythema
and excoriations. 3. Bleeding did not occur. 4. Pustulations or vesicula-
tions were not seen in this series. 5. The infants that were allergic to the
substance of the tape showed less areas of irritation. 6. The controls did
not have as good results as those on whom the perforated tape was used.
7. The area could be immediately cleaned and retaped without loss of
time or setbacks.
CONCLUSION
Because of at least 50 per cent improvement in the use of the multiple
perforated adhesive tape over the plain tape as shown by less dermatologie
lesions, this tape is recommended in the prophylactic taping of acquired
umbilical hernia in infancy.

Downloaded From: http://archpedi.jamanetwork.com/ by a Oakland University User on 06/07/2015