Repeated application of self-adhesive transcutaneous electrical nerve stimulation electrodes: an assessment of skin microflora

Abstract

Transcutaneous electrical nerve stimulation (TENS) is sed by physiotherapists throughout the world to manage cute and chronic pain [1]. During TENS, electrical currents re generated by a portable battery-powered device and delivred through the skin using re-usable self-adhesive electrodes ttached to the intact skin surface. TENS electrodes are made f knitted stainless steel fibres which form a conductive surace which is backed with polyurethane film on one side nd Multistick adhesive gel on the other. The goal of TENS s to activate underlying nerves, as this has been shown to educe transmission of pain-related information in the cenral nervous system. Patients can purchase TENS without rescription to self-administer treatment at home for a wide ariety of pains, including wound pain. In hospital settings, ENS is used for pain associated with childbirth and surgial procedures. TENS is generally considered safe, although ontamination from the re-use of TENS electrodes may prove azardous to patients [1]. Medical instruments that make contact with the skin have een shown to transfer micro-organisms between patients, ncluding stethoscopes [2], ultrasound probes [3] and resable electrocardiogram (ECG) Welsh cup electrodes [4,5]. e-usable self-adhesive skin electrodes are used extensively n health care for routine assessment (e.g. electrocardiogaphy and electroencephalography) and for treatments (e.g. ransdermal drug and electrical delivery systems). These may e a potential source of micro-organism transmission. Adhe-